Abstract:

Objective　To explore the effects of different restoration methods for extensive anterior maxillary tooth defects. Methods　This was a prospective study. Ninety children undergoing anterior maxillary primary tooth restoration at Yangling Demonstration District Hospital from September 2021 to June 2023 were selected as the study objects. The children were divided into three groups (A, B, and C) according to the restoration methods, with 30 cases in each group. Group A had 17 boys and 13 girls who were (3.76±0.78) years old. Group B had 15 boys and 15 girls who were (3.21±0.89) years old. group C had 19 boys and 11 girls who were (3.58±0.67) years old. Group A received direct resin filling restoration; group B underwent fiber post combined with translucent crown resin restoration; group C received fiber post CAD/CAM resin crown restoration. The periodontal indicators [plaque index (PLI) and bleeding index (BI)], restoration success rates, fracture resistance indexes, and levels of inflammatory factors [tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8)] in the gingival crevicular fluid before and after the treatment were compared between the three groups by one-way analysis of variance and χ² test. Results　Before the restoration, there were no statistical differences in the periodontal indicators, fracture resistance index, and levels of inflammatory factors between the 3 groups (all P>0.05). After the restoration, the PLI, BI, and levels of TNF-α and IL-8 in group C [0.40±0.25, 0.67±0.35, (613.18±48.18) ng/L, and (525.08±29.97) ng/L] were lower than those in group A [0.87±0.31, 1.10±0.50, (702.49±62.08) ng/L, and (578.37±30.48) ng/L] and group B [0.73±0.38, 0.70±0.45, (650.76±59.13) ng/L, and (552.41±35.15) ng/L], with statistical differences (F=17.297, 9.021, 18.711, 20.867; all P<0.05); the fracture resistance index in group C was higher than those in group A and group B [(0.61±0.08) kN vs. (0.50±0.09) kN and (0.51±0.01) kN], with a statistical difference (F=22.808; P<0.05). The restoration success rate in group C was higher than those in group A and group B [96.23% (102/106) vs. 74.79% (89/119) and 84.69% (83/98)], with a statistical difference (χ²=20.021; P<0.001). Conclusion　The fiber post CAD/CAM resin crown restoration method for extensive anterior maxillary tooth defects can improve the restoration success rate, periodontal health, and fracture resistance of the restoration structure, and reduce the levels of inflammatory factors.

Key words:

Children, Anterior maxillary teeth, Transparent crown, Restoration, Fiber post, Fracture resistance

摘要：

目的　探讨不同修复方式对上颌乳前牙大面积缺损的修复效果。方法　采用前瞻性研究，选取2021年9月至2023年6月在杨凌示范区医院进行上颌乳前牙修复的90例患儿作为研究对象，根据修复方法分为A组、B组、C组，每组各30例。A组男17例、女13例，年龄（3.76±0.78）岁，采用树脂直接充填修复方法；B组男15例、女15例，年龄（3.21±0.89）岁，采用纤维桩结合透明冠树脂修复方法；C组男19例、女11例，年龄（3.58±0.67）岁，采用纤维桩计算机辅助设计与制造（CAD/CAM）树脂冠修复方法。对比3组患儿治疗前后牙周指标［牙菌斑指数（PLI）、出血指数（BI）］、修复成功率、抗折裂强度指数、龈沟液炎症因子［肿瘤坏死因子-α（TNF-α）、白细胞介素-8（IL-8）］水平。组间比较采用ANOVA单因素分析及χ²检验。结果　修复前，3组患儿牙周指标、抗折裂强度指数、炎症因子水平比较，差异均无统计学意义（均P>0.05）。修复后，C组患儿PLI、BI及TNF-α、IL-8水平［（0.40±0.25）分、（0.67±0.35）分、（613.18±48.18）ng/L、（525.08±29.97）ng/L］均低于A组［（0.87±0.31）分、（1.10±0.50）分、（702.49±62.08）ng/L、（578.37±30.48）ng/L］、B组［（0.73±0.38）分、（0.70±0.45）分、（650.76±59.13）ng/L、（552.41±35.15）ng/L］，差异均有统计学意义（F=17.297、9.021、18.711、20.867，均P<0.05）；C组患儿抗折裂强度指数为（0.61±0.08）kN，高于A组［（0.50±0.09）kN］、B组［（0.51±0.01）kN］，差异有统计学意义（F=22.808，P<0.05）。C组患儿修复成功率为96.23%（102/106），高于A组［74.79%（89/119）］、B组［84.69%（83/98）］，差异有统计学意义（χ²=20.021，P<0.001）。结论　在上颌乳前牙大面积缺损修复治疗中，采用纤维桩CAD/CAM树脂冠修复方法可以提高修复成功率，改善牙周健康，增加修复结构的抗折裂强度，减少炎症因子水平。

关键词:

儿童, 上颌乳前牙, 透明冠, 修复, 纤维桩, 抗折裂强度