目的:探讨4种口腔修复材料对咀嚼和牙龈功能的影响。
方法:收集2019年10月至2022年1月接受口腔修复治疗的167例牙体缺损患者。将其随机分为4组,其中纯钛组41例,钴铬合金组40例,镍铬合金组43例,二氧化锆组43例。记录并比较4组患者治疗6个月后的疗效及满意度。咀嚼功能(咀嚼效率,咬合力),牙龈功能[菌斑指数(PLI),牙龈指数(GI)和沟出血指数(SBI)],龈沟液炎症相关指标[肿瘤坏死因子α(TNF-α),白细胞介素-6(IL-6),天冬氨酸转氨酶(AST)和碱性磷酸酶(碱性磷酸酶,ALP)]治疗前后测定并比较4组。采用SPSS20.0软件包进行统计学分析。
结果:4组疗效差异无统计学意义(P>0.05)。治疗前后,4组咀嚼效率和咬合力差异无统计学意义(P>0.05).治疗前,PLI没有显着差异,GI,SBI,龈沟液重量,TNF-α,4组龈沟液中IL-6、AST和ALP的表达(P>0.05).与治疗前相比,PLI,4组患者治疗后GI、SBI均下降(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,龈沟液的重量没有显着差异,TNF-α,4组龈沟液中IL-6、AST和ALP的表达(P>0.05).颌骨流体的重量,TNF-α,龈沟液中IL-6、AST、ALP明显升高(P<0.05),增加顺序为氧化锆组<纯钛组<钴铬合金组≈镍铬合金组。4组修复体完整性和颜色满意度比较差异无统计学意义(P>0.05)。但4组患者的边缘适应度和敏感性满意度差异有统计学意义(P<0.05).
结论:纯钛,钴铬合金,镍铬合金和二氧化锆可用于治疗牙列缺陷,它们都可以获得令人满意的咀嚼功能。此外,二氧化锆修复具有改善牙龈功能和龈沟液炎症相关指标的作用,具有广阔的应用前景。
OBJECTIVE: 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.