关键词:

牙体缺损, 水激光预处理, Er, YAG激光预处理, 全瓷嵌体, 修复

Abstract:

Objective　To investigate the clinical results of water laser pretreatment of all-ceramic inlay dental restorations and to analyze the factors influencing the long-term prognosis. Methods　Convenience sampling method was used to select 136 patients with dental defects admitted to The Third Affiliated Hospital of Air Force Medical University from May 2022 to January 2023 as the study subjects, and they were divided into two groups by the random number table method with 68 cases in each group. After excluding patients with detachment, there were 65 cases in the control group, 33 males and 32 females, aged 22-63 (46.06±8.50) years, with the number of dental defects being 1 in 45 cases, 2 in 16 cases, and 3 in 4 cases, and Er:YAG laser pretreatment was carried out; there were 64 cases in the observation group, 34 males and 30 females, aged 23-66 (44.22±9.83) years, with the number of dental defects being 1 in 48 cases, 2 in 14 cases, and 3 in 2 cases, and water laser pretreatment was carried out. On the basis, both groups were given all-ceramic inlay dental restoration. The results of the two groups were compared at 12 months after dental restoration [United States Public Health Service (USPHS) revised evaluation criteria], as well as oral health before and 12 months after restoration [probing depth (PD), gingival index (GI), and plaque index (PI)], amount of blood loss during dental restoration, pain and discomfort disappeared time after dental restoration, and survival rate of all-ceramic inlays at 18 months after dental restoration. Independent sample t test, paired t test, Mann-Whitney U test, and χ² test were used for statistical analysis. COX regression analysis was used to analyze the factors affecting the survival rate of all ceramic inlays. Results　At 12 months after dental restoration, there was no statistically significant difference in the grading of the dental restoration effect (restoration integrity, edge fitness, color matching, edge staining, retention, sensitivity, gingival health, and secondary caries) between the two groups (all P>0.05). At 12 months after dental restoration, there was no statistically significant difference in the PD, GI, or PI between the two groups (all P>0.05). The amount of blood loss in the observation group was less than that in the control group [(1.23±0.41) ml vs. (1.57±0.47) ml] (P<0.05). The pain and discomfort disappeared time after dental restoration in the observation group were shorter than those in the control group [(7.53±3.03) d vs. (8.69±2.77) d, (9.33±3.04) d vs. (10.51±3.18) d] (both P<0.05). There was no statistically significant difference in the survival rate of all ceramic inlays between the two groups (P>0.05). COX regression analysis showed that PD (HR=44.349, 95%CI= 7.519-261.594) and GI (HR=5.036, 95%CI= 1.232-20.594) were independent risk factors for the survival rate of all ceramic inlays after dental restoration (both P<0.05). Conclusions　The use of water laser pretreatment before dental restoration of all-ceramic inlays can obtain the same effect of Er:YAG laser pretreatment, and at the same time, it can reduce the amount of bleeding in the restoration process to a certain extent, and shorten the disappearance time of pain and discomfort after restoration. It is necessary to strengthen the oral health management after dental restoration, in order to improve the survival rate of all-ceramic inlays.

Key words:

Dental defects, Water laser pretreatment, Er:YAG laser pre-treatment, All-ceramic inlays, Repair