国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (8): 1297-1301.DOI: 10.3760/cma.j.cn441417-20240730-08014

• 论著 • 上一篇    下一篇

不同修复方式对4~5 mm后牙缺损患儿治疗效果的影响

孙颖  雷彦华   

  1. 榆林市第一医院口腔科,榆林  719000

  • 收稿日期:2024-07-30 出版日期:2025-04-15 发布日期:2025-04-20
  • 通讯作者: 雷彦华,Email:18717634656@163.com
  • 基金资助:

    陕西省自然科学基础研究计划(2022JQ-927);榆林市科技计划项目(YF-2020-063)

Different restoration methods for children with 4-5 mm posterior tooth defects

Sun Ying, Lei Yanhua   

  1. Department of Stomatology, Yulin First Hospital, Yulin 719000, China

  • Received:2024-07-30 Online:2025-04-15 Published:2025-04-20
  • Contact: Lei Yanhua, Email: 18717634656@163.com
  • Supported by:

    Basic Research Plan of Natural Science in Shaanxi (2022JQ-927); Plan of Science and Technology in Yulin (YF-2020-063)

摘要:

目的 评估树脂充填、金属预成冠和瓷嵌体三种修复方法对4~5 mm后牙缺损患儿治疗效果的影响。方法 采用前瞻性研究设计,选取2022年1月至2023年1月榆林市第一医院收治的163例(180颗患牙)4~5 mm后牙缺损患儿作为研究对象,通过随机数字表法分为A组(55例,60颗)、B组(54例,60颗)、C组(54例,60颗)。A组男27例、女28例,年龄(6.87±1.52)岁,采用树脂充填修复;B组男28例、女26例,年龄(6.92±1.46)岁,采用金属预成冠修复;C组男27例、女27例,年龄(6.95±1.49)岁,采用瓷嵌体修复。对比3组患儿疗效、牙周状况[菌斑指数(PI)、牙龈指数(GI)、探诊深度(PD)]、咬合功能、儿童口腔健康影响程度量表(COHIP)及儿童口腔健康生活量表(ECOHIS)评分,并随访1年,统计3组牙体情况(边缘密合性、邻接关系、磨耗情况、修复体情况)。统计学方法采用t检验、χ2检验、方差分析。结果 B组、C组治疗总有效率为81.7%(49/60)、91.7%(55/60),高于A组的63.3%(38/60),差异有统计学意义(χ2=14.878,P<0.001)。修复3个月后,B组、C组PI评分[(0.62±0.07)分、(0.57±0.06)分]、GI评分[(0.53±0.06)分、(0.50±0.05)分]、COHIP评分[(15.21±2.17)分、(12.47±1.78)分]均低于A组[(0.86±0.09)分、(0.72±0.08)分、(29.27±4.37)分];ECOHIS评分[(85.74±12.25)分、(86.89±12.41)分]均高于A组[(78.19±10.98)分];PD[(2.04±0.21)mm、(2.00±0.20)mm]均小于A组[(2.36±0.24)mm];最大咬合力[(2.21±0.23)kg、(2.05±0.20)kg]、咬合面积[(72.82±10.40)mm2、(74.14±10.59)mm2]均大于A组[(1.23±0.17)kg、(61.31±8.75)mm2];咬合接触时间[(1.02±0.19)s、(0.98±0.18)s]均短于A组[(1.26±0.21)s];差异均有统计学意义(F=260.602、204.960、542.108、9.468、49.457、408.473、30.198、36.661,均P<0.05)。随访1年后,B组、C组在边缘密合性、邻接关系、磨耗及修复体情况等成功率上均高于A组,差异均有统计学意义(χ2=8.291、10.179、10.015、12.975,均P<0.05)。结论 与树脂充填修复相比,金属预成冠及瓷嵌体修复对治疗4~5 mm后牙缺损患儿疗效较好,在改善牙周状况、咬合功能及口腔健康相关生活质量方面更为有效,且在长期牙体维护上也显示出较好效果。

关键词:

瓷嵌体, 树脂充填, 金属预成冠, 后牙缺损, 牙周状况

Abstract:

Objective To evaluate the effects of resin filling, metal prefabricated crowns, and ceramic inlays for children with 4-5 mm posterior tooth defects. Methods This was a prospective study. From January 2022 to January 2023, 163 children with 4-5 mm posterior tooth defects on 180 teeth treated at Yulin First Hospital were selected as the study objects, and were divided into group A (55 cases with 60 affected teeth), group B (54 cases with 60 affected teeth), and group C (54 cases with 60 affected teeth) by the random number table method. There were 27 boys and 28 girls in group A; they were (6.87±1.52) years old. There were 28 boys and 26 girls in group B; they were (6.92±1.46) years old. There were 27 boys and 27 girls in group C; they were (6.95±1.49) years old. Group A were restored with resin, group B with metal prefabricated crowns, and group C with ceramic inlays. The treatment effects, periodontal health indicators [plaque index (PI), gingival index (GI), and probing depth (PD)], occlusal function, and scores of Child Oral Health Impact Profile (COHIP) and Early Childhood Oral Health Impact Scale (ECOHIS) were compared between the 3 groups. All the 3 groups were followed up one year to assess their tooth conditions, including marginal integrity, proximal contact, wear, and restoration status. The statistical methods included t and χ2 tests and analysis of variance. Results The overall clinical treatment efficacies of groups B [81.7% (49/60)] and C [91.7% (55/60)] were higher than that in group A [63.3% (38/60)], with a statistical difference (χ2=14.878, P<0.001). Three months after the restoration, the scores of PI (0.62±0.07 and 0.57±0.06), GI (0.53±0.06 and 0.50±0.05), and COHIP (15.21±2.17 and 12.47±1.78) in groups B and C were lower than those in group A (0.86±0.09, 0.72±0.08, and 29.27±4.37); the score of ECOHIS in groups B (85.74±12.25) and C (86.89±12.41) were higher than that in group A (78.19±10.98); the PD's in groups B [(2.04±0.21) mm] and C [(2.00±0.20) mm] were smaller than that in group A [(2.36±0.24) mm]; the maximum occlusal forces [(2.21±0.23) kg and (2.05±0.20) kg] and occlusal areas [(72.82±10.40) mm2 and (74.14±10.59) mm2] in groups B and C were bigger than those in group A [(1.23±0.17) kg and (61.31±8.75) mm2]; the occlusal contact times in groups B [(1.02±0.19) s] and C [(0.98±0.18) s] were shorter than that in group A [(1.26±0.21) s]; there were statistical differences (F=260.602, 204.960, 542.108, 9.468, 49.457, 408.473, 30.198, and 36.661; all P<0.05). After one year's follow-up, groups B and C had higher success rates in marginal integrity, proximal contact, wear, and restoration conditions than group A, with statistical differences (χ2=8.291, 10.179, 10.015, and 12.975; all P<0.05). Conclusions Metal prefabricated crowns and ceramic inlays show superior treatment outcomes and shorter treatment times compared to resin fillings for children with 4-5mm posterior tooth defects. They are more effective for improving periodontal health, occlusal function, and oral health-related quality of life, and demonstrate better long-term tooth maintenance.

Key words:

Ceramic  , inlays;Resin  , dillings;Metal prefabricated crowns;Posterior  , tooth  , defects;Periodontal  , conditions