钴铬合金及银钯合金烤瓷冠对牙周组织的影响

背景：金属烤瓷全冠是修复牙体缺损的最常用方法,牙周问题是导致修复失败的最常见原因。 目的：评价钴铬合金和银钯合金作为烤瓷冠内冠材料对牙周组织的影响。 方法：选择采用钴铬合金和银钯合金烤瓷冠修复患者75例,189颗患牙,其中106颗采用钯合金烤瓷冠修复体,83颗应用钴铬合金修复体。于修复前后临床对比患牙龈沟出血指数、龈沟液量、龈沟液中与炎症相关的细胞因子白细胞介素1β和肿瘤坏死因子α浓度,以及龈沟液中牙龈卟啉单胞菌、伴放线嗜血杆菌、福赛斯坦纳菌等3种细菌检出率的变化。 结果与结论：①与修复前比较,钴铬合金烤瓷冠修复12个月后,患牙龈沟出血指数和龈沟液量、龈沟液中细胞因子白细胞介素1β、肿瘤坏死因子α水平及龈沟液中牙龈卟啉单胞菌、福赛斯坦纳菌检出率升高(P < 0.05或P﹤0.01),伴放线嗜血杆菌检出率无明显变化(P > 0.05)。②与修复前比较,银钯合金烤瓷冠修复12个月后,龈沟出血指数和龈沟液量升高(P < 0.05),龈沟液中细胞因子白细胞介素1β、肿瘤坏死因子α水平及3种细菌检出率无明显变化(P > 0.05)。表明两种材料的烤瓷冠对患牙牙周组织均有影响,其中银钯合金影响较小,钴铬合金影响较大。

Influences of cobalt-chromium alloy versus silver-palladium alloy porcelain crown on periodontal tissues

BACKGROUND: Metal porcelain crown is the most commonly used method of repair of dental defects, and periodontal problems are the most common causes of repair failure.  OBJECTIVE: To evaluate the influence of cobalt-chromium alloy and silver-palladium alloy as the materials of inner crown on periodontal tissue. METHODS:Totally 189 clinical diseased teeth from 75 patients were chosen in this study. 106 teeth were repaired with cobalt-chromium alloy porcelain crown, and 83 were repaired with silver-palladium alloy porcelain crown. The changes in periodontal sulcus bleeding index and amount of gingival crevicular fluid were observed. Interleukin-1 beta, tumor necrosis factor alpha and the positive rates of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythia in the gingival crevicular fluid were detected. RESULTS AND CONCLUSION: In the cobalt-chromium alloy porcelain crown group, there were significant differences in periodontal sulcus bleeding index, the amount of gingival crevicular fluid, interleukin-1 beta, and tumor necrosis factor alpha as well as the positive rates of Porphyromonas gingivalis and Tannerella forsythia in the gingival crevicular fluid prior to and 12 months post-restoration   (P < 0.05), while there was no significant difference in the positive rate of Actinobacillus actinomycetemcomitans (P > 0.05). In the silver-palladium alloy porcelain crown group, there were significant differences in periodontal sulcus bleeding index and the amount of gingival crevicular fluid    (P < 0.05), but no differences in interleukin-1 beta, tumor necrosis factor alpha and the positive rates of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Tannerella forsythia in the gingival crevicular fluid prior to and 12 months post-restoration (P > 0.05). The cobalt-chromium alloy porcelain crown may have an adverse effect on periodontal tissue to a certain degree, while the silver-palladium alloy is an ideal substrate material of porcelain fused to metal crown.