胡艳荷 张晓萍 胡柏

[摘要]目的：探討不同材料桩核冠对上颌前牙牙体缺损修复患者疗效的影响。方法：纳入笔者医院2015年10月-2016年10月收治的上前牙牙体缺损患者86例（共172颗患牙），根据随机数字表法分成实验组和对照组，每组43例（86颗患牙）。对照组行铸造桩联合钴铬烤瓷冠修复治疗，实验组行纤维桩联合全瓷冠修复治疗。比较两组治疗成功率，于术后3个月评价两组美观度，包括颜色匹配、形态匹配、继发龋、磨损与断裂、敏感以及边缘适合性。电话随访3年，分析远期抗折性能。结果：实验组修复成功82颗（95.35%），失败4颗（4.65%），对照组修复成功74颗（86.05%），失败12颗（13.95%），实验组成功率显著高于对照组（P<0.05）。实验组颜色匹配、形态匹配、继发龋、磨损与断裂、敏感、边缘适合性评分与总分均显著高于对照组（P<0.05）。实验组远期桩折断、桩松动脱落发生率分别为2.33%、3.49%，显著低于对照组的10.47%、11.63%（P<0.05）。结论：纤维桩联合全瓷冠对上前牙牙体缺损患者进行治疗，能提高修复成功率，并进一步改善美观度，远期抗折性能更好。

[关键词]上前牙牙体缺损;纤维桩;全瓷冠;抗折性能

[中图分类号]R783.4    [文献标志码]A    [文章编号]1008-6455（2021）03-0135-03

Clinical Comparative Study on Different Materials of Post Core Crown in the Restoration of Maxillary Anterior Teeth Defects

HU Yan-he1， ZHANG Xiao-ping1， HU Bai2

（1. Department of Stomatology， Liyuan Hospital， Tongji Medical College， Huazhong University of Science and Technology，Wuhan 430077，Hubei，China;2.Department of Prosthodontics，Changsha Stomatological Hospital， Changsha 410000，Hunan，China）

Abstract：Objective To investigate the effect of post core crown with different materials on the restoration of maxillary anterior teeth defects. Methods Among the 86 （172） patients with anterior tooth defects admitted to our hospital from October 2015 to October 2016， they were divided into experimental group and control group with 43 （86） cases respectively according to the random number table method. The control group was treated with cast pile and cobalt-chromium ceramic crown， and the experimental group was treated with fiber pile and all-ceramic crown.The treatment success rate of the two groups was compared， and the aesthetic value of the two groups was evaluated 3 months after the operation， including color matching， shape matching， secondary caries， wear and tear， sensitivity， and edge suitability. Telephone follow-up was conducted for 3 years to analyze the long-term folding resistance. Results In the experimental group， 82 （95.35%） were successfully repaired， 4（4.65%） failed， 74（86.05%） in the control group and 12（13.95%） failed. The success rate of the experimental group was significantly higher than that of the control group （P<0.05）.The scores of color matching， shape matching， secondary caries， wear and fracture， sensitivity， marginal fitness and total scores in the experimental group were significantly higher than those in the control group （P<0.05）.The incidence of broken and loose piles in the experimental group was 2.33% and 3.49% respectively， which was significantly lower than 10.47% and 11.63% in the control group （P<0.05）. Conclusion  Fiber post combined with all-ceramic crown can improve the success rate of repair and further improve the aesthetic degree of anterior tooth defects.

Key words：anterior teeth defect;fiber post;all ceramic crown; fracture resistance

前牙牙体缺损的主要特点为牙体形态异常、咬合关系被破坏，它可影响患者的牙髓和牙周[1]。金属桩与金属烤瓷修复法是治疗前牙牙体缺损的常用方式，其中金属桩具备良好的物理性能，但弹性模量大，且根折、颜色改变发生率较高[2]。此外，有研究认为，金属桩可导致根尖部、牙周组织的微环境发生变化，削弱局部免疫力，导致局部病变，对本位牙生存非常不利[3]。玻璃纤维桩具备操作简单、生物相容性好、透光性能佳等特点，其桩体表现为半透明或白色，在美学修复中适用[4]。本研究旨在观察纤维桩联合全瓷冠对上前牙牙体缺损患者美观度及远期抗折性能的影响，现将结果报道如下。

1  资料和方法

1.1  一般资料：纳入笔者医院2015年10月-2016年10月收治的上前牙牙体缺损患者86例（共172颗患牙），均行根管治疗。……