镍铬合金烤瓷冠修复对牙周组织的影响

背景:随着金属烤瓷技术的出现,镍铬合金成为应用最广泛的非贵金属类金属烤瓷用航?镍铬合金烤瓷冠金属边缘主要与牙龈接触,因此它对牙周组织可能有一定影响.目的:了解镍铬合金烤瓷冠对患牙牙周组织的影响.设计、时间及地点:回顾性病例分析,病例来自2006-01/2007-01解放军南京军区福州总院四七六临床部口腔科.对象:采用镍铬合金烤瓷冠进行上颌切牙修复的患者19例,共23颗患牙,年龄(32.5±10.8)岁.选择健康的对侧同名牙作为对照.方法:所有临床操作均由同一位医生进行,在修复体制作过程中,严格遵守口腔修复原则.常规牙体预备,排龈线排龈,均为唇侧龈下肩台0.5 mm,圆凹形肩台厚度为0.5 mm.硅橡胶印模材取模,制作临时冠.全冠制作时,尽量恢复其正常的生理解剖外形,牙冠轴面突度的增加不超过0.2 mm.永久件粘结.主要观察指标:在镍铬合金烤瓷冠戴入6～9个月后复诊,进行牙周临床检查,分别采集患牙及对照牙的龈沟液并定量,在实验室对龈沟液中的C-反应蛋白和肿瘤坏死因子α水平进行检测.结果:符合临床合格要求的镍铬合金烤瓷冠修复后,患牙的菌斑指数没有明显改变,但龈沟液量、探诊深度、龈沟内出血指数、龉狄耗贑-反应蛋白和肿瘤坏死因子α水平明显高于健康牙(P<0.05).结论:镍铬合金烤瓷冠对患牙的牙周组织有一定的不良影响.

Effects of Ni-Cr based porcelain-fused-to-metal crown on periodontal tissue

BACKGROUND: Along with the emergence of porcelain-fused-to-metal (PFM) technique, Ni-Cr alloy has been shown to be the most available non-novel metal alloy used for preparation of PFM materials. The metal margin of Ni-Cr based PFM crown possibly produces some effects on periodontal tissue for it is primarily contacted with gingiva. OBJECTIVE: To investigate the influences of Ni-Cr alloy PFM crown on periodontal tissue. DESIGN, TIME AND SETTING: A retrospective case analysis was performed. All cases were from Department of Stomatology, the 476 Hospital of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between January 2006 and January 2007.PARTICIPANTS: Totally 23 maxillary incisors were included from 19 patients who averaged (32.5±10.8)years old and received tooth restoration using Ni-Cr based PFM crowns. Healthy contralateral corresponding teeth were used as controls. METHODS: All clinical operations were conducted by one dentist. Dental restoration principles should be strictly followed during preparation of dental prosthesis. A routine tooth preparation was performed. Specifically, gingival retraction cords were used for gingival recession, with a shoulder prepared 0.5 mm below the labial gingiva and concave shoulder thickness 0.5 mm. A temporary crown was made using silicon rubber. The normal physiological anatomical profile of complete crown should be recovered as possible while preparation. Dental axial crown overcontour should be increased within 0.2 mm. Finally, a permanent sticking was followed.MAIN OUTCOME MEASURES: At 6-9 months after wearing Ni-Cr alloy PFM crown, the gingival crevicular fluid was collected from affected and control teeth for quantitation and laboratory examinations (C reactive protein and tumor necrosis factor- a included),PARTICIPANTS: Alter placement of Ni-Cr alloy PFM crown which was clinically accepted, plaque index of affected tooth did not alter significantly, but gingival crevicular fluid volume, probing depth, sulcus bleeding index, and levels of C reactive protein and tumor necrosis factor-α were significantly greater in affected teeth than in control teeth (P < 0.05).CONCLUSION: Ni-Cr alloy PFM crown produces some harmful effects on periodontal tissue.