根管治療后不同冠修復方式在牙隱裂伴牙髓炎患者中的修復效果及對牙周指標的影響

翟家彬 唐子春

【摘要】目的：探討根管治療后不同冠修復方式治療牙隱裂伴牙髓炎的臨床效果。方法：選擇2019年3月至2021年3月口腔科收治的56例牙隱裂伴牙髓炎患者，所有患者均行根管治療，根不同冠修復方式分組，將采用全瓷冠修復的30例患者納入 A 組，采用金屬烤瓷冠修復的26例患者納入 B 組。評估修復效果，觀察修復前和修復后牙周指標、齦溝液中炎癥因子變化，隨訪6個月，記錄隨訪結果。結果： A 組與 B 組修復總有效率（93.33%比73.08%）對比，差異有統計學意義（P<0.05）。兩組修復后齦溝探診深度、牙齦指數和齦溝液量提高，牙齦出血指數降低（P<0.05）;與 B 組比較， A 組修復后牙周指標明顯改善（P<0.05）。兩組修復后白細胞介素-8（IL-8）、腫瘤壞死細胞因子-α（TNF-α）、基質金屬蛋白酶-8（MMP-8）升高（P<0.05）， A 組修復后 IL-8、TNF-α和 MMP-8與 B 組比較，明顯更低（P<0.05）。A 組頸緣黑線、牙折裂發生率與 B 組比較，明顯更低（P<0.05）。結論：針對牙隱裂伴牙髓炎患者，在根管治療后采用全瓷冠修復效果滿意，對牙周影響小，炎癥反應輕。

【關鍵詞】牙隱裂;牙髓炎;根管治療;牙周指標

【中圖分類號】R783.3【文獻標識碼】A 【文章編號】2096-5249（2022）05-0171-03

Restorative effects of different crown restoration methods in patients with cracked teeth and pulpitis after root canal therapy and their effects on periodontal indexes

Zhai Jia-bin1， Tang Zi-chun2

1.Department of Emergency， Nanjing Stomatological Hospital Medical School of Nanjing University， Nanjing210000， China

2.Stomatological Hospital of Soochow University， Suzhou 215000， China

【Abstract】Objective：To investigate the clinical e?ect of di?erent crown restoration methods in the treatment of cracked teeth with pulpitis after root canal therapy.Method：A total of 56 patients with cracked teeth and pulpitis who were admitted to the Department of Stomatology from March 2019 to March 2021 were selected. All patients received root canal therapy and were grouped by di?erent crown restoration methods，thirty patients repaired with all-ceramic crowns were included in group A，and 26 patients repaired with metal-porcelain crowns were includ- ed in group B.The restoration e?ect was evaluated，and the changes of periodontal indexes and in?ammatory fac- tors in gingival crevicular ?uid before and after restoration were observed. Follow-up results were recorded for 6 months. Result：The total e?ective rate of repair between group A and group B was compared（93.33%vs73.08%）， and the di?erence was statistically significant（P<0.05）.After restoration，gingival sulcus probing depth（GCD），gingival? index? and? gingival? crevicular ?uid? increased，while? gingival? bleeding? index? decreased? in? both groups（P<0.05）;compared with group B，periodontal indexes in group A after restoration Significant improve- ment（P<0.05）.The levels of interleukin-8（IL-8），tumor necrosis cytokine-α（TNF-α）， and matrix metallo- proteinase-8（MMP-8）in the two groups increased after repair（P<0.05），and in group A after repair Compared with group B，IL-8，TNF-α and MMP-8 were significantly lower（P<0.05）.Compared with group B，the in- cidence of black line and tooth fracture in group A was significantly lower（P<0.05）.Conclusion：For patients with cracked teeth and pulpitis，the use of all-ceramic crowns after root canal treatment is satisfactory，with little impact on the periodontium and mild in?ammation.

【Key words】Cracked teeth;Pulpitis;Root canal treatment;Periodontal index

牙隱裂指牙冠表面的非生理性細小裂紋，又稱牙微裂，是口腔科常見病癥。該癥發病隱匿，且無特異性臨床表現，僅在咀嚼硬物或受到冷熱刺激時有不適感，易被患者忽視。牙髓炎是牙隱裂常見并發癥，其會加重病情，出現激發痛、咬合痛、損傷牙本質。牙隱裂伴牙髓炎若不及時診治，可導致牙齒劈裂，影響咀嚼功能。目前，臨床針對牙隱裂伴牙髓炎患者通常給與根管治療，其能保留患者牙齒，但無法增強牙齒抗阻力[1-2]。……