[肾素结合复合带环冠在乳切牙中的临床性能]
[Clinical performance of rensin-bonded composite strip crowns in primary incisors].
作者信息
Chen X X, Zhong J, Yan W J, Zhang H M, Jiang X, Huang Q, Xue S H, Liu X G
机构信息
Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China.
Department of Prosthodontics, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing 100050, China.
出版信息
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Oct 18;52(5):907-912. doi: 10.19723/j.issn.1671-167X.2020.05.019.
OBJECTIVE
To evaluate the clinical success of the treatment of maxillary anterior primary incisors caries with composite resin strip crowns.
METHODS
Children who presented with severe early childhood caries and were treated comprehensive caries under general anesthesia from January to December 2016 were enrolled in this study. Composite crowns using preformed celluloid crown (3M ESPE, USA) called as "strip crown technique" were applied to treat vital primary incisors with two or multiple surface cavities. Selective etchings of enamel, Universal Bond adhesive and 3M Z350 resin were used to make strip crowns. The patients returned at the end of 6, 12 and 18 months and received clinical and radiologic examinations. Dentists who did not attend the treatment evaluated the strip crowns clinically by modified United States Public Health Service (USPHS) criteria.
RESULTS
Four hundred eighteen restorations, placed in 127 children aged 1.17-5.75 years (average of 3.22), were evaluated. The overall retention rate was 97.8% at the end of 6 months, 93.6% at 12 months and 89.2% at 18 months. After 18 months, 28 restorations (6.7%) were totally lost and 4.1% were rated as having lost some resin material. Only four teeth (1.0%) had secondary caries at the end of 18 months and 1.4% teeth had pulpal pathology requiring root canal treatment. Composite crowns had good performance in contour and adjacent contact and improved aesthetics significantly. Twenty-nine teeth (6.9%) showed mild gingivitis and 93.1% showed healthy gingival. 11.2% of the teeth demonstrated color change because plaque accumulation and the polish could remove the stains. The complete loss of strip crowns was mainly related to eating bites.
CONCLUSION
Strip crowns performed well for restoring primary incisors with large or multisurface caries for periods of over 18 months. The strip crowns can be a durable and aesthetic restoration for vital carious primary incisors with adequate tooth structure after caries removal. Functional movement is an important cause of complete loss. Because of the high technical sensitivity and its requirement of the cooperation of children, strip crowns are more suitable for older and cooperative children as well as children receiving dental treatment under sedation or general anesthesia.
目的
评估复合树脂带环冠修复上颌乳前牙龋齿的临床效果。
方法
选取2016年1月至12月因重度幼儿龋齿在全身麻醉下接受综合龋齿治疗的儿童纳入本研究。使用美国3M ESPE公司生产的预成赛璐珞冠（即“带环冠技术”）制作复合冠，用于治疗有两个或多个面龋洞的活髓乳前牙。采用选择性釉质酸蚀、通用粘结剂和3M Z350树脂制作带环冠。患者分别在6个月、12个月和18个月结束时复诊，接受临床和影像学检查。未参与治疗的牙医根据改良的美国公共卫生服务（USPHS）标准对带环冠进行临床评估。
结果
共评估了127名年龄在1.17至5.75岁（平均3.22岁）儿童的418颗修复体。6个月结束时总体保留率为97.8%，12个月时为93.6%，18个月时为89.2%。18个月后，28颗修复体（6.7%）完全脱落，4.1%被评定为有部分树脂材料脱落。18个月结束时仅有4颗牙齿（1.0%）发生继发龋，1.4%的牙齿有牙髓病变需要根管治疗。复合冠在外形和邻面接触方面表现良好，显著改善了美观。29颗牙齿（6.9%）出现轻度牙龈炎，93.1%牙龈健康。11.2%的牙齿因菌斑堆积出现颜色改变，打磨可去除污渍。带环冠完全脱落主要与咬食有关。
结论
带环冠在修复有大面积或多面龋的乳前牙方面表现良好，可维持超过18个月。对于去除龋坏组织后有足够牙体结构的活髓龋坏乳前牙，带环冠可作为一种持久且美观的修复方式。功能运动是带环冠完全脱落的重要原因。由于技术敏感性高且需要儿童配合，带环冠更适合年龄较大且配合的儿童，以及在镇静或全身麻醉下接受牙科治疗的儿童。
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