不同材质桩核冠在前牙美学区修复的临床研究

目的：观察玻璃纤维桩联合全瓷冠与铸造金属桩联合钴铬烤瓷冠在前牙美学区牙体缺损修复中的临床疗效。方法将前牙美学区牙体缺损需行桩核修复的患者100例（150颗牙），按照患者的选择意愿，分为玻璃纤维桩联合全瓷冠修复组（A组，50例70颗）和铸造金属桩联合钴铬烤瓷冠修复组（B组，50例80颗）。对修复前后牙周探诊深度、龈沟液碱性磷酸酶（ALP）及修复体边缘适合度和美学表现进行观察检测，随访3年，观察两组修复体的效果。结果两组修复成功率分别为88.6%和77.5%，存在显著性差异（P＜0.05）。修复后1年,玻璃纤维桩联合全瓷冠修复组的边缘适合度、颜色匹配均显著优于铸造金属桩联合钴铬烤瓷冠修复组（P＜0.05）。修复后1年和3年,两组的牙周探诊深度较修复前均有所增加，但未发现存在显著性差异（P＞0.05）；铸造金属桩联合钴铬烤瓷冠修复组中，龈沟液中ALP水平显著高于修复前水平（P＜0.05）。结论玻璃纤维桩全瓷冠对基牙牙周刺激较小，具有良好的生物相容性及美学效果，是一种理想的前牙美学区修复体。

The clinical study of restoration for anterior aesthetic zone with different material post and core crown

Objective To observe the clinical effect of glass fiber pile combined with all-ceramic crown in restoration for dental defects of anterior aesthetic zone compared with cast metal post-core combined with cobalt-chromium PFM crown. Methods The present investigation enrolled 100 patients （150 teeth） who had been treated for dental defects of anterior aesthetic zone. According to the patient＇s request, they were divided into two groups. After root canal therapy, Group A（50 patients, 70 teeth） was treated by glass fiber pile combined with all-ceramic crown. Group B（50 Patients, 80 teeth） was treated by cast metal post-core combined with cobalt-chromium PFM crown. We detected the periodontal probing depth and the alkaline phosphatase （ALP） levels in gingival crevicular fluid （GCF） in the preoperation and postoperation.We observed the fitness of prosthesis edge and the aesthetic manifestations of anterior zone. Followed up for 1 to 3 years, we observed the success rate for restoration and evaluated the long-term curative effect between two groups. Results There was statistical difference in the success rate for restoration between two groups （88.6%vs.77.5%, P〈0.05）. After restoration for 1 year, the marginal adaptation and color match in the group A were significantly better than those in the group B（P〈0.05）. After treatment for 1 year and 3 years, periodontal probing depth between two groups has increased over that in the preoperation, but the difference was not statistically significant （P〉0.05）. The levels of ALP in GCF of group B was significantly higher than that in the preoperation （P〈0.05）. Conclusion Glass fiber pile combined with all-ceramic crown has relatively small stimulation on periodontium, has a good biocompatibility and aesthetics, which can be used as an ideal restoration method for anterior aesthetic restorations.