第一恒磨牙分体铸造桩核冠修复临床探究.docVIP

第一恒磨牙分体铸造桩核冠修复临床探究[摘要] 目的:探讨第一恒磨牙残根、残冠的分体式铸造桩核冠修复的方法和意义。方法:常规X线牙片检查,评估牙根的状况,进行牙体预备,分别制取主根管桩核和辅柱核蜡型,技工制作、包埋、铸造、打磨、抛光,完成口内试戴,调磨、粘固。结果:163颗牙,随访3年,无一例发生修复体松动及脱位、桩核折断及冠根折裂的现象。结论:分体桩核与传统单柱核相比有明显的优势,特别是保存第一恒磨牙残根、残冠方面很重要,解决了多根牙可共同就位道的问题。 [关键词] 第一恒磨牙;分体铸造桩核;残根 [中图分类号] R783.3 [文献标识码]B[文章编号]1673-7210(2010)03(a)-166-02 Clinical study on repair of split-made post core crown of the first permanent molar YANG Junzhou (The Third People’s Hospital of Puyang City, Puyang 457000, China) [Abstract] Objective: To explore the methods and significance of restoration of split-made post core crown of residual root and crown of the first permanent molar. Methods: Via routine X-ray dental film examination to assess the status of root for dental preparation, respectively to make the main root tube post-core and auxiliary-core wax type by craft making, embedding, casting, grinding and polishing, and to complete mouth trials, adjusting and cementing. Results: 3 years’ investigation showed that among the 163 teeth, none of them with phenomena such as prosthesis loosening and dislocation, post-core crown fracture and root fracture. Conclusion: The split post core has obvious advantage compared with the traditional single-column core, in particular, to preserve the residual root and crown of the first permanent molar solved the issue of multi-root teeth being hard to find a common placing path. [Key words] First permanent molar; Split-made post core; Residual root 随着根管治疗和修复技术的发展,第一磨牙残根、残冠越来越多的被保存下来,以往多以桩核冠修复,因第一磨牙承担主要咀嚼功能,受力较大,易造成桩核脱位,残冠、残根折裂等并发症,笔者2002～2005年采用铸造分体桩核冠的方法修复第一磨牙163例,经3年临床观察取得了比较满意的效果。现报道如下: 1 资料与方法 1.1一般资料 2002～2005年采用铸造分体桩核冠修复第一磨牙残根、残冠163颗,随访3年。患者年龄30～60岁,患牙均经完善的根管治疗,其中上颌牙79颗,下颌牙84颗;牙体缺损在1/2～3/4者56颗,残根107颗;缺损在龈上者150颗,缺损在龈下3 mm以内牙槽嵴顶以上者13颗(牙体预备前应做冠延长术)。 1.2材料 铸造桩核材料 Ni-Cr合金,蜡型材料 “上齿牌”蜡线条。黏接材料“上齿牌”磷酸锌水门汀。 1.3 修复方法 1.3.1 常规X线牙片检查:了解根充是否到位、饱满,并估计牙根长度、根管的方向和数目等,为根管预备做准备。 1.3.2 牙体预备:包括残冠及根面预备和髓室及根管预备两部分。①残冠及根面预备:对于残冠保留龈上3 mm牙体组织,常规预备、颊、舌(颚)、