氧化锆桩加氧化锆冠与纤维桩加氧化锆冠修复牙体大面积缺损的效果观察

doi:10.3969/j.issn.1006-6233.2025.06.21

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摘要 目的: 探讨氧化锆桩加氧化锆冠修复与纤维桩加氧化锆冠修复牙体大面积缺损的效果观察。方法: 共纳入117例在本院接受牙体大面积缺损修复的患者,收治时间为2020年4月至2024年4月。根据随机数字表法,将患者分为氧化锆桩组(n=61)和纤维桩组(n=56)。氧化锆桩组采用氧化锆桩加氧化锆冠修复,纤维桩组采用纤维桩加氧化锆冠修复。随访6个月,比较两组患者修复前和修复后6个月的咀嚼功能(咬合力、咀嚼效率)、修复体稳固性(PTV值)、修复总时间、牙龈健康[牙龈出血指数(BI)、牙周袋深度(PD)、牙龈指数(GI)]、龈沟液炎性因子[白细胞介素-1β (IL-1β)、肿瘤坏死因子α(TNF-α)、前列腺素E₂(PGE₂)]、修复体脱落情况、边缘密合度以及美学效果[粉红美学评分(PES)和白色美学评分(WES)]。结果: 修复6个月后,两组的咀嚼功能均明显提升,且氧化锆桩组的咬合力和咀嚼效率修复前后差值均高于纤维桩组(P<0.05)。纤维桩组的修复总时间为(12.00±3.50)d,氧化锆桩组的修复总时间为(27.00±7.50)d,纤维桩组的时间效率优于氧化锆桩组(t=13.660,P<0.001)。两组的修复体稳固性均有所增加,且氧化锆桩组修复前后PTV差值高于纤维桩组,差异有统计学意义(P<0.05)。修复后6个月,两组修复体的牙周健康状况均有所改善,且纤维桩组修复前后的BI、PD、GI指数差值均大于氧化锆桩组(P<0.05);纤维桩组修复前后的IL-1β、TNF-α和PGE₂水平差值均大于氧化锆桩组,差异有统计学意义(P<0.05)。修复6个月后,两组修复体脱落情况和边缘密合度差异均无统计学意义(P>0.05)。修复6个月后,纤维组修复前后的PES和WES评分差值均高于氧化锆桩组(P<0.05)。结论: 纤维桩修复在时间效率、美学效果和牙周健康改善方面表现更优;氧化锆桩修复在咀嚼效能和稳固性方面更具优势。

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	褚芹芹
	潘宝胜
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关键词 ：氧化锆桩, 氧化锆冠, 纤维桩, 咀嚼功能, 稳固性, 牙体大面积缺损

Abstract：Objective: To investigate the effect of zirconia post plus zirconia crown and fiber post plus zirconia crown in repairing large area tooth defects. Methods: Totally 117 patients who received large-area tooth defect restoration in the hospital from April 2020 to April 2024 were included. With the random number table method, the patients were divided into the zirconia post group (n=61) and the fiber post group (n=56). The zirconia post group received zirconia post plus zirconia crown restoration, and the fiber post group underwent fiber post plus zirconia crown restoration. The patients were followed up for 6 months. The masticatory function (occlusal force, masticatory efficiency), restoration stability (PTV value), restoration time efficiency, gingival health [gingival bleeding index (BI), periodontal pocket depth (PD), gingival index (GI)], gingival crevicular fluid inflammatory factors [interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α), prostaglandinE₂ (PGE₂)], restoration shedding status, edge tightness and aesthetic effect [pink esthetic score (PES), white esthetic score (WES)] were compared between groups before restoration and at 6 months after restoration. Results: After 6 months of restoration, the masticatory function in the two groups was significantly improved, and the differences of occlusal force and masticatory efficiency before and after restoration in the zirconia post group were higher than those in the fiber post group (P<0.05). The total restoration time was (12.00±3.50) days in the fiber post group and (27.00±7.50) days in the zirconia post group, and the time efficiency in the fiber post group was better than that in the zirconia post group (t=13.660, P<0.001). The stability of restorations in both groups was increased, and the difference of PTV value before and after restoration was higher in the zirconia post group than that in the fiber post group (P<0.05). The periodontal health status was improved in both groups at 6 months after restoration, and the differences of BI, PD and GI before and after restoration were greater in the fiber post group compared to the zirconia post group (P<0.05). The differences of IL-1β, TNF-α and PGE₂ before and after restoration in the fiber post group were greater compared with those in the zirconia post group (P<0.05). After 6 months of restoration, there were no statistical differences in the restoration shedding status and edge tightness between both groups (P>0.05). The differences of PES score and WES score before and after restoration in the fiber post group after 6 months of restoration were higher compared to the zirconia post group (P<0.05). Conclusion: Fiber post restoration has better performance in terms of time efficiency, aesthetic effect and periodontal health improvement, and zirconia post restoration has more advantages in masticatory efficiency and stability.

Key words： Zirconia post Zirconia crown Fiber post Masticatory function Stability Large-area tooth defect

基金资助:2019年安徽省重点研究与开发计划项目,(编号:201904a07020023)

引用本文:

褚芹芹, 潘宝胜, 张辉, 谢元璐. 氧化锆桩加氧化锆冠与纤维桩加氧化锆冠修复牙体大面积缺损的效果观察[J]. 河北医学, 2025, 31(6): 987-993.
CHU Qinqin, PAN Baosheng, ZHANG Hui, et al. The Effect of Zirconia Post plus Zirconia Crown and Fiber Post plus Zirconia Crown in Repairing Large Area Tooth Defects. HeBei Med, 2025, 31(6): 987-993.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.06.21 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I6/987

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