【作者】 马守治；

【导师】 闫??程辉；

【作者基本信息】 福建医科大学 ， 口腔临床医学， 2005， 硕士

【摘要】 目的 (1)探讨不同材料的全冠龈边缘对Beagle犬牙周环境的影响。(2)探讨全冠龈边缘对人牙周环境的影响。 方法 (1)用手用龈上、龈下刮治器对4只Beagle犬进行全口龈上洁治、龈下刮治。三周后,对49颗犬牙行瓷熔附金属(porcelain fused metal,PFM)冠修复术,PFM冠的唇侧边缘为烤瓷边缘,舌侧边缘为金属边缘,均与龈缘平齐。于牙体预备前和PFM冠经玻璃离子水门汀粘固后4周,分别记录实验牙(唇侧近中、远中,舌侧近中、远中)菌斑指数(plaque index,PLI)、牙周探诊深度(probing depth,PD)、龈沟出血指数(sulcus bleeding index,SBI),测量龈沟液量(gingival crevicular fluid,GCF),并检测龈沟液中天冬氨酸转氨酶(aspartate aminotransferase,AST)的水平。整个实验过程每周给予旋转刷牙法刷牙1次。(2)对需作全冠或双端固定桥(固位体为全冠)修复并符合纳入标准的20名患者的30颗天然牙,在牙体预备前、暂时冠经氧化锌水门汀粘固后1周和全冠或双端固定桥经玻璃离子水门汀粘固后7周,分别记录其颊侧牙龈(近中位点、远中位点)的PLI、PD、SBI,并测量其GCF量、GCF-AST活性。全冠或固定桥粘固前后分别测量冠边缘间隙。暂时冠和全冠粘固后对患者各进行口腔健康教育1次。 结果 (1)动物实验结果表明,PFM冠粘固后4周,舌侧牙龈的PD、PLI≥1的频率、GCF量、SBI≥2频率、AST活性明显增加(P<0.01);颊侧牙龈的PD、PLI≥1的频率、GCF量均无明显变化,SBI≥2的频率、AST活性明显增加(P<0.05);两组GCF量、SBI≥2频率、AST活性有明显的差异(P<0.05)。(2)临床实验结果表明,暂时冠粘固后1周或全冠粘固后7周,暂时冠、全冠(烤瓷组、金属组、龈上组、龈下组)对应牙龈的PD、SBI≥2频率、GCF量及GCF-AST活性没有明显变化,PLI≥1的频率明显下降(P<0.01;全冠粘固后冠边缘间隙明显增加(P<0.01),增加量与粘固前边缘间隙大小呈负相关。 结论 (1)动物实验表明每周给Beagle犬刷牙1次,PFM冠粘固后4周,烤瓷边缘和金属边缘对应的牙周组织炎症均明显加重,金属边缘对应的牙周组织尤为明显。可能是更多还原

【Abstract】 Objectives (1)To evaluate the influence of different materials of PFM crown margin on periodontal conditions in beagle dogs. (2) To investigate the influence of crowns margin on periodontal conditions of human.Methods (1) Four beagle dogs were utilized in this study. Three weeks after commencing oral hygiene procedures through supragingival scaling and subgingival scaling, forty-nine dog teeth were prepared for receiving porcelain fused metal(PFM) crowns. One week later, the PFM crowns were cemented, whose buccal margins were made of porcelain fused to metal (PFM)and lingual margins were metal. Clinical parameters were recorded on four sites (mesiolongual, mesiobuccal, distobuccal, distoiongual) of all test teeth immediately before tooth preparation and after 4 weeks of cementation of PFM crowns. During the studying period, professional oral hygiene was performed for the Beagles dogs one time a week. (2) Twenty patients requiring 30 artificial crowns were selected for this study, who corresponded with entry provisions. GCF volume , AST in GCF, PD and the frequency of SBI≥2 and PLI≥1 in 20 patients has been examined immediately before the preparation, 1 week after cementation of temporary crowns and 8 weeks after cementation of dural crowns(PFM group, metal group, subgingival group, supragingival group). The marginal opening of crowrrs were measured before and after the cementation. The oral health education was given after the cementation of temporary crowns and durable crowns.Results (1) The results of animal research were that the volumn of GCF, the frequency of PLI≥1 and SBI≥2, PD and the activity of AST in GCF increased significantly for the group of lingual gingiva (P<0.01) in the time of four weeksafter cementation of crowns. For the buccal gingiva margin, the activity of GCF-AST and the frequency of SBI^2 increased significantly (P<0. 05) , but PD, GCF and the frequency of PLI^l didn’ t change significantly. The difference of GCF, the activity of GCF-AST and the frequency of SBI^2 between two groups are significant after A weeks of c.enient.at. ion of crowns (P<0. 05) . (2) The results of clinical research were that GCF volume ,GCF-AST and the frequency of SB1 ^2 did not differ significantly among the groups of before the teeth preparation , 1 week after cementation of temporary crowns and 7 weeks after cemention of crowns(PFM group, metal group, subgingival group, supragingival group) (P>0. 01) , although the frequency of PLI^l decreased significantly (P<0. 01). The marginal opening increased significantly after cementation(P<0. 01), which was negatively correlated to the opening of margin before cementation.Conclusion (1) When professional oral hygiene was performed one time a week, both PFM and metal margins could contribute to periodontal inflammation. The metal contributes to inflammation more greatly than PFM. The reason may be that the degree of plaque adherence to metal is greater than PFM. (2) For 1 week after cementation of temporary crowns and 7 weeks after cementation of durable crowns , there were not unfavourable influence of the best crowns on the periodontal conditions when oral health education was executed. (3) The marginal opening increased significantly after cementation, which was negatively correlated to the opening of margin before cementation within limits .更多还原