摘要
目的:评价瓷贴面修复连续下前牙黑三角的临床效果,为瓷贴面在减小黑三角美学修复中的应用提供参考。方法:对存在连续多颗下前牙黑三角的12名患者共45颗患牙采用邻面扩展型瓷贴面修复,向龈方下移邻面接触点,增宽邻面颈部外形,利用邻面挤压方法进行牙龈塑型。分别在术前、术后即刻、1、6、12、18、24个月测量记录黑三角水平向和垂直向的数值变化,并在每次复查时参照美国公共卫生署USPHS的修正标准对瓷贴面的修复体完整性、颜色匹配、边缘着色、边缘适合性、表面粗糙度、继发龋、术后敏感和牙龈健康状况等8项指标进行临床效果评价。结果:有1位患者(4个瓷贴面,3个黑三角)在术后12个月时失访,其余11名患者全部完成随访。术后即刻与术前相比,黑三角的水平距离由(2.71±0.61)mm减小至(1.10±0.42)mm,垂直距离由(5.46±0.66)mm减小至(2.64±0.41)mm,差异具有统计学意义(P<0.05)。术后1个月与术后即刻相比黑三角的水平距离由(1.10±0.42)mm减小至(1.01±0.42)mm,垂直距离由(2.64±0.41)mm减小至(2.56±0.41)mm,差异具有统计学意义(P<0.05)。术后1、6、12、18、24个月之间比较,黑三角的数值差异不具有统计学意义(P>0.05)。术后即刻有3颗(6.7%)基牙出现轻度敏感,贴面粘固后缓解,其余指标检查在术后即刻和术后1个月均未见明显异常,各项评价标准达到Ⅰ级。术后6个月,2颗(4.4%)贴面舌侧边缘轻微着色,3颗(6.7%)基牙牙龈轻度探诊出血。术后12个月,5颗(12.2%)轻微着色,1颗(2.4%)轻微间隙,5颗(12.2%)牙龈轻度探诊出血。术后18个月,7颗(17.1%)轻微着色,4颗(9.8%)轻微间隙,7颗(17.1%)牙龈轻度探诊出血。术后24个月,8颗(19.5%)轻微着色,6颗(14.6%)轻微间隙,8颗(19.5%)牙龈轻度探诊出血。所有贴面在随访期间均未出现崩瓷、折裂或者脱落,颜色匹配良好,基牙无继发龋。结论:瓷贴面修复减小连续下前牙黑三角能获得良好的美学效果,具有一定的临床意义。
Objective:To evaluate the clinical effect of porcelain veneers for the restoration of continuous mandibular anterior teeth with gingival black triangle,and to provide reference for the application of porcelain veneers in the aesthetic restoration of reduced black triangles.Methods:A total of 45 teeth in 12 patients with continuous mandibular anterior teeth with gingival black triangle were repaired with adjacent extended porcelain veneer.The adjacent contact point was moved down to the gingival direction,the adjacent cervical profile was widened,and the gingival shape was molded by extrusion.The changes in the horizontal and vertical values of the black triangle were measured and recorded preoperatively,immediately postoperatively,and 1,6,12,18,24 months postoperatively,and the clinical outcomes of the porcelain veneers were evaluated at each review with reference to the USPHS modified criteria for restoration integrity,color matching,margin staining,margin fit,surface roughness,secondary caries,postoperative sensitivity,and gingival health.Results:One patient(4 porcelain veneers,3 black triangles)was lost at 12 months postoperatively,while the remaining 11 patients all completed follow-up.The horizontal distance was reduced from(2.71±0.61)mm to(1.10±0.42)mm,and the vertical distance was reduced from(5.46±0.66)mm to(2.64±0.41)mm immediately,and the difference was statistically significant(P<0.05).The horizontal distance was reduced from(1.10±0.42)mm to(1.01±0.42)mm and the vertical distance was reduced from(2.64±0.41)mm to(2.56±0.41)mm at 1 month postoperatively compared with the immediate postoperative period,and the difference was statistically significant(P<0.05).The difference in the value of the black triangle from 1 to 24 months postoperatively was not statistically significant(P>0.05).Three(6.7%)abutment teeth showed mild sensitivity immediately after operation,which was relieved after veneer bonding.The other indicators did not show any abnormality after operation and 1 month after operation,and the evaluation criteria reached grade I.At 6 months after operation,2(4.4%)had slight staining on the lingual margin,and 3(6.7%)had slight bleeding on the gingival probing.At 12 months after operation,5(12.2%)had slight staining,1(2.4%)had slight gap,and 5(12.2%)had mild bleeding on probing.At 18 months after operation,7(17.1%)had slight staining,4(9.8%)had slight gap,and 7(17.1%)had slight bleeding on gingival probing.At 24 months after operation,8(19.5%)had slight staining,6(14.6%)had slight gap,and 8(19.5%)had slight bleeding on gingival probing.All veneers did not collapse,fracture or fall off during the follow-up period,with good color matching and no secondary caries in the abutment teeth.Conclusion:Porcelain veneer can reduce the black triangle of continuous lower anterior teeth and obtain good aesthetic results,and has certain clinical significance.
作者
宋春平
丛景科
王明臻
SONG Chun-ping;CONG Jing-ke;WANG Ming-zhen(Department of Prosthodontics,Qingdao Stomatological Hospital,Qingdao Clinical Research Center for Oral Diseases,Qingdao 266000,China)
出处
《口腔颌面修复学杂志》
2023年第3期180-185,共6页
Chinese Journal of Prosthodontics
基金
青岛市医疗卫生重点学科建设项目(项目编号:2020-2022)。
关键词
瓷贴面
黑三角
龈乳头退缩
美学
porcelain veneer
gingival black triangle
gingival papilla retraction
aesthetics
