平面对接式边缘全瓷修复体修复后牙大面积缺损的短期临床修复效果

doi:10.13481/j.1671-587X.20210326

摘要/Abstract

摘要： 目的

采用平面对接式边缘的椅旁CAD/CAM全瓷修复体修复后牙大面积缺损，分析患者的短期修复效果。

方法

回顾性分析椅旁CAD/CAM全瓷修复后牙大面积缺损患者的临床资料。共计患牙107颗，修复体均为平面对接式边缘，统计修复体类型。全部患牙均采用“改良美国公众健康服务标准”进行即刻检查以及12个月后的随访检查，比较即刻检查和复诊时修复体完整性、颜色匹配性、修复体固位、牙体完整性、邻接关系和牙周组织健康的A级构成比。

结果

修复体包括32个髓高嵌体和75个髓超嵌体。即刻与复诊检查时各项指标的A级构成比比较，髓高嵌体的修复体完整性由100%下降至96.88%，颜色匹配性由84.38%增加至93.75%；髓超嵌体的修复体固位由100%下降至98.67%，颜色匹配性由89.33%增加至92.00%；2类修复体的基牙完整性、邻接关系及牙周组织健康A级构成比均保持100%；修复失败患者包括1例髓超嵌体脱落和1例髓高嵌体折裂。

结论

对于大面积缺损的后牙髓高嵌体和髓超嵌体修复，采用平面对接式的边缘设计短期修复效果稳定，是较为理想的修复方式。

关键词: 椅旁CAD/CAM, 牙体缺损, 髓高嵌体, 髓超嵌体, 边缘形态

Abstract:

Objective： To restore the extensive posterior tooth defect with chair-side CAD/CAM all-ceramic restorations with edge to edge margin ，and to explore the short-term clinical efficacy.

Methods

The clinical data of patients with extensive defects of posterior teeth restored by chair-side CAD / CAM all-ceramic restoration were retrospectively analyzed. A total of 107 teeth were selected， and the prostheses were all with edge-to-edge margins. The types of prostheses were counted. All the teeth were assessed by using “the modified USPHS criteria” immediately and 12 months after operation. The proportions and relative ratios of grade A of the restorations immediately and 12 months after operation were assessed by these indicator，such as restoration integrity， color match， restoration retention， tooth integrity， proximal contact， and periodontium health.

Results

There were 32 endo-onlays and 75 endo-overlays. The comparation results of the A-grade proportion of each index during the observation period immediately and 12 months after operation showed that the restoration integrity of onlays was decreased from 100% to 96.88%， and the color matching of onlays was increased from 84.38% to 93.75%. The restoration retention of overlays was decreased from proportions of grade A of 100% to 98.67%， and the color matching of overlays was increased from 89.33% to 92.00%. The tooth integrities， proximal contact， and periodontium health of two kinds of restorations all remained 100%.Among the patients who failed to repair， 1 case was restoration exfoliation and 1 case was restoration fracture.

Conclusion

The endo-onlays and endo-overlays with edge to edge margin show good short-term clinical efficacies in restoring extensive posterior tooth defect， which is an ideal repair method.

Key words: chairside CAD/CAM, tooth defect, endo-onlay, endo-overlay, marginal type

中图分类号:

R783.3

高愉淇, 储顺礼, 赵爽, 陈星竹, 刘双, 于明岳, 刘玉艳. 平面对接式边缘全瓷修复体修复后牙大面积缺损的短期临床修复效果[J]. 吉林大学学报(医学版), 2021, 47(3): 740-746.

Yuqi GAO, Shunli CHU, Shuang ZHAO, Xingzhu CHEN, Shunag LIU, Mingyue YU, Yuyan LIU. Short-term clinical efficacy of all-ceramic restorations with edge to edge margin in restoring extensive posterior tooth defect[J]. Journal of Jilin University(Medicine Edition), 2021, 47(3): 740-746.

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Criterion	Alpha(A)	Bravo(B)	Charlie(C)
Restoration integrity	Restoration completely retained	Cracks appear in restoration	Restoration partially retained
Immediate	100.00	0.00	0.00
Subsequent	96.88	0.00	3.12
Color matching	Matches the adjacent tooth structure	Light mismatch in color	Mismatch outside acceptable range
Immediate	84.38	15.62	0.00
Subsequent	93.75	6.25	0.00
Restoration retention	Completely stable	Slightly unstable	Loosen or fall off
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00
Tooth integrity	No further defect in abutment	Marginal split in abutment	Cusp or tooth fracture
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00
Proximal contact	Difficult to pass the dental floss	Relatively easy to pass the dental floss	Lack of interproximal contact and food accumulate
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00
Periodontium health	Healthy gingival tissue	Slightly bleeding on probing and slight inflammation	Swollen and bleeding gums and sever inflammation
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00

Criterion	Alpha(A)	Bravo(B)	Charlie(C)
Restoration integrity	Restoration completely retained	Cracks appear in restoration	Restoration partially retained
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00
Color matching	Matches the adjacent tooth structure	Light mismatch in color	Mismatch outside acceptable range
Immediate	89.33	10.67	0.00
Subsequent	92.00	8.00	0.00
Restoration retention	Completely stable	Slightly unstable	Loosen or fall off
Immediate	100.00	0.00	0.00
Subsequent	98.67	0.00	1.33
Tooth integrity	No further defect in abutment	Marginal split in abutment	Cusp or tooth fracture
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00
Proximal contact	Difficult to pass the dental floss	Relatively easy to pass the dental floss	Lack of interproximal contact and food accumulate
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00
Periodontium health	Healthy gingival tissue	Slightly bleeding on probing and slight inflammation	Swollen and bleeding gums and sever inflammation
Immediate	100.00	0.00	0.00
Subsequent	100.00	0.00	0.00

Item	Gender	Restoration	Tooth position	Pulp condition	Time of treatment failure	Reason
1	Male	Endo-onlay	27	Non vital	7 months after restoration	Fracture
2	Male	Endo-overlay	26	Non vital	2 months after restoration	Exfoliation

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