张海英 楚金普 王军 秘双燕

[摘要]目的：觀察应用两种复合树脂在前牙即刻微创美学修复中的修复体优良率、患者满意度和临床效果。方法：选取176例患者，共382颗前牙，均有不同程度影响美观和功能的缺损或病损，随机分为两组。实验组：80例患者（共160颗患牙），应用Ceram Xduo纳米复合树脂修复;对照组：96例患者（共222颗患牙），Polofill Supra复合树脂修复。修复完成后进行问卷调查，按照VAS对修复体美学效果进行评分;2年后回访，统计两组修复体成功率。结果：问卷分析结果表明，两组前牙即刻微创美学修复优良率总体比较，有显著性差异（P<0.05）;两组在龋损、牙间隙、冠缺损、畸形过小牙、无髓牙和着色牙前牙即刻微创美学修复完成后的医师专业评价（VAS）和患者满意度（VAS）评分比较，均有显著性差异（P<0.05）;2年后回访，统计两组在龋损（91.07%、82.28%）、牙间隙（94.44%、81.25%）、冠缺损（83.33%、66.67%）、畸形过小牙（96.11%、82.86%）、无髓牙（87.50%、73.08%）、牙着色（90.00%、78.13%）的成功率比较，差异均无统计学意义。结论：Ceram Xduo纳米复合树脂和Polofill Supra复合树脂脂能满足患者即刻微创的美容修复需求，修复体美观满意度和成功率高，值得在临床推广应用。

[关键词]复合树脂;美学修复;微创;前牙牙体缺损;临床观察

[中图分类号]R781    [文献标志码]A    [文章编号]1008-6455（2021）05-0129-04

Clinical Observation on Immediate Minimally Invasive Aesthetic Restoration of Anterior Teeth with Two Kinds of Dental Resins

ZHANG Hai-ying1，CHU Jin-pu2，WANG Jun3， MI Shuang-yan4

（1. Department of Stomatology，Zhaoqing Medical College， Zhaoqing 526020，Guangdong，China; 2. Department of Endodontics，Zhengzhou University， Zhengzhou 450001，Henan，China; 3. Department of Stomatology，Lanling People's Hospital， Linyi 277799，Shandong，China; 4. Department of Stomatology，Zhuhai Baibo Stomatological Hospital， Zhuhai 519000，Guangdong，China）

Abstract：Objective To observe the excellence rate， satisfaction and clinical effect of two types of composite resin in the immediate minimally invasive aesthetic restoration of anterior teeth. Methods  176 patients， whose 382 anterior teeth in total had defects or lesions that affected the aesthetics and function to various degrees， were selected. 80 patients （160 teeth in total） were treated with Ceram Xduo nano composite resin as the experimental group， and 96 patients （222 teeth in total） were treated with Polofill-Supra composite resin as the control group. After the restoration was completed， a questionnaire survey was conducted， and the aesthetic effect of the restoration was scored according to VAS; two years later， a return visit was conducted to count the success rate of the two groups of restoration. Results The results of questionnaire analysis showed that there was significant difference between the two groups in the overall comparison of the excellent rate of immediate minimally invasive aesthetic restoration of anterior teeth （P<0.05）， there was significant difference between the two groups in the comparison of physician professional evaluation （VAS） and patient satisfaction （VAS） scores after the completion of immediate minimally invasive aesthetic restoration of caries， tooth space， crown defect， malformed small teeth， pulpless teeth and colored anterior teeth （P<0.05）.In the follow-up survey two years later， there was no significant difference between the experimental group and the control group in the success rate of caries （91.07%， 82.28%）， tooth space （94.44%， 81.25%）， crown defect （83.33%， 66.67%）， malformed oversmall teeth （96.11%， 82.86%）， pulpless teeth （87.50%， 73.08%）， tooth coloring （90.00%， 78.13%）. Conclusion  Ceram Xduo nanocomposite resin and Polofill Supra composite resin can meet the needs of patients with immediate minimally invasive cosmetic repair， and the aesthetic satisfaction and success rate of the prosthesis are high， which is worthy of clinical application.

Key words： composite resin; aesthetic repair; minimally invasive; defects and lesions of anterior teeth; clinical observation

前牙的正常与否，决定容貌美，影响发音与咀嚼，甚至影响生理和心理健康。前牙进行美学修复尤为重要，修复方法根据缺损程度有烤瓷全冠修复、贴面修复和树脂直接修复等，烤瓷全冠和贴面疗效颇佳，但存在牙体组织损伤多、费用昂贵、治疗周期长等问题，部分患者较难接受。随着科技的进步，光固化复合树脂材料的完善及粘接材料粘接性能的增强，使其具有适应证广、创伤小、操作简便、费用低及治疗过程耗时短等几大特点[1-2]。临床上越来越多前牙即刻微创美学修复采用光固化复合树脂修复材料，并取得了好的治疗效果[3]。近年来，人们审美能力的提高及维权意识的增强，口腔医疗过程常常由医生主导（Caregiver-oriented） 转为患者主导（Paitent-oriented）。患者对治疗效果的满意程度决定患者忠诚度和治疗成功的关键[4]。……