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

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