不同充填材料修复对楔状缺损患牙牙周组织健康的影响

目的观察不同充填材料修复上颌前磨牙（54︱45）楔状缺损对患牙牙周组织健康的影响。方法选择40例54︱45楔状缺损患者共160颗患牙作为研究对象,采用玻璃离子（GI）、树脂改性玻璃离子（RMGI）、聚酸改性复合树脂/复合体（PMCR）和光固化复合树脂（CR）分别对同一患者的不同患牙的楔状缺损进行修复并分组。于修复前和修复后1周、1个月和6个月检测各组患牙牙周相关生化指标,包括龈沟液量及龈沟液内天冬氨酸转氨酶和碱性磷酸酶活性。结果与修复前比较,修复后各组楔状缺损患牙龈沟液量明显增加,龈沟液中天冬氨酸转氨酶和碱性磷酸酶活性显著提高（P〈0.05）。修复前和修复后1周,各项牙周生化指标组间比较差异均无统计学意义（P〉0.05）;修复后1个月和6个月,GI组各项牙周生化指标显著高于其他三组（P〈0.05）,而PMCR组各项牙周生化指标明显低于其他三组（P〈0.05）。结论临床常用的四种充填材料修复54︱45楔状缺损均可导致牙周组织损伤,其中玻璃离子修复产生的负面影响最为显著。

Effects of different dental filling materials in wedge-shaped defect restorations on periodontal tissues

Objective To evaluate the effects of different dental filling materials in wedge-shaped defect restorations of maxilla premolars （54|45）on periodontal tissues.MethodsForty patients (160 teeth) with wedge-shaped defect （54|45）of maxilla premolars were selected, and four different maxilla premolars of each patient were randomly filled with glass ionomer (GI group), rensin-modified glass-ionomer (RMGI group), polyacid-modified composite resin/compomer (PMCR group) and composite resin (CR group), respectively. The periodontal health indexes including amount of gingival crevicular fluid and activity of aspartate aminotransferase and alkaline phosphatase in gingival crevicular fluid of tested teeth were recorded before restorations and one week, one month and six months after restorations. Results Compared with those before restorations, the amount of gingival crevicular fluid significantly increased in each group after restorations, and the activity of aspartate aminotransferase and alkaline phosphatase in gingival crevicular fluid also significantly increased (P<0.05). Before restorations and one week after restorations, there was no significant difference in each index among four groups (P>0.05). One month and six months after restorations, the indexes of GI group were significantly higher than those of the other groups (P<0.05), while the indexes of PMCR group were significantly lower than those of the other groups (P<0.05). Conclusion All the four commonly used dental filling materials have adverse effects on periodontal tissues after restorations of wedge-shaped defect (54|45), and adverse effects from restorations with GI may be most significant.