桩核修复失败的原因分析

目的分析桩核修复失败的原因，探讨影响桩核修复效果的可能因素。方法收集因桩核修复失败前来修复科就诊的患者107例109颗牙，通过门诊常规检查、X线片诊断及病史调查，分析桩核修复失败的原因。结果桩核松脱共71颗．牙体劈裂38颗。引起桩核松脱的原因依次为：患牙缺损达到龈下（43．7％）、桩核长度不足（21．1％）、桩核与根管结合不好（12．7％）、桩核锥度过大（9．9％）、患者饮食习惯及咬合不良（7．0％）、修复时间超过5年（2．8％）、活动义齿基牙（2．8％）。牙体劈裂中，失败的主要原因依次为：桩核非贵金属制造且根管壁薄（47．4％）、螺纹桩（31．6％）、继发龋齿（21．1％）。结论引起桩核修复失败的原因较复杂，临床医师应严格掌握适应证，根据患者具体情况做出正确选择，从而减少修复失败。

Causes of clinical failure of post-core repairing

Objective To analyze the causes of clinical failure of post-core repairing. Methods One hundred and seven failure cases of post-core repairing were enrolled in the study. The causes of failure were analyzed by routine examination, X-ray and medical history inquiry. Results Seventy-one teeth were due to the loosing of post crown, 38 teeth were due to the broken dental crown. Among 71 loosing teeth, the main causes of failure in order were the root below the gingival （43.7 % ）, short post-and-core （21.1%）, unsuitable post-root canal （12.7%）, angle of post （9.9%）, eating habit and occlusion （8.8%）, repair time ≥5y （2.8%）, and abutment of denture （2.8%）. Among 38 teeth split, the main causes of failure in order were the base metal cast post and thin-walled root canal （47.5%）, screw post （31.6%） and secondary caries in dental cervix （21.1%）. Conclusion The causes of failure cases in post-core repairing are complex. The clinician should make the choice strictly on the condition of the patients, so that to reduce the failure rate.