后牙金铂合金全金属颈环烤瓷熔附金属全冠的应用价值

 目的 探讨后牙金铂合金全金属颈环烤瓷熔附金属全冠(porcelain fused to metal ,PFM)的应用价值。方法 选取99例进行后牙金铂合金PFM修复的患者,共修复牙体182颗,其中93颗牙体采用金铂合金PFM全金属颈环羽状肩台设计,89颗牙体采用凹面肩台设计,戴冠1年和3年后,比较两组设计边缘适应性、牙龈健康状况、继发龋发病率、牙龈染色及稳定性的差异。结果 戴冠1年后,两组设计边缘适应性、牙龈健康状况、继发龋发病率及牙龈染色无明显差异。戴冠3年后,后牙金铂合金全金属颈环PFM边缘适合性优的比例(92.47%)高于凹面肩台PFM设计(82.02%);后牙金铂合金全金属颈环PFM造成牙龈病变的比例及继发龋的比例(18.28%和3.22%)低于凹面肩台PFM(34.83%和11.24%);前者牙龈染色的程度重于后者,差异有统计学意义(P<0.05)。后牙金铂合金全金属颈环PFM随着时间推移缘适应性、牙龈健康状况、继发龋发病率无明显变化,而凹面肩台设计PFM的以上指标均向不利方向发展(P<0.05)。结论 后牙金铂合金全金属颈环PFM具有良好的边缘适应性、稳定性、较低的牙龈病变的比例及继发龋的比例,但造成牙龈染色的概率较大。后牙金铂合金全金属颈环PFM可作为后牙区修复的一种常规设计方案。

Clinical application of Au-Pt alloy PFM of full metal margin to posterior teeth

Objective To study the application value of Au-Pt alloy porcelain fused to metal(PFM)of full metal margin to posterior teeth. Methods 99 patients with Au-Pt alloy PFM restoration were recruited. 182 posterior teeth were restored. 93 posterior teeth were restored with Au-Pt alloy PFM of full metal margin, 89 posterior teeth were restored with Au-Pt alloy PFM of concave shoulder. After 1 and 3 years, the clinical effect in marginal adaptation /gigival health /secondary caries /the color of the gingiva and the stability were observed. The clinical effect in marginal adaptation/gigival health and secondary caries of posterior teeth of Au-Pt alloy PFM of full metal margin had not obvious change, but they were to the adverse direction about Au-Pt alloy PFM of concave shoulder (P<0.05). Results One year later, the clinical effect on marginal adaptation /gigival health /secondary caries and the color of the gingival had no significant difference between the two groups. Three years later, The good proportion of marginal adaptation of Au-Pt alloy PFM of full metal margin(92.47%) was better than Au-Pt alloy PFM of concave shoulder(82.02%). The proportion of periodontal lesions and secondary caries of the former (18.28% and 3.22%)were better than the latter(34.83% and 11.24%). The degree of the former gum being shaded was worse than the latter, the differences was statistically significant (P<0.05). Conclusions In the long run, posterior teeth restored with Au-Pt alloy PFM of full metal has good margin marginal adaptation / lower gum disease rate and secondary caries rate, but gum has greater risk of dyeing. Posterior teeth of Au-Pt alloy PFM of full metal margin can be recommended as clinical routine design.