成品螺纹桩核与铸造桩核前牙烤瓷冠临床效果观察

目的:观察成品螺纹桩核和铸造桩核前牙烤瓷冠临床效果,比较二者的优缺点。方法:将前牙烤瓷桩冠分为成品螺纹桩核组(130件)和铸造桩核组(105件),失败类型包括:冠脱位、桩脱位、冠折、根折和桩折5类。结果:成品螺纹桩核组共出现失败病例10例,而铸造桩核组共出现失败病例5例。结论:螺纹桩核和铸造桩核均是较好的烤瓷冠桩核,但二者各有所长。正确选择适应症,尽量保存健康牙体,考虑临床和患者的方便,是取得良好修复效果的关健。     

银粉加强型玻璃离子制作核桩的固位力对比研究

目的 以实验方法比较银粉玻璃离子（GISRR）可塑性核桩和铸造核桩的固位力。方法 在两组各10枚离体前磨牙分别制作铸造核桩和银粉玻璃离子可塑性核桩,测试其固位力并进行比较。结果 铸造核桩组固位力为（17.567±12.765）kg,可塑性核桩组为（32.197±15.581）kg,t检验P<0.05,有显著性差异。结论 银粉玻璃离子可塑性核桩固位力优于铸造核桩。     

钉固位树脂核修复残根残冠的临床应用

国内采用螺纹钉、预成简单根管桩、铸造桩核固位对前后牙残根残冠修复的方法，已有很多报道[1，2]，并且已获得2年以上的成功。但是破坏至龈下或者平齐牙龈，龈上已无完整冠部牙体组织的残根残冠，无法通过简单桩、铸造桩核修复而获得良好固位力和抗力。临床中我们在对这类患牙，采用螺纹钉固位，加光固树脂核形成残根残冠的龈上冠部结构，最后用烤瓷冠和铸造全冠完成残根残冠修复的过程中，初步探讨钉固位树脂核修复后能否在行使咀嚼功能咬合中获得良好的固位和抗力。1.材料和方法1.1临床资料：大连医科大学第二临床医院口腔门诊中100颗认…     

银汞桩核的应用研究

利用根管修复牙体缺损的桩核技术，已有两百多年历史。早在1700s年，Fauchard就将木桩置人根管辅助牙冠固位。目前临床常用的桩核是铸造金属桩、成品根管桩加复合树脂核。银汞桩核作为一种临床操作简便易行，价格低廉，无需过多制备根冠，不易造成根折的传统的修复牙体缺损的方法，开始引起临床工作者的注意并应用于临床。     

桩和核装置的固位性

近代主张用临床技术来加强结构脆弱的牙齿,但这些技术尚未对照公认的实验标准进行测验。本文对传统的粘固铸造桩和核修复体与用针和(或)桩及复合树脂一次修复的牙齿进行了比较,并测试其对拉力、剪力和扭力的抗移位性,以便评定这些新技术的固位可靠性。用铸造检、核和牙冠来重建一个牙齿其牙根应能承受咀嚼力。虽成品桩仍被采用,而铸造检和核的修复体比成品桩的固位更好。但不是一切牙根都能适应铸造桩和核的     

铸造桩核替换简单桩核的方法

简单桩冠因其桩钉为成品桩钉或不锈钢丝弯制而成,与根管密合性较差,如果根管有龋坏时则更为严重,因此在临床上要用烤瓷牙修复时,常需取下它们,换成铸造桩核,再进行烤瓷牙修复。但如果桩冠固位较紧,一时无法取出时,不少人就会在原桩冠的基础上备牙进行修复。然而,有时使用一段时间后,烤瓷冠会出现连桩钉一起脱落的现象,若烤瓷冠依然完好,此时即是以铸造桩核替换简单塑料桩核的好时机。     

