关键词:

前牙缺损, 二氧化锆全瓷冠, 钴铬合金烤瓷冠, 病原菌

Abstract:

Objective　To analyze the effects of zirconia all-ceramic crown and cobalt(Co)-chromium(Cr) alloy porcelain crown in repairing anterior teeth defect, the patients' gingival health, and the detection of pathogenic bacteria in subgingival plaque. Methods　A prospective study was conducted on 153 patients (226 teeth) with anterior teeth defect treated at Department of Stomatology, Sun Simmiao Hospital, Beijing University of Chinese Medicine from August 2021 to August 2022. The patients were divided into a control group (76 cases, 112 teeth) and a research group (77 cases, 114 teeth) by the random number table method. There were 42 males and 34 females in the control group; they were (33.65±4.72) years old; their disease course was (5.14±1.23) months. There were 44 males and 33 females in the research group; they were (33.74±4.53) years old; their disease course was (5.15±1.22) months. The control group received Co-Cr alloy porcelain crown restoration, and the research group received zirconia all-ceramic crown restoration. Both groups were followed up for 1 year. The restoration effects, detection of subgingival plaque pathogens 1 year after restoration, chewing function, gingival crevicular fluid inflammatory factors before and 1 month after restoration, periodontal statusbefore and 6 months after restoration, and adverse reactions within 1 year after restoration were compared between the two groups. t test and χ² test were used. Results　The total excellent rate 1 year after restoration in the research group was higher than that in the control group [93.51% (72/77) vs. 82.89% (63/76)], with a statistical difference (χ²=4.149, P=0.042). One month after restoration, the bite forces and masticatory efficiencies of the two groups were higher than those before restoration, while the SDHue counts of the two groups were lower than those before restoration, and those in the research group changed more obviously, with statistical differences (all P<0.05). Six months after restoration, the scores of teeth mobility, plaque index (PLI), and gingival index (GI) [(3.54±0.63) and (1.67±0.35); (1.11±0.14) and (0.78±0.12); (0.98±0.14) and (0.79±0.13)] of the control group and the research group were lower than those before restoration [(20.75±3.31) and (20.77±3.24); (1.82±0.23) and (1.85±0.24); (1.47±0.22) and (1.44±0.25)], and those in the research group changed more obviously, with statistical differences (t=22.734, 15.661, and 8.700; all P<0.05). One year after restoration, the detection rates of Porphyromonas gingivalis (Pg), Fusobacterium nucleatum (Fn), Tannerella forsythia (Tf), and Actinobacteria actinomycetemcomitans (Aa) in the research group were lower than those in the control group [2.60% (2/77) vs. 11.84% (9/76), 3.90% (3/77) vs. 14.47% (11/76), 3.90% (3/77) vs. 14.47% (11/76), and 2.60% (2/77) vs. 13.16% (10/76)], with statistical differences (χ²=4.899, 5.148, 5.148, and 5.902; all P<0.05). One month after restoration, the levels of matrix metalloproteinase-8 (MMP-8), tumor necrosis factor-α (TNF-α), aspartate aminotransferase (AST), and C-reactive protein (CRP) in the gingival crevicular fluid of the two groups were higher than those before restoration, and those in the research group changed more obviously, with statistical differences (all P<0.05). There was no difference in the total incidence of adverse reactions within 1 year after restoration between the two groups (P>0.05). Conclusion　Compared with Co-Cr alloy porcelain crown, zirconia all-ceramic crown can improve the restoration effect, chewing function, and periodontal condition, reduce the pathogenic bacteria of subgingival plaque, and inhibit the expression of inflammatory factors in gingival crevicular fluid, and has fewer adverse reactions.

Key words:

Anterior teeth defect, Zirconia all-ceramic crown, Co-Cr alloy porcelain crown, Pathogenic bacteria