透明硅胶导板辅助成品纤维桩 修复前磨牙的临床效果研究

程增遂 邢晓伟 唐学英 张力

摘 要：目的：比较成品纤维桩在口内直接法和在透明硅胶导板上间接法修复前磨牙的临床效果。方法：选取60例患者共65颗上颌前磨牙进行桩核和冠修复，对照组30例患者33颗患牙采用直接法制作纤维桩核，实验组30例患者32颗患牙采用透明硅橡胶模型导板间接法制作纤维桩核，追踪观察3年比较其临床效果。结果：全部患者在治疗后6、12、24、36个月復查，对照组的修复成功率为97%、90.9%、81.8%，75.8%，实验组的修复成功率为100%、100%、96.9%，96.9%。卡方检验两组治疗后6、12、24个月的成功率无显著性差异（P>0.05）;治疗后36个月复查，实验组的修复成功率高于对照组，卡方检验差异有统计学意义（P<0.05）。结论：利用透明硅胶导板的间接法比直接法成品纤维桩修复前磨牙3年内有较好的临床效果。

关键词：上颌前磨牙;成品纤维桩;透明硅橡胶;间接修复

中图分类号：R783.3  文献标识码：A     文章编号：1001-5922（2021）10-0062-05

Clinical Effect of Transparent Silicone Rubber Templates Assisted Finished Fiber Post in Repairing Premolars

Cheng Zengsui， Xing Xiaowei， Tang Xueying， Zhang Li

（Handan Stomatology Hospital， Handan 056001， China ）

Abstract：Objective： To compare the clinical effect of the finished fiber post in the oral cavity and the indirect method on the transparent silicone guide plate in the restoration of premolars.Methods： A total of 65 maxillary premolars from 60 patients were selected for post-core and crown restorations， the 33 teeth of 30 patients in the control group were made of fiber post and core by direct method， and 32 teeth of 30 patients in the experimental group were made of transparent silicone rubber models， the clinical effect was tracked by 3years.Results： The success rates of the control group were 97% after 6 months treatment，90.9% after 12 months， 81.8% after 24 months， and 75.8% after 36 months， the success rates of the experimental group were 100% after 6 months treatment，100% after 12 months， 96.9% after 24 months， and 96.9% after 36 months.  There was no statistical difference between the two groups of the success rates after6 months，12 months and 24 months after treatment in the chi-square test （P> 0.05）; after 36 months of treatment， the repair success rate of the experimental group was higher than that of the control group.The difference in chi-square test was statistically significant （P <0.05）.Conclusion： The indirect method using transparent silica gel guide plate has better clinical effect than the direct method of finished fiber post for repairing premolars within 3 years.

Key words：maxillary premolar; finished fiber post; transparent silicone rubber; indirect restorations

近年来，人们的口腔保健意识逐渐提高，对保留残根进行桩核冠修复的需求也日益增长。纤维桩具有良好的美观性和物理机械性能，与牙本质近似的弹性模量，折断后易与磨除取出，导致不可修复性根折的可能性较低等优势，符合近年来提出的微创医疗的理念[1]，应用越来越普及。但是对于扁形根管多见的上颌前磨牙，成品纤维桩不能较好的匹配其根管形态，剩余间隙需要较厚的粘接剂来恢复，树脂厚度增加，聚合收缩也增大，容易导致脱接和微渗漏。本研究选择上颌前磨牙大面积缺损需桩核冠修复的患者，用直接法和间接法制作纤维桩和树脂核，通过2～3年随访追踪，比较其临床效果。期望通过体外制作树脂核的方式增加成品纤维桩的适合性。