颈缘移位（CMR）对牙周健康的影响：一项对照试验的 12 个月结果。

Influence of cervical margin relocation (CMR) on periodontal health: 12-month results of a controlled trial.

机构信息

Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100, Italy.

出版信息

J Dent. 2018 Feb;69:70-76. doi: 10.1016/j.jdent.2017.10.008. Epub 2017 Oct 20.

DOI:10.1016/j.jdent.2017.10.008

PMID:29061380

Abstract

OBJECTIVES

The concept of Cervical Margin Relocation (CMR) consists on placing a base layer of direct resin composite to elevate supra-gingivally the proximal indirect bonded restorations. The aims of this clinical study were to evaluate 1. Bleeding on Probing (BoP) on posterior indirect restorations with one interproximal margin relocated cervically, and 2. possible correlation between depth of the interproximal margins and BoP.

METHODS

CMR (Group 1) and shoulder preparations (Group 2) were performed in 35 posterior teeth and evaluated after 12 months (T12). Cavities' margins were placed below the Cemento-Enamel-Junction (CEJ). CMR was applied in one interproximal box-slot preparation using G-Premio Bond, for dentin hybridization, and universal flow resin composite (GC Co. Tokyo, Japan). Pressed lithium disilicate crowns (LS2) (LiSi Press, GC Co. Tokyo, Japan) were made and placed with proprietary luting material. At baseline and after 12 months, clinical surrogate parameters were assessed; and measurements were recorded for the restorative margin position in relation to margo gingivae by probing, and radiographically, the distance from the bone crest was calculated (in mm). Statistical analysis was performed.

RESULTS

CMR was associated with statistically significant increased BoP scores compared to shoulder preparation at T12 (53.0% vs. 31.5% per site, respectively) (p=0.10). Gingival Index (GI) and Plaque Index (PI) were not statistically different between both groups. The linear distance between the bone crest and the restorative margin was 2mm in 13 out of 19 experimental sites of Group 1, and 6 out of 11 of Group 2.

CONCLUSIONS

Higher incidence of BoP can be expected around teeth treated with the concept of CMR and in coincidence with deep margins placed at or closer than 2mm from the bone crest.

CLINICAL SIGNIFICANCE

CMR is a clinically sensitive-technique, especially when performed on deep subgingival margins.

摘要

目的

颈缘迁移（CMR）的概念是指在近龈下位置用直接树脂复合材料形成一个底层，以提升间接粘结修复体的龈上位置。本临床研究的目的是评估 1. 颈缘迁移后后牙间接修复体的探诊出血（BoP）情况，以及 2. 近中边缘深度与 BoP 之间的可能相关性。

方法

在 35 颗后牙上进行 CMR（第 1 组）和肩台预备（第 2 组），并在 12 个月时（T12）进行评估。牙体预备边缘放置于牙骨质-釉质界（CEJ）以下。在一个近中箱型预备体中应用 G-Premio Bond 进行牙本质混合处理，并用通用流动树脂复合材料（GC Co. Tokyo, Japan）进行粘结。制作并使用专有粘固材料放置加压二硅酸锂冠（LS2）（LiSi Press，GC Co. Tokyo, Japan）。在基线和 12 个月时，评估临床替代参数；通过探测测量修复边缘相对于牙龈边缘的位置，并通过放射影像学测量从牙槽嵴的距离（以毫米计）。进行了统计学分析。

结果

与肩台预备相比，在 T12 时，CMR 与探诊出血评分显著增加相关（分别为 53.0%和 31.5%）（p=0.10）。两组的牙龈指数（GI）和菌斑指数（PI）无统计学差异。第 1 组的 19 个实验位点中有 13 个，第 2 组的 11 个位点中有 6 个，牙槽嵴和修复边缘之间的线性距离为 2 毫米。