不同修复体全冠修复对牙周病患者患牙颈缘及牙周健康状况的影响

目的 探讨不同修复体全冠修复对牙周病患者患牙颈缘及牙周健康状况的影响.方法 回顾性分析2016年1月至2019年8月在云南省第二人民医院口腔修复科进行全冠修复的牙周病患者172例(180个牙位)临床资料,根据所用全冠修复材料的不同将患者分为全瓷冠组84例(90个牙位)及钴铬合金组88例(90个牙位),全瓷冠组采用二氧化锆全瓷冠进行修复,钴铬合金组采用钴铬合金烤瓷冠进行修复.修复完成后,比较两组患者颈缘状况(适合性、完整性、颈缘凸度及颜色协调度);修复后随访6个月,比较两组修复前后患牙龈沟液(GCF)中软骨糖蛋白39(YKL-40)、抵抗素、天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP)水平差异.结果 全瓷冠组的颈缘适合性、凸度及颜色协调度占比情况与钴铬合金组比较,差异均有统计学意义(P<0.05).两组修复前GCF量、YKL-40、抵抗素、AST及ALP水平比较,差异无统计学意义(P>0.05).钴铬合金组修复前后GCF量、YKL-40、抵抗素、AST及ALP水平变化差值高于全瓷冠组,差异均有统计学意义(P<0.05).结论 二氧化锆全瓷冠修复相较钴铬合金烤瓷冠修复的颈缘效果更佳,对牙周组织健康影响更小,值得临床推广应用.

Effects of different restorations on health status of cervical margin and periodontium

Objective Toinvestigate the influence of differentrestorations on the health status of cervical margin and periodontal. Methods The clinical data ofpatients withperiodontal disease who received full crown restoration in the Department of Prosthodontics of Yunnan Second People''s Hospital from January 2016 to August 2019 were retrospectively analyzed. A total of 172 patients (180 teeth) were divided into all ceramic crown group (84 cases, 90 teeth) and cobalt chromium alloy group (88 cases, 90 teeth).The all ceramic crown group was restored with zirconia all ceramic crown, while the cobalt chromium alloy group with cobalt chromium alloy porcelain crown. After restoration, the fitness and integrity of cervical margin, crown and color coordination of the two groups were evaluated. The levels of cartilage glycoprotein 39 (YKL-40), resistin, aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in GCF were measured 6 months after restoration. Results 96.67%(87/90) of the all ceramic crown group and 94.44%(85/90) of the co Cr alloy group had grade B tooth integrity after restoration, and there was no significant difference between the two groups (P>0.05).In the all ceramic crown group, 96.67%(87/90), 97.78%(88/90) and 94.44%(85/90) of the cervical marginal fitness, convexity and color harmony reached grade B, respectively, while in the co Cr alloy group, 90.00%(81/90), 88.89%(80/90) and 85.56%(77/90) respectively. Compared with the difference before and after repair,the GCF, YKL-40, resistin, AST and ALP levels in the co Cr alloy group were significantly higher than those in the all ceramic crown group (P<0.05).Conclusions Compared with cobalt chromium alloy, all ceramic crowns have better cervical marginal effect and less influence on periodontal tissue health, which is worthy of clinical application.