全瓷冠、高嵌体与覆盖体对大面积牙体缺损后牙修复效果及牙周组织的影响

摘要 目的：探讨全瓷冠、高嵌体与覆盖体对大面积牙体缺损后牙修复效果及牙周组织的影响。方法：选择2015年6月到2018年5月选择在本院诊治的大面积牙体缺损后牙患者144例作为研究对象，根据随机抽签原则将其分为全瓷冠组、高嵌体组与覆盖体组各48例。全瓷冠组给予二氧化锆全瓷冠修复治疗，高嵌体组给予高嵌体修复治疗，覆盖体组给予覆盖体修复治疗，观察随访患者的预后情况。结果：三组修复后3个月的牙龈指数（GI）与探诊出血（BOP）阳性率低于修复前，高嵌体组、覆盖体组低于全瓷冠组（P<0.05）。全瓷冠组、高嵌体组、覆盖体组修复后3年的龋齿、牙周炎症、牙体修复体折断等并发症发生率为2.1 %、16.7 %、8.3 %，对比有差异（P<0.05）。高嵌体组、覆盖体组随访3年的修复体固位、修复体外形、修复体边缘适合性评分都高于全瓷冠组（P<0.05）。随访3年，三组修复体固位对比无差异（P>0.05），但修复体外形、修复体边缘适合性对比有差异（P<0.05）。全瓷冠组、高嵌体组、覆盖体组随访3年的满意度分别为87.5 %、97.9 %和100.0 %，对比有差异（P<0.05）。结论：全瓷冠、高嵌体与覆盖体在大面积牙体缺损后牙修复的应用均具有一定的效果，对牙周组织也有一定的影响，在临床上要根据患者实际情况合理选择修复方法。

The Effect of All-ceramic Crowns, Onlays and Coverings on the Restoration of Large-scale Tooth Defects and the Influence of Periodontal Tissues

ABSTRACT Objective: To investigate the effects of all-ceramic crowns, onlays and overlays on the restoration of large-scale tooth defects and periodontal tissues. Methods: From June 2015 to May 2018, 144 cases of patients with posterior teeth with large dental defects diagnosed and treated in our hospital were selected as the research objects. All the cases were equally divided into the all-ceramic crown group, onlay group and the covering group accorded to the principle of random lottery. The all-ceramic crown group were given zirconia all-ceramic crown restoration treatment, the onlay group were given onlay restoration treatment, and the covering group were given overdenture restoration treatment, observed the prognosis of the followed-up patients. Results: The gingival index (GI) and the positive rate of probing bleeding (BOP) at 3 months after restoration were lower in the three groups than before restoration, the onlay group and overlay group were lower than all porcelain crown group (P<0.05). The incidence of complications such as dental caries, periodontal inflammation, and tooth and prosthesis broken in the all-ceramic crown group, onlay group, and covering group were 2.1 %, 16.7 % and 8.3 % after 3 years of restoration, and compared the difference among the three groups were statistically significant(P<0.05). After 3 years of follow-up, there was no difference in the retention of prostheses among the three groups(P>0.05), however, there were differences in the shape and edge fitness of the restoration(P<0.05). The three-year followed-up satisfaction of the all-ceramic crown group, onlay group and covering group were 87.5 %, 97.9 % and 100.0 %, respectively, and the difference were statistically significant (P<0.05). Conclusion: All-ceramic crowns, onlays and overlays have certain effect in the restoration of large-area tooth defects, and also have certain influence on the periodontal tissue. In clinical practice, the reasonable choice of restoration methods should be based on the actual situation of the patient.