Abstract:

Objective　To evaluate the effects of glass fiber post-core crowns versus cobalt-chromium alloy post-core crowns in the restoration of molar teeth with residual roots and crowns. Methods　One hundred and two patients with residual roots and crowns of molars treated at Shangluo Traditional Chinese Medicine Hospital from January 2021 to January 2023 were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 51 cases in each group. There were 28 males and 23 females in the control group; they were (44.26±4.36) years old. There were 29 males and 22 females in the observation group; they were (44.38±4.47) years old. The control group received cobalt-chromium alloy post and core restorations, and the observation group received glass fiber post and core restorations. After one year's follow-up, the restoration effects, restoration success rates, periodontal indicators [sulcus bleeding index (SBI), gingival index (GI), and plaque index (PI)], masticatory efficiencies, occlusal function, levels of IL-6 and TNF-α in gingival crevicular fluid, and adverse reactions were compared between the two groups by χ² and t tests. Results　The Likert score and restoration success rate in the observation group were higher than those in the control group [25.02±1.69) vs. (22.16±1.31) and 96.08% (49/51) vs. 80.39% (41/51)], with statistical differences (t=9.552; χ²=6.044; both P<0.05). Before the restoration, there were no statistical differences in periodontal index, masticatory efficiency, occlusal function, and levels of IL-6 and TNF-α between the two groups (all P>0.05). After the restoration, the SBI, GI, PI, and levels of IL-6 and TNF-α in the observation group were lower than those in the control group [(0.61±0.19) vs. (0.98±0.26), (0.64±0.18) vs. (1.45±0.39), (0.82±0.21) vs. (1.38±0.25), (48.46±4.92) ng/L vs. (54.69±5.64) ng/L, and (4.69±1.02) ng/L vs. (5.75±1.14) ng/L], with statistical differences (t=8.205, 13.467, 12.249, 5.945, and 4.949; all P<0.05). The masticatory efficiency and occlusal function in the observation group were higher than those in the control group [(91.58±7.89)% vs. (86.25±7.65)% and (147.11±13.58) 1bs vs. (136.58±12.05) 1bs], with statistical differences (t=3.464 and 4.142; both P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group [5.88% (3/51) vs. 19.61% (10/51)], with a statistical difference (χ²=4.320; P<0.05). Conclusions　Glass fiber post-core crowns show better aesthetic results, periodontal health indicators, masticatory efficiency, and occlusal function compared to cobalt-chromium post-core crowns. They also effectively reduce the levels of IL-6 and TNF-α in gingival crevicular fluid and decrease the incidence of adverse reactions.

Key words:

Periodontal index, Glass fiber post-core crowns, Cobalt-chromium post-core crowns, Molar residual root and crowns, Aesthetic effect

摘要：

目的　探讨玻璃纤维桩核冠与钴铬合金桩核冠修复磨牙残根残冠的效果。方法　采用随机对照试验，选取2021年1月至2023年1月在商洛市中医医院治疗的102例磨牙残根残冠患者作为研究对象，通过随机数字表法分为对照组（51例）和观察组（51例）。对照组男28例、女23例，年龄（44.26±4.36）岁，予以钴铬合金桩核冠修复；观察组男29例、女22例，年龄（44.38±4.47）岁，予以玻璃纤维桩核冠修复。治疗后随访1年，对比两组患者修复效果、修复成功率、修复前后牙周指数［龈沟出血指数（SBI）、牙龈指数（GI）、牙菌斑指数（PI）］、咀嚼效率、咬合功能、龈沟液白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平，并评估不良反应发生情况。统计学方法采用t检验、χ²检验。结果　观察组Likert评分及修复成功率均高于对照组［25.02±1.69）分比（22.16±1.31）分、96.08%（49/51）比80.39%（41/51）］，差异均有统计学意义（t=9.552，χ²=6.044；均P<0.05）。修复前，两组患者牙周指数、咀嚼效率、咬合功能及IL-6、TNF-α水平比较，差异均无统计学意义（均P>0.05）。修复后，观察组SBI、GI、PI及IL-6、TNF-α水平均低于对照组［（0.61±0.19）分比（0.98±0.26）分、（0.64±0.18）分比（1.45±0.39）分、（0.82±0.21）分比（1.38±0.25）分、（48.46±4.92）ng/L比（54.69±5.64）ng/L、（4.69±1.02）ng/L比（5.75±1.14）ng/L］，差异均有统计学意义（t=8.205、13.467、12.249、5.945、4.949，均P<0.05）；观察组咀嚼效率、咬合功能均高于对照组［（91.58±7.89）%比（86.25±7.65）%、（147.11±13.58）1bs比（136.58±12.05）1bs］，差异均有统计学意义（t=3.464、4.142，均P<0.05）。观察组不良反应发生率为5.88%（3/51），低于对照组的19.61%（10/51），差异有统计学意义（χ²=4.320，P<0.05）。结论　与钴铬合金桩核冠相比，玻璃纤维桩核冠在修复磨牙残根残冠时美学效果、牙周健康指标、咀嚼效率和咬合功能方面表现更佳，同时能有效降低龈沟液中IL-6、TNF-α水平，减少不良反应发生。

关键词:

牙周指数, 玻璃纤维桩核冠, 钴铬合金桩核冠, 磨牙残根残冠, 美学效果