上海口腔医学

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (4): 405-409.doi: 10.19439/j.sjos.2023.04.013

• 论著 • 上一篇    下一篇

4种口腔修复材料对咀嚼及牙龈功能的影响

王怡婷1, 文少敏2, 李小红1, 李苑荟1   

  1. 1.海口市第三人民医院 口腔科,海南 海口 571199;
    2.海南医学院第一附属医院 口腔修复科,海南 海口 570100
  • 收稿日期:2023-01-28 修回日期:2023-03-03 发布日期:2023-09-07
  • 通讯作者: 王怡婷,E-mail：e7403nk@163.com
  • 作者简介:王怡婷（1997-）,女,学士,主治医师
  • 基金资助:
    海南省卫生健康行业科研项目（20A200250）

Effect of 4 kinds of prosthodontic materials on masticatory and gingival function

WANG Yi-ting1, WEN Shao-min2, LI Xiao-hong1, LI Wan-hui1   

  1. 1. Department of Stomatology, Haikou Third People's Hospital. Haikou 571199;
    2. Department of Oral Restoration, The First Affiliated Hospital of Hainan Medical University. Haikou 570100, Hainan Province, China
  • Received:2023-01-28 Revised:2023-03-03 Published:2023-09-07

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摘要： 目的 探讨4种口腔修复材料对咀嚼及牙龈功能的影响。方法 收集2019年10月—2022年1月行口腔修复治疗的167例牙体缺损患者,随机分为4组,即纯钛组41例、钴铬合金组40例、镍铬合金组43例和二氧化锆组43例。记录4组治疗后6个月疗效及满意度,记录并比较4组治疗前及治疗后6个月的咀嚼功能(咀嚼效率、咬合力)和牙龈功能[菌斑指数(plaque index, PLI)、牙龈指数(gingival index, GI)、龈沟出血指数(sulcus bleeding index, SBI)]、龈沟液炎症相关指标[肿瘤坏死因子(tumor necrosis factor alpha, TNF-α)、白介素6 (interleukin-6, IL-6)、天冬氨酸转氨酶(aspartate aminotransferase, AST)及碱性磷酸酶(alkaline phosphatase, ALP)]。采用 SPSS 20.0软件包对数据进行统计学分析。结果 4组的疗效具有可比性(P>0.05)。治疗前后,4组的咀嚼效率和咬合力具有可比性(P>0.05),与治疗前比,治疗后4组的咀嚼效率和咬合力显著增高(P<0.05)。治疗前,4组的PLI、GI、SBI、龈沟液重量、龈沟液中TNF-α、IL-6、AST和ALP具有可比性(P>0.05),与治疗前比,治疗后4组的PLI、GI和SBI显著降低(P<0.05),降低顺序为钴铬合金组≈镍铬合金组<纯钛组<二氧化锆组。治疗前,4组的龈沟液重量、龈沟液中TNF-α、IL-6、AST和ALP具有可比性(P>0.05),与治疗前比,治疗后4组的龈沟液重量、龈沟液中TNF-α、IL-6、AST和ALP显著增高(P<0.05),增高顺序为二氧化锆组<纯钛组<钴铬合金组≈镍铬合金组。4组的修复体完整性、颜色满意度具有可比性(P>0.05),4组的边缘适合性、敏感性满意度差异显著(P<0.05)。结论 纯钛、钴铬合金、镍铬合金及二氧化锆均可用于牙体缺损治疗,可获得满意的咀嚼功能;但与纯钛、钴铬合金、镍铬合金相比,二氧化锆具有改善牙龈功能及龈沟液炎症的作用,具有更广阔的应用前景。

关键词: 牙体缺损, 口腔修复材料, 咀嚼功能, 牙龈功能

Abstract: PURPOSE: To investigate the effect of 4 kinds of prosthodontic materials on masticatory and gingival function. METHODS: A total of 167 patients with dental defects who underwent prosthodontic treatment from October 2019 to January 2022 were collected. They were randomly divided into 4 groups with 41 cases in the pure titanium group, 40 cases in the cobalt-chromium alloy group, 43 cases in the nickel-chromium alloy group and 43 cases in the zirconium dioxide group. The curative effect and satisfaction degree after 6 months of treatment in 4 groups were recorded and compared. The masticatory function (chewing efficiency, bite force), gingival function[plaque index(PLI), gingival index(GI) and sulcus bleeding index(SBI)], gingival crevicular fluid inflammation-related indicators[tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6), aspartate aminotransferase(AST) and alkaline phosphatase (alkaline phosphatase, ALP)] before and after treatment were measured and compared in 4 groups. Statistical analysis was performed with SPSS 20.0 software package. RESULTS: There was no significant difference in curative effect in 4 groups(P>0.05). Before and after treatment, there was no significant difference in mastication efficiency and bite force in 4 groups(P>0.05). Before treatment, there was no significant difference in PLI, GI, SBI, gingival crevicular fluid weight, TNF-α, IL-6, AST and ALP in gingival crevicular fluid in 4 groups(P>0.05). Compared with before treatment, PLI, GI and SBI in 4 groups were decreased after treatment (P<0.05), and the decrease was in the order of cobalt-chromium alloy group≈nickel-chromium alloy group<pure titanium group<zirconia dioxide group. Before treatment, there was no significant difference in the weight of gingival crevicular fluid, TNF-α, IL-6, AST and ALP in gingival crevicular fluid in 4 groups(P>0.05). The crevicular fluid weight, TNF-α, IL-6, AST and ALP in gingival crevicular fluid were significantly increased(P<0.05), and the increase was in the order of zirconia group<pure titanium group<cobalt-chromium alloy group≈nickel-chromium alloy group. There was no significant difference in restoration integrity and color satisfaction in 4 groups(P>0.05), but there was significant difference in marginal fitness and sensitivity satisfaction in 4 groups(P<0.05). CONCLUSIONS: Pure titanium, cobalt-chromium alloy, nickel-chromium alloy and zirconium dioxide can be used for the treatment of dentition defects, and they all can obtain satisfactory chewing function. In addition, zirconium dioxide restoration has the effect of improving gingival function and inflammation-related indicators of gingival crevicular fluid with a broader application prospect.

Key words: Tooth defect, Prosthodontic materials, Masticatory function, Gingival function

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