磨牙纵折保留修复的临床观察

目的:探讨利用桩核烤瓷冠辅以牙龈切除术或牙冠延长术修复纵折至龈下的磨牙,以提高纵折磨牙保存成功率的方法。方法:对56例劈裂至龈下的第一磨牙去除牙折片后采用镍铬合金桩核加3种不同种类烤瓷冠(镍铬合金烤瓷冠、金铂合金烤瓷冠、IPS EmpressⅡ铸瓷冠)进行修复,部分配合牙冠延长术或牙龈切除术,随访观察1年,比较直接修复和配合牙周手术对修复效果的影响,以及不同种类烤瓷冠对修复效果的影响。结果:纵折磨牙拔除牙折片后采用桩核烤瓷冠直接修复和配合牙冠延长术修复,随诊观察1年后的修复有效率分别为80%和94.4%,后者治疗效果好于前者,差异有统计学意义。两种修复方法中,失败者均出现在镍铬合金烤瓷冠修复中。结论:修复劈裂至龈下的纵折磨牙采用桩核烤瓷冠配合牙冠延长术或牙龈切除术是一种有效的治疗方法,贵金属烤瓷冠和全瓷冠的应用会进一步提高修复效果。

Clinical observation of restoration of vertically fractured molars

Objective: To repair vertically fractured molars by using cast metal posts and cores plus PFM crowns after the crown lengthening or gingivectomy if necessary.Methods:56 vertically fractured first molars were restorated by two methods.Some of them were directly repaired by three kinds of crowns(PFM,gold alloy PFM,all porcelain crowm)plus cast metal posts and cores.The others used the crown lengthening or gingivectomy before repaired.All patients were revisited after a year.The clinical success rate was calculated.Results:The success rates of directly restoration and restoration after the crown lengthening or gingivectomy were 80% and 94.4%.Restorable effect of the PFM crowns plus cast metal posts and cores after gingiva operations were better than directly restorations.All the losers were found in the cases that were restorated by Ni-Cr alloy PFM crown.Conclusion: The method is a good choice to restored the vertically fractured molars by posts and cores plus PFM crowns after the crown lengthening or gingivectomy.The usage of gold alloy or all porcelain will improve the success rate.