刘鲁慧 景钦莲 宋生璋

[摘要]目的：探討纳米复合树脂与光固化复合树脂在老年牙体缺损修复中的应用价值。方法：选取笔者医院2015年5月-2017年5月收治的老年牙体缺损患者116例，根据患者所应用的修复材料分成纳米组（n=58）、光固化组（n=58）。纳米组采用纳米复合树脂修复，光固化组采用光固化复合树脂修复，随访24个月。比较两组修复效果，分析两组治疗后6、12、24个月的釉质、釉质咬合接触区磨耗深度。根据患者牙齿修复情况对边缘适合性、边缘变色、表面光滑性及色泽匹配性进行评分，分析牙齿美观度，并观察两组并发症情况。结果：纳米组总优良率为94.83%，高于光固化组的82.76%，两组比较差异有统计学意义（P<0.05）。两组治疗后12、24个月的釉质、釉质咬合接触区磨耗深度均高于治疗后6个月，且纳米组显著低于光固化组（P<0.05）。两组治疗后边缘适合性、边缘变色、表面光滑性、色泽匹配性评分均高于治疗前，且纳米组边缘适合性、边缘变色评分显著高于光固化组（P<0.05）。纳米组牙敏感发生率为1.72%，显著低于光固化组的12.07%（P<0.05）。 结论：与光固化复合树脂相比，纳米复合树脂的修复效果更好，且能减少釉质、釉质咬合接触区的磨耗深度，进一步改善患牙边缘适合性及边缘变色，降低牙敏感发生率。

[关键词]牙体缺损修复;光固化复合树脂;纳米复合树脂;磨耗深度;并发症

[中图分类号]R783.3    [文献标志码]A    [文章编号]1008-6455（2020）09-0145-03

Follow-up Study of Different Resin Materials for Repairing Senile Dental Defects

LIU Lu-hui1，JING Qin-lian2，SONG Sheng-zhang3

（1.Department of Stomatology， Qinghai Communications Hospital，Xining 810000， Qinghai，China; 2.Department of Stomatology， Xining First People's Hospital，Xining 810000，Qinghai，China; 3.Department of Stomatology， Affiliated Hospital of Qinghai University， Xining 810000，Qinghai，China）

Abstract：Objective  To explore the application value of nano-composite resin and light-cured composite resin in the restoration of senile dental defects. Methods 116 elderly patients with dental defects admitted to our hospital from May 2015 to May 2017 were divided into nano group （n=58） and light curing group （n=58） according to the materials used by the patients.The nano-group was repaired with nano-composite resin， and the light-cured group was repaired with light-cured composite resin. The follow-up period was 24 months.The repairing effect was compared between the two groups， and the wear depth of enamel and enamel occlusal contact area was analyzed 6， 12 and 24 months after treatment.According to the patient's dental restoration situation， the marginal fitness， edge discoloration， surface smoothness and color matching were scored， and the aesthetic degree of teeth was analyzed， and the complications of the two groups were observed. Results The total excellent and good rate of nano-group was 94.83%， which was higher than that of photo-curing group （82.76%）. The difference was statistically significant（P<0.05）.The wear depth of enamel and enamel occlusal contact area in the two groups at 12 and 24 months after treatment was higher than that at 6 months after treatment， and the wear depth in the nano group was significantly lower than that in the light curing group （P<0.05）.After treatment， the scores of edge fitness， edge discoloration， surface smoothness and color matching in the two groups were higher than those before treatment， and the scores of edge fitness and edge discoloration in the nano group were higher than those in the light curing group （P<0.05）.The incidence of dental sensitivity in nano-group was 1.72%， which was significantly lower than that in light-cured group （12.07%） （P<0.05）. Conclusion Compared with light-cured composite resin， nanocomposite resin has better restoration effect， and can reduce the wear depth of enamel and enamel occlusal contact zone， further improve the marginal fitness and discoloration of affected teeth， and reduce the incidence of tooth sensitivity.

Key words：dental defect repair;photocurable composite resin;nanocomposite resin;wear depth;complication

牙体缺损在口腔科中比较常见，采用口腔修复材料进行填充，能达到治疗目的。近年来，我国口腔填充材料类型越来越多，不同材料的应用对牙齿修复效果也有一定影响[1]。目前，口腔科常用的修复材料为光固化复合树脂与纳米复合树脂。研究表明光固化复合树脂具有色泽逼真、容易成形及创伤小等特点，是一种比较理想的修复材料[2]。然而，有研究提示其所致的牙敏感发生率较高[3]。纳米复合树脂具有即刻修复、经济、适应证广等优势，在口腔科中应用效果良好[4]。本研究旨在分析纳米复合树脂与光固化复合树脂在老年牙体缺损修复中的应用价值，观察两种材料对患者远期疗效的影响，现报道如下。……