GC铸型树脂在铸造桩核中的应用

目的 介绍ＧＣ铸型树脂在铸造核制作中的使用方法及其特点。方法 对共要临床运用时的方法介绍，临床观察、结果分析，同时与其它方法相比较。结果 发现用ＧＣ铸型树脂制作铸造桩核具有担任简单快速、桩核形态恢复良好、密合度高、固位力强等特点。结论ＧＣ铸型树脂非常适合地制作铸造桩核，值得临床推广。     

三种形式桩核冠修复磨牙大面积缺损的临床研究

目的 采用成品桩-光敏树脂核冠、成品桩-汞核冠及铸造桩核冠修复大面积缺损的磨牙,观察并比较其临床修复效果。方法 对87颗经过完善根管充填的大面积缺损的磨牙,14颗用成品桩-树脂核冠,41颗用成品桩-汞核冠,32颗行铸造桩核-冠修复,对其临床效果随访2～3年。结果 成品桩-树脂核冠组有1例桩折断,1例继发龋,成品桩-汞核冠组有1例刺激性龈炎;铸造桩核冠组有1例根折,经统计学检验,汞核冠组及铸造桩核冠组修复效果无显著性差异,树脂核冠组与汞核冠及铸造桩冠组有1例根折,经统计学检验,汞核冠组及铸造桩核冠组修复效果无显著性差异,树脂核冠组与汞核冠及铸造桩冠组有显著性差异。结论 成品桩-汞核冠和铸造桩核冠修复大面积缺损磨牙的效果较成品桩-树脂核冠好。     

铸造桩核单根管固位修复磨牙大部缺损

目的:观察铸造桩核单根管固位修复磨牙大部缺损的疗效.方法:对27颗上颌磨牙利用腭侧根管固位,根管桩钉长度平均7.05 mm,9颗下颌磨牙选择一个较粗根管固位,根管桩钉长度平均6.39 mm,根据临床牙冠的高度,分别设计金属烤瓷冠,金属全冠,嵌体冠修复,观察其使用效果.结果:单根管固位桩钉长度6～7 mm时,可达到固位要求,修复牙与对照牙最大NFDA1力测定未见明显差异.结论:铸造桩核利用一个根管固位时,只要固位钉具有一定长度,可以保证正常行使咀嚼功能的固位需求,而下颌磨牙根管较细或弯曲,不能利用单根管固位时,建议利用近远中两个根管作螺纹钉树脂冠核固位.     

上颌磨牙组合式铸造桩核的制作及应用

目的:评价上颌磨牙组合式铸造桩核的临床效果。方法:对临床上牙冠缺损范围较大,牙根分叉角度大,难以取得共同就位道的上颌磨牙,采用组合式铸造桩核进行修复。结果:32例患者,35颗组合式铸造桩核,修复后与牙体组织密合;其后制作全冠或固定桥,使用1～5a效果良好,无1例桩核脱落。结论:组合式铸造桩核不仅解决了上颌磨牙根分叉大、难以制作铸造桩核的问题,而且利用了其倒凹,增加了桩核的固位力,增强了修复体的强度。     

磨牙缺损桩核修复的临床探讨

目的：探索一种磨牙缺损的分类方法,并提出相对应的桩核修复方法用以指导临床。方法：临床选择140例磨牙缺损患者,根据牙体预备后牙冠缺损壁的多少分为一壁缺损、二壁缺损、三壁缺损和四壁缺损,采用螺纹钉＋树脂核、玻璃纤维桩核或铸造桩核冠修复,1年后对修复效果进行评价。结果：经1年的临床随访,铸造插销桩组出现l例冠桩脱落,铸造整体桩组出现1例根折,玻璃纤维桩组出现2例桩折,修复效果较满意。结论：根据牙冠缺损壁的多少将磨牙缺损进行分类,有利于临床医师不同桩核修复方法的选择,提高了磨牙残冠残根修复的成功率。     

Techniques for immediate core buildup of endodontically treated teeth.

