摘要
目的 观察龈壁提升后采用椅旁计算机辅助设计/计算机辅助制作(computer-aideddesign/computer-aided manufacturing,CAD/CAM)优韧瓷高嵌体修复老年患者磨牙龈下缺损的临床效果.方法 选取2022年1月至2023年5月在北京中西医结合医院口腔科行龈壁提升后用CAD/CAM优韧瓷高嵌体修复的患者68例,共计68颗磨牙,用树脂充填进行龈壁提升后用椅旁CAD/CAM优韧瓷高嵌体修复,修复后1周、6个月、12个月时随访观察,按照美国公众健康服务标准从边缘密合性、牙体完整性、修复体折裂、边缘着色、牙龈健康状况、修复体固位、继发龋7个方面分A、B、C三级评价临床效果.结果 术后1周复查,无失访,68例嵌体在7个方面均评价为A级.术后6个月,失访1例,有65例评价为A级;有1例嵌体脱落,重新粘固后,随访至今无脱落;1例牙龈轻度炎症.术后12个月,失访新增2例,63例评价为A级,2例牙龈轻度炎症,边缘密合性、牙体完整性、边缘着色、修复体固位、继发龋方面表现良好.修复后12个月成功率为92.6％(63/68).结论 对于老年人磨牙龈下缺损,龈壁提升后用CAD/CAM优韧瓷高嵌体修复具有修复成功率高、精确高效、方便快捷的优点,适合在临床推广应用.
Abstract
Objective To observe the clinical effects of chairside CAD/CAM LavaTM Ultimate composite resin nanoceramics onlays restorations after gingival wall elevation in repairing subgingival defects of molars in elderly patients,providing reference for clinical application. Methods From January 2022 to May 2023,68 patients with a total of 68 molar teeth were selected after gingival wall elevation and restoration with CAD/CAM Ultimate ceramic onlay in the Stomatology Department of Beijing Hospital of Integrated Chinese and Western Medicine. After gingival wall elevation with resin filling,chairside CAD/CAM Ultimate ceramic onlays restorations were applied. At 1 week,6 months,and 1 year after restoration,the clinical effect was evaluated according to the American public health service standards in 7 aspects:edge cohesion,dental integrity,fracture of the restoration,edge coloring,gingival health,restoration retention,and secondary caries in A,B,and C grades. Results One week post-operation,there were no lost follow-ups. The onlays in all seven aspects were evaluated as Grade A in all 68 cases. At 6 months post-operation,one case was lost to follow-up,leaving 65 cases evaluated as Grade A. In one case,the onlay fell off,and after re-adhesion,no loss was observed. One case exhibited mild gingival inflammation. After 12 months post-operation,there were 2 additional cases lost to follow-up. Among the remaining 63 cases,evaluations showed Grade A ratings. Two cases exhibited mild gingival inflammation. Marginal integrity,tooth integrity,marginal discoloration,restoration retention and absence of secondary caries were all well maintained. The success rate at 12 months post-repair was 92.6％ (63/68). Conclusion For elderly patients with subgingival defects on molars,CAD/CAM Ultimate ceramic onlays restorations after gingival wall elevation offer advantages of high restoration success rates,precision,efficiency,convenience and rapid application,making them suitable for clinical promotion and application.
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