金属嵌体冠在低龈距磨牙残冠修复中的应用

  目的  探索金属嵌体冠在龈距不足的磨牙保存修复中的应用效果。  方法  选择2015年1月—2020年5月在蚌埠医学院第一附属医院口腔科就诊的患者作为研究对象，纳入龈距为1~3 mm的磨牙残冠患者50例，共计50颗患牙，包括男性28例28颗患牙，女性22例22颗患牙，年龄为18~60岁，平均年龄为42岁。所有患者进行完善的根管治疗，然后进行牙体预备，利用髓腔固位，制作纯钛金属嵌体冠。于修复体粘接后1、6、12、18个月时复查，参考美国公共卫生署对牙科修复体的评价标准，观察修复体有无松动脱落、修复体或牙体有无折裂、修复体边缘密合性、有无继发龋、牙龈情况、有无食物嵌塞等情况并记录。  结果  50例患者均未失访，随访1个月时各项观察指标均无异常，随访期内无牙体或修复体折裂发生，第5、9、16个月分别出现嵌体冠脱落病例。此外，6个月复查时出现1例边缘不密合、2例牙龈炎，其中1例牙龈炎伴发食物嵌塞；12个月时累计出现2例边缘不密合，其中1例边缘不密合伴发继发龋，3例牙龈炎，其中2例牙龈炎伴发食物嵌塞；18个月时累计出现3例边缘不密合，3例边缘不密合均伴发继发龋，4例牙龈炎，其中2例牙龈炎伴发食物嵌塞。  结论  金属嵌体冠在龈距不足的磨牙修复中应用效果满意。 

Application of metal endocrown in the restoration of residual crown of low occlusal gingival distance molar

  Objective  To explore the effect of metal endocrown in the preservation and restoration of molar with insufficient gingival distance.  Methods  Patients from the Department of Stomatology of the First Affiliated Hospital of the Bengbu Medical College were selected for the study. The main criteria included 50 molars with 1-3 mm gingival distance, 50 molars with 50 teeth, including 28 males with 28 teeth and 22 females with 22 teeth (age range=18-60 years; average=42 years). After complete root-canal treatment, the tooth was prepared, a pure titanium inlay crown was prepared using the pulp cavity, and re-examination was conducted 1, 6, 12, and 18 months after the restoration was bonded (in reference to the United States Public Health Service evaluation criteria for dental restorations). The loosening and falling off of the prosthesis, fracture of the prosthesis or tooth, marginal tightness, secondary caries, gingival condition, and food impaction were observed and recorded.  Results  All 50 patients did not lose the follow-up, and all observation indices were normal during 1 month follow-up. During the follow-up period, no tooth or prosthesis fracture occurred, and the inlay crown fell off at the 5th, 9th, and 16th months, respectively. We found one case of marginal misfit, two cases of gingivitis, and one case of gingivitis with food impaction in 6 months. At 12 months, we found 2 cases of marginal misfit, 1 of marginal misfit with secondary caries, 3 of gingivitis, and 2 of gingivitis with food impaction. At 18 months, we found 3 cases of marginal misfit, 3 of marginal misfit with secondary caries, 4 of gingivitis, and 2 of gingivitis with food impaction.  Conclusion  The application of metal endocrown in the restoration of molars with insufficient gingival distance is satisfactory.