Access to the pulp chamber for endodontic treatment is indicated inter alia as a result of extensive caries, trauma to the tooth causing fracture or loss of vitality, requiring restoration of the missing tooth structure. Different approaches and materials are described in the literature for foundation restorations, either with a cast post and core or immediately, with a chairside post-and-core system. This article briefly reviews the current data regarding the microbiologic, prosthetic, mechanical, and periodontal aspects while emphasizing the immediate approach using amalgam, resin composites, and glass ionomers. Factors affecting retention of the post are presented to guide the clinician in selecting a suitable post-and-core system to preserve optimal root structure and prevent root fracture. Three clinical cases are presented in which tooth structure was restored using different techniques: in the first two, provisional acrylic resin shells, one custom made and the other prefabricated, were used to house an amalgam coronal-radicular dowel core, where in the third case, a copper band was used for a composite post-and-core system. All cases emphasize the ease of production and short chairtime in the stages of crown fabrication.     

Root canal retained restorations: 1. General considerations and custom-made cast posts and cores

The first article in this series reviews general considerations relating to the use of root canal retained restorations. The authors discuss factors affecting retention, the arguments for cast versus wrought posts, reinforcement of the tooth, and treatment planning. Clinical procedures for constructing custom-made cast posts and cores, using direct and indirect techniques, are also described. The three subsequent articles will deal with threaded and unthreaded prefabricated post-and-core systems, and root-face attachments for the retention of complete and partial overdentures.     

2种材质桩核修复磨牙残冠的抗疲劳强度

目的比较2种桩核材料用于磨牙残冠桩核冠修复的抗疲劳强度。方法收集制备20个下颌第一磨牙残冠,分别用纤维桩和铸造插销式分体桩进行桩核冠修复,测定其抗疲劳强度,并对两种修复方式的疲劳强度和折裂模式进行比较。结果铸造插销式分体桩核冠用于磨牙残冠的修复可获得良好的抗疲劳强度,与纤维桩核冠修复相比较,差异具有统计学意义(P﹤0.05)。结论磨牙残冠选用铸造插销式分体桩核冠修复可以获得更好的力学性能,对于合并有夜磨牙、紧咬牙等习惯的患者,应该采取降低牙尖斜度等方法来减小垂直及侧向牙合力。     

Up to 17-year controlled clinical study on post-and-cores and covering crowns

OBJECTIVE: The aim of this long-term follow-up was to collect up to 17-year survival data of different metal post-and-core restorations with a covering crown. METHODS: At initiation of the study, a controlled clinical trial, single tooth was provided with an artificial covering crown, by 18 operators. Restorations under investigation were the post-and-core restorations: cast post-and-core restorations, prefabricated metal post and resin composite core restorations, and post-free all-composite core restorations. Before treatment allocation, the recipient tooth was categorized according to the expected dentin height after tooth preparation. A tooth was assessed to have "substantial dentin height" (Trial 1) or "minimal dentin height" (Trial 2). The study sample consisted of 257 patients that received 307 core restorations. The performance of the restorations was based on data collected from the files of the current dentists monitoring the oral health of the patients. The survival probability was analyzed at different levels: on the restoration level (S(R)), and on the level of the tooth carrying the restoration (S(T)). Kaplan Meier analyses were used to compare survival probabilities. RESULTS: "Type of post-and-core restoration" showed no influence on the survival probability (at both levels) in both trials (P-value>0.05). The 17-year survival rates at restoration level varied from 71% to 80%, and at tooth level from 83% to 92%. CONCLUSIONS: The results of this study showed no difference in survival probabilities among different core restorations under a covering crown of endodontically treated teeth. The preservation of substantial remaining coronal tooth structure seems to be critical to the long-term survival of endodontically treated crowned teeth.     

An alternative post-and-core method for patients with limited interarch space

BACKGROUND: The authors describe a technique for placement of a three-unit posterior fixed partial denture where one abutment lacked sufficient interarch space. CASE DESCRIPTION: This method involves the use of a cast post and core with a precision attachment soldered into the core to provide the necessary retention and resistance. The prosthesis is retained by a combination of cement and screw retention. CLINICAL IMPLICATIONS: This method is desirable when there is insufficient interarch space for a conventional post-and-core restoration. Achieving internal reinforcement by connecting the precision attachment to the residual root should provide the prosthesis with retention and added stability.     

