【作者】 卓锋；

【导师】 汲平；

【作者基本信息】 山东大学 ， 口腔临床医学， 2008， 硕士

【摘要】 目的:通过对不同材料的烤瓷熔附金属全冠(PFM)修复后对基牙不同时期进行临床指标观察和龈沟液(GCF)的量以及TNF-α,IL-6浓度水平的测定,来研究PFM修复后基牙GCF量的变化与牙周指标的关系,探讨TNF-α,IL-6的浓度水平与牙周组织健康的关系及不同的内冠材料对牙周组织的影响。方法:随机选择30例分别接受镍铬合金烤瓷冠、镍铬合金镀金烤瓷冠、金沉积烤瓷冠和金铂合金烤瓷冠修复上前牙的患者为实验对象,在严格限定轴面外形、边缘适合性、牙周状况、冠边缘等方面的情况下,选取符合标准的PFM40颗,分为四组,每组10颗。在修复前,修复后一个月和六个月时用2mm×10mm的滤纸条在唇、舌侧的近远中轴角处用滤纸吸着法分别取其龈沟液,同时记录临床观察指标,以修复前为基准,采用ELISA法进行TNF-α,IL-6浓度水平的检测,分析GI、GCD、GCF的量与TNF-α,IL-6水平在修复前后的变化关系。结果:1.镍铬合金组PFM修复后一个月、六个月其临床指标、GCF量、GCF中TNF-α的量与修复前相比有显著性差异。2.镍铬合金镀金组PFM修复后一个月其临床指标、GCF量、GCF中TNF-α的量与修复前相比未出现显著性差异,而修复后六个月其临床指标、GCF量、GCF中TNF-α的量与修复前相比有显著性差异。3.金沉积组、金铂合金组PFM修复后一个月和六个月其临床指标、GCF量、GCF中TNF-α的量与修复前相比均未出现显著性差异。4.镍铬合金组与镍铬合金镀金组在PFM修复后一个月时临床指标、GCF量、GCF中TNF-α的浓度有显著性差异,六个月时未出现显著性差异。5.镍铬合金组与金沉积组、金铂合金组相比在PFM修复后一个月、六个月时临床指标、GCF量、GCF中TNF-α的浓度与修复前相比均有显著性差异。6.镍铬合金镀金组与金沉积组、金铂合金组在PFM修复后一个月时临床指标、GCF量、GCF中TNF-α的量无显著差异,在六个月时有显著差异。7.金沉积组与金铂合金组相比在PFM修复后一个月、六个月时临床指标、GCF量、GCF中TNF-α的浓度无显著差异。8.4种不同内冠材料在戴入1个月、6个月时对GCF中IL-6的影响材料之间的差别不具有显著性。结论:1.不同种类金属基底PFM对牙龈组织均有刺激性,但程度不一。2.镍铬合金和镍铬合金镀金比金沉积、金铂合金更易导致牙周组织的炎性改变,因此在临床上应尽可能采取贵金属烤瓷修复。3.本实验以GI、GCD、GCF分泌量,IL-6和TNF-α的浓度作为评价牙龈炎症的指标,这对于监测不同种类金属基底PFM的临床应用效果有一定参考价值。更多还原

【Abstract】 Objective:To investigate the changes of gingival crevicular fluid(GCF)volume and the level of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in GCF during different materials porcelain-fused-to-metal(PFM)crowns restoration.The relationship between the the level of interleukin-6(IL-6)、tumor necrosis factor-α(TNF-α)and the health of periodontal tissue was discussed and the effect of different inner crown materials on periodontal tissue was explored.Methods:The anterior teeth of 30 patients by random were conceived the restoration of Ni-Cr alloy PFM,gilt Ni-Cr alloy PFM,auro-galvano-crown PFM,and Au-Pt alloy PFM.Under the circumstances of strictly limiting crown axial contour,margin adaptation and periodontal conditions,the margin of crowns,a total of 40 teeth selected.They were divided into 4 groups,of which per group were 10 teeth.GCF was collected from labial and lingual of mesial site and distal site before the tooth preparation by 3MM filter paper.At the point of 1 month and 6 months after cementation,GCF collected at the same sites.At same time,clinical observation indexes were recorded.Before preparation,the volume of GCF and the level of IL-6 and TNF-αwere regarded as the baseline.The level of IL-6 and TNF-αwere detected by ELISA(enzyme-linked-immunosorbent assay)method,and analyzed the variation between the pre-restoration and post-restoration.Results:1.Compared to pre-restoration,the clinical observation indexes,the volume of GCF, the amount of TNF-αin GCF have marked difference in Ni-Cr alloy group after 1 month and 6 months.2.Compared to pre-restoration,the clinical observation indexes,the volume of GCF, the amount of TNF-αin GCF have no conspicuous difference in gilt Ni-Cr alloy group after 1 month;however,they have marked difference after 6 months.3.Compared to pre-restoration,the clinical observation indexes,the volume of GCF, the amount of TNF-αin GCF have no conspicuous difference in auro-galvano-crown and Au-Pt alloy group after 1 or 6 months.4.Compared to gilt Ni-Cr alloy group,the clinical observation indexes,the volume of GCF,the amount of TNF-αin GCF have marked difference in Ni-Cr alloy group after 1 month;however,they have no conspicuous difference after 6 months.5.Compared to auro-galvano-crown and Au-Pt alloy group,the clinical observation indexes,the volume of GCF,the amount of TNF-αin GCF have marked difference in Ni-Cr alloy group afterl or 6 months.6.Compared to auro-galvano-crown and Au-Pt alloy group,the clinical observation indexes,the volume of GCF,the amount of TNF-αin GCF have no conspicuous difference in gilt Ni-Cr alloy group after 1 month;however,they have marked difference after 6 months.7.Compared to Au-Pt alloy group,the clinical observation indexes,the volume of GCF,the amount of TNF-αin GCF have no conspicuous difference in auro-galvano-crown group after 1 or 6 months.8.Among the four kinds of crowns,there were no significant differences in IL-6 level at the 1 or 6 months.Conclusions:1.Different metal base alloys had different effects on the gingiva.2.Compared to auro-galvano-crown and Au-Pt alloy,Ni-Cr alloy and gilt Ni-Cr alloy were susceptible to inflammation of the periodontal tissue.Therefore,we should take noble metal PFM as possible as we can in the clinic.3.These 5 indexes,namely GI,GCD,GCF,IL-6 and TNF-α,can reflect the effect of different metal base alloy of PFM on the gingiva.Being used as evaluating indicators,they were definitely valuable for appraising the clinical effect of different PFM.更多还原