石英纤维桩和纯钛桩核在前牙残根残冠美学修复中的应用研究

刘帆 宋楠

[摘要]目的：探究石英纖维桩和纯钛桩核在前牙残根残冠美学修复中的应用效果。方法：选择76颗离体上颌中切牙，分为石英纤维组和纯钛组，每组38颗，经万能材料测试机测试抗折强度进行比较。同时选择笔者医院收治的120例前牙残根残冠患者，共147颗患牙，随机分为石英纤维组（60例，71颗牙）和纯钛组（60例，76颗牙），石英纤维组患者患牙以石英纤维桩核修复，纯钛组患者患牙以纯钛桩核修复，比较两组患者修复结果、修复失败原因及修复满意度。结果：材料性能比较，纯钛组离体牙抗折能力高于石英纤维组（P<0.05）;经修复，石英纤维组和纯钛组患者患牙修复成功率为88.73%和92.11%，差异无统计学意义（P>0.05）;修复失败原因中，纯钛组患者根折的发生率显著高于石英纤维组（P<0.05），松脱位发生率显著低于石英纤维组（P<0.05），其他修复失败原因发生率比较，差异无统计学意义（P>0.05）;修复后，石英纤维组患者修复效果、美观度及舒适度评分显著高于纯钛组（P<0.05）。 结论：在前牙残根残冠修复中，石英纤维桩美观度与抗根折优越，纯钛桩核抗松脱位性能优越，实际美学修复过程中应根据患者牙体破坏程度及固位形选择适宜的桩核材料。

[关键词]石英纤维桩核;纯钛桩核;前牙残根残冠;美学修复;应用效果

[中图分类号]R783.3    [文献标志码]A   [文章编号]1008-6455（2021）06-0126-04

Application of Quartz Fiber Post Core and Pure Titanium Post Core in Aesthetic Repair of Residual Roots and Crowns of Anterior Teeth

LIU Fan， SONG Nan

[Department of Stomatology， Zhongda Hospital Southeast University （Jiangbei）， Nanjing 210000， Jiangsu， China]

Abstract： Objective To explore the application effects of quartz fiber post core and pure titanium post core in aesthetic repair of residual roots and crowns of anterior teeth. Methods 76 isolated maxillary central incisors were selected and divided into quartz fiber group and pure titanium group， with 38 teeth in each group. And the fracture resistance was tested by universal material testing machine and compared between groups. 120 patients with residual roots and crowns of anterior teeth （147 affected teeth in total） in our hospital were selected and randomly divided into quartz fiber group （60 cases， 71 teeth） and pure titanium group （60 cases， 76 teeth）. The affected teeth in quartz fiber group were repaired with quartz fiber post core， and the affected teeth in pure titanium group were repaired with pure titanium post core. The repair results， repair failure reasons and repair satisfaction were compared between the two groups. Results  Comparison of material properties showed that the fracture resistance of isolated teeth in pure titanium group was higher than that in quartz fiber group （P<0.05）. After repair， the success rates of dental repair in quartz fiber group and pure titanium group were 88.73% and 92.11% （P>0.05）. Among the reasons of repair failure， the incidence rate of root fracture in pure titanium group was significantly high than that in quartz fiber group （P<0.05）， and the incidence rate of dislocation was significantly lower than that in quartz fiber group （P<0.05）， and there were no significant differences in the incidence rates of other repair failure reasons （P>0.05）. After repair， the scores of repair effects， aesthetics and comfort in quartz fiber group were significantly higher than those in pure titanium group （P<0.05）. Conclusion In the repair of residual roots and crowns of anterior teeth， quartz fiber post core has excellent aesthetics and resistance to root fracture，and pure titanium post core has excellent resistance to dislocation. In the actual aesthetic repair process， a suitable post core material should be selected according to the degree of dental damage and the retention shape of the patient.

Key words： quartz fiber post core; pure titanium post core; residual roots and crowns of anterior teeth; aesthetic repair; application effects

前牙残根残冠在临床中十分常见，主要因龋坏、外伤等原因导致破坏牙体，牙冠大部分缺损形成残冠，残冠缺损仅剩牙根形成残根，残根残冠后牙齿根管暴露于有菌环境中，易被致病菌侵袭导致其他牙周疾病[1]。根管治疗配合桩核修复是残根残冠美学修复的主要手段，其中桩核冠修复是保留残根、残冠并恢复其外观形态、功能的最佳修复方法，而桩核材料的选择直接影响残根残冠美学修复效果[2-3]。目前，临床中的桩核材料分为金属和非金属类，金属类桩核强度高，但弹性模量高于牙本质而易导致牙根折裂，在美学方面存在一定不足[4-5]，非金属类桩核则具有较好的机械性能、生物相容性及抗腐蚀性，美学性能也良好，逐渐在临床中推广应用[6-7]。……