Fracture resistance of endodontically treated anterior teeth restored with four post-and-core systems.

OBJECTIVE: The purpose of this study was to evaluate the fracture resistance and the mode of failure of endodontically treated teeth restored with four post-and-core systems. METHOD AND MATERIALS: Forty intact human incisors were randomly divided into four groups. Teeth from each group received endodontic therapy and one of four post-and-core systems: serrated, parallel-sided, cast post and core; serrated, parallel-sided, prefabricated post and resin-composite core; carbon-fiber-reinforced (CFC) post and resin-composite core; and ceramic post and resin-composite core. A full-coverage metal crown was fabricated and cemented onto each tooth. Each specimen was subjected to a compressive load at a 45-degree angle to its axis until failure. The failure load was recorded and compared statistically. The mode of failure of the specimens was analyzed. RESULTS: There was no significant difference in the failure loads among groups. More catastrophic root fracture was detected in the group restored with ceramic posts and resin-composite cores. CONCLUSION: The fracture resistance of endodontically treated teeth restored with these four post-and-core systems could be accepted clinically. Unfavorable tooth fracture was shown in all groups.     

纤维桩与插销桩修复磨牙严重缺损的临床研究

目的比较2种桩核材料用于磨牙严重缺损的修复效果。方法80颗磨牙缺损患牙随机分为2组,分别进行玻璃纤维桩核冠修复和铸造插销式分体桩核冠修复,2年后对修复效果进行评价。结果玻璃纤维桩组出现1颗冠折;插销式分体桩组所有患牙均未出现冠松动脱落、冠桩脱落、冠折、根折、桩折,2组差异无统计学意义(P<0.05)。结论对于磨严重牙缺损患者,选用玻璃纤维桩核冠修复或铸造插销式桩核冠修复均可,但对于缺损严重合并牙根条件差的患牙,选用玻璃纤维桩需慎重。     

An in vitro study of the fracture resistance and the incidence ofvertical root fracture of pulpless teeth restored with six post-and-coresystems

STATEMENT OF PROBLEM: Posts and cores are often required with pulpless teeth to provide retention and resistance form for complete crowns. Nevertheless, conventional posts may increase the potential for root fracture. PURPOSE: This study compared the resistance to vertical root fracture of extracted teeth treated with post-core systems that were modified with polyethylene woven fibers (Ribbond) with those treated with conventional post-and-core systems. MATERIAL AND METHODS: Canal instrumentation was performed for 60 maxillary central incisors, and complete crown preparations were made. The coronal portion of each tooth was amputated, and 6 post-and-core systems were studied. Specimens were mounted in acrylic resin blocks with a layer of polyvinyl siloxane covering the roots. Loads were applied at an angle of 130 degrees and measured with a universal testing machine. Results were analyzed statistically with 1-way analysis of variance with Student-Newman-Keuls grouping and chi-square analysis. RESULTS. Cast posts and cores resulted in significantly higher failure thresholds than all others, except for prefabricated, comparably sized, parallel-sided posts with composite cores. All failures in the group with cast posts involved fracture of the teeth, whereas 70% of the teeth with comparably sized parallel-sided posts and composite cores failed as a result of tooth fractures and 30% experienced core fractures. The woven fiber post-core system was significantly lower in strength than all others, and exhibited significantly fewer vertical root fractures. CONCLUSIONS: Polyethylene woven fiber and composite resin without a prefabricated post resulted in significantly fewer vertical root fractures, but mean failure load was the lowest. Smaller diameter prefabricated posts combined with the polyethylene woven fiber and composite cores improved resistance to failure. Traditional cast posts and cores were the strongest of the 6 post-core systems.