三种桩核系统修复前牙残根残冠的临床应用
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[摘要]目的：比较金属铸造桩核、纤维桩核与氧化锆桩核修复前牙残根残冠的临床效果。方法：选择60例患者60颗前牙残根残冠，随机分为3组，每组20例。A组采用金属铸造桩核修复，B组采用氧化锆桩核修复，C组采用纤维桩核修复。随访12个月后对临床效果进行评价。结果：在12个月的观察期间，A组有3例松动脱落，3例出现根折，2例出现牙龈炎症及7例边缘出现黑线；B组各有1例出现根折和牙龈炎症；C组各有1例出现松动脱落，桩核折断和牙龈炎症。所有复诊患者均未见继发性根尖周炎。结论：非金属桩核的粘结性、抗根折能力和美观性均优于金属铸造桩核，并且更有利于牙周组织的健康。三者对牙龈和牙髓疾病控制方面无显著差异。
[关键词]氧化锆桩核；纤维桩核；金属铸造桩核；前牙残根残冠；临床效果
[中图分类号]R783 [文献标识码]A [文章编号]1008-6455(2011)06-0981-03
Clinical application of three post-core systems restored in anterior teeth
GUAN Da-rong,ZHANG Pei-fen
(Department of Prosthodontics,Foshan Chancheng Stomatology Hospital,Foshan 528000,Guangdong,China)
Abstract:ObjectiveTo evaluate the clinical effect of zirconia post-core system, fiber post-core system and cast metal post-core system.MethodsSixty maxillary central incisors and canines received endodontic treatment and were divided into 3 groups (n=20) as follows: A, cast metal post and core (Ni-Cr); B, zirconia post and core; C, fiber post with composite resin core. Results Three restorations of A group and one restoration of C group were loosened. One restoration of C group failed in term of fracture of the restoration. Three restorations of A group and one restoration of B group failed in term of fracture of the root.Two cases of A group and one case of B group and one case of C group showed gingival inflammation. Seven cases of A group showed gray line in gingival. No periapical pathology was observed among these three groups. Conclusion None-metallic post and core had superior property of bonding, fracture resistance and esthetic results than cast metal post and core, and seem to be a reliable treatment option.
Key words:zirconia post-core;fiber post-core;cast metal post-core;anterior teeth;clinical effect
桩核冠是修复牙体大面积缺损如残根残冠的主要手段之一。金属桩核具有较高的强度和硬度使其成为早期修复残根残冠的主流方式，但其不透光性、易腐蚀性、致敏性、易根折和美学性能差等缺点限制了金属铸造桩核在临床的应用[1]。近年来学者们研制非金属桩核系统，其中包括高抗弯强度和断裂韧性的氧化锆桩核以及弹性模量与牙本质相近的纤维桩核[2]。目前国内的学者对金属铸造桩核和非金属桩核进行大量的基础研究，但有关其临床应用比较报道较少。因此本研究旨在通过比较3种桩核系统修复前牙残根残冠的临床效果，为临床医师选择合适的桩核系统提供参考。
1资料和方法
1.1研究对象：选取2009年1月～2010年1月佛山市禅城区口腔医院修复科收治的60例上颌前牙需接受桩核冠修复的患者为研究对象，共60颗患牙，随机分为3组，每组20例，A组采用金属铸造桩核修复，B组采用氧化锆桩核修复，C组采用纤维桩核修复。其中男32例，女28例，年龄18～50岁，平均29岁。纳入标准：①牙体严重缺损并已做完善根管治疗，术后根尖片显示根充恰填、密实，根尖周无阴影或原阴影面积逐渐减小；②牙周组织健康 ......
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