镍铬合金烤瓷冠修复牙与对照牙牙周微生态及龈沟液蛋白水平的比较

目的观察比较镍铬合金烤瓷冠（Ni-Cr based porcelain-fused-metal crown）修复患牙与牙周健康对照牙龈下菌斑微生物分布、龈沟液总蛋白水平及牙周临床指标的差异。方法选择临床病例13例，前牙区咬合关系基本正常。采用镍铬合金烤瓷冠修复上颌切牙17颗，对侧同名健康天然牙作为对照。烤瓷冠戴入6～8个月后复诊，进行牙周健康状况的临床检查，分别取患牙、对照牙龈沟液及龈下菌斑盐水涂片。龈沟液定量并检测总蛋白水平。龈下菌斑涂片革兰染色，分类计数革兰阴性球菌、杆菌、弯曲菌、螺旋体及革兰阳性球菌、杆菌，共计数200个细菌。结果修复患牙与对照牙比较探诊深度、龈沟出血指数、龈沟液量、龈沟液总蛋白水平、龈下菌斑中革兰阴性杆菌增加，革兰阳性球菌减少，差异均有显著性（P〈0．05）。而菌斑指数及其他形态的细菌数差异无显著性。结论临床合格的镍铬合金烤瓷冠修复亦使患牙龈下菌群分布发生变化，可能是导致患牙牙龈炎症的原因之一；龈沟液量及总蛋白水平增加；牙周临床指标显示不良改变。

Comparison of the microecology and total protein of GCF between the teeth restored by Ni-Cr based porcelain-flased-metal crown and control teeth

Objective To compare the difference of the microecology of the subgingival plaque, total protein of the GCF（ gingival crevicular fluid） and periodontal clinical parameters between the teeth restored by Ni-Cr based porcelainfused-metal （PFM） crown and control teeth. Methods 13 patients with normal occlusion in anterior teeth were selected. 17 maxillary incisors possessed Ni-Cr based PFM crown with subgingvial margins were selected for study. The contralateral homonym healthy teeth were treated as control teeth. The patients were followed up 6 or 8 months after the placement of the crowns. Periodontal clinical parameters were scored, GCF samples and subgingival plaque smears were collected. The weight of GCF and total protein concentrations of GCF were detected. The smears were stained in gram and the bacillus and cocci of G^＋ and G^- and forniciform bacilli and leptospria were counted in 200 bacteria respectively. Results There were significant differences in clinically parameters （ expect for plaque index） and total protein concentrations of GCF and G- bacillus between the test and control teeth, Conclusions Ni-Cr based PFM may alter the distribution proportion of all bacteria. Some periodontal clinical parameters,weight and the total protein concentration of GCF also changed.