磨牙症综合征的牙合面贴面修复治疗效果：一项为期 22.4 个月的随访研究。
Occlusal veneer restoration treatment outcomes of cracked tooth syndrome: A 22.4-month follow-up study.
机构信息
Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310020, Zhejiang, China.
出版信息
Clin Oral Investig. 2024 Jun 12;28(7):368. doi: 10.1007/s00784-024-05735-x.
OBJECTIVES
The aims of this clinical study were to investigate success rate, vital pulp survival rate, tooth survival rate and patient-reported masticatory ability by evaluating the pain symptoms and signs of the cracked teeth as well as Index of Eating Difficulty (IED) and Oral Health Impact Profile-14 (OHIP-14) questionnaire after cracked teeth were restored with occlusal veneers.
MATERIALS AND METHODS
27 cracked teeth of 24 patients with cold and/or biting pains without spontaneous/nocturnal pains were recruited in this study. The cracked teeth were restored with occlusal veneers fabricated by lithium disilicate ceramic. Cold test and biting test were used to evaluate pain signs. IED and OHIP-14 questionnaire were used to evaluate masticatory ability. FDI criteria was used to evaluate restorations. The paired Wilcoxon test was used to analyze significant differences of detection rate of pain signs, OHIP scores and IED grade before and after restorations. Kaplan-Meier survival curve was used to describe the success rate, vital pulp survival rate, and tooth survival rate.
RESULTS
27 cracked teeth were restored with occlusal veneers with average of 22.4-month follow-up. Two cracked teeth had pulpitis and pain signs of the other cracked teeth completely disappeared. OHIP total scores were significantly reduced after treatment. Scores of 'pain', 'occlusal discomfort', 'uncomfortable to eat', 'diet unsatisfactory' and 'interrupted meals' reduced significantly after treatment. After treatment, IED grades of 25 vital teeth were significantly lower than those before treatment. FDI scores of 25 restorations except for 2 teeth with pulpitis were no greater than 2. The 12 months accumulated pulp survival rate of the cracked teeth was 92.6%. The 12 months accumulated tooth survival rate was 100%. The success rate at the latest recall was 92.6%.
CONCLUSION
Occlusal veneer restorations with success rate of 92.6% and the same pulp survival rate might be an effective restoration for treating the cracked teeth.
CLINICAL RELEVANCE
The occlusal veneer restorations might be an option for treating the cracked teeth when cracks only involve enamel and dentin, not dental pulp.
目的
本临床研究旨在通过评估牙隐裂患者的疼痛症状和体征，以及通过评估冷测试和咬诊、Index of Eating Difficulty（IED）问卷和Oral Health Impact Profile-14（OHIP-14）问卷来评价牙隐裂患牙经牙合面贴面修复后的成功率、活髓保存率、患牙保存率和患者自述的咀嚼能力。
材料和方法
本研究共纳入 24 例有冷刺激痛和/或咬物痛但无自发痛和夜间痛的牙隐裂患者的 27 颗患牙。所有患牙均采用二硅酸锂陶瓷制作的牙合面贴面进行修复。采用冷诊和咬诊评估疼痛体征，采用 IED 和 OHIP-14 问卷评估咀嚼能力，采用 FDI 标准评价修复体。采用配对 Wilcoxon 检验分析修复前后疼痛体征检出率、OHIP 评分和 IED 分级的差异。采用 Kaplan-Meier 生存曲线描述成功率、活髓保存率和患牙保存率。
结果
27 颗牙隐裂患牙均采用牙合面贴面修复，平均随访 22.4 个月。2 颗患牙发生牙髓炎，其余患牙的疼痛症状完全消失。治疗后 OHIP 总分显著降低，“疼痛”“咬合不适”“咀嚼不适”“饮食不满意”和“中断进食”评分显著降低。治疗后 25 颗活髓牙的 IED 分级显著低于治疗前。除 2 颗牙髓炎患牙外，其余 25 颗修复体的 FDI 评分均不大于 2。12 个月时牙隐裂患牙的活髓保存率为 92.6%，12 个月时患牙保存率为 100%，末次随访时成功率为 92.6%。
结论
成功率为 92.6%且活髓保存率相同的牙合面贴面修复可能是治疗牙隐裂的有效方法。
临床意义
对于仅累及釉质和牙本质而未累及牙髓的牙隐裂，牙合面贴面修复可能是一种治疗选择。
Zotero 插件