Four year's clinical evaluation of glass fiber reinforced resin-bonded fixed partial denture as a periodontal splint to replace lost anterior teeth

目的 评价玻璃纤维增强复合树脂粘接义齿修复前牙缺失的临床存活率并分析其影响因素.方法 选择1～3颗前牙缺失、缺牙区邻牙牙周支持丧失严重、不符合种植义齿及全冠固位固定义齿修复条件的30例患者,制作玻璃纤维(Everstick C&B)增强复合树脂粘接义齿30个.采用树脂粘接系统(Superbond C&B)进行粘接固定修复.在修复即刻、修复后1、2、3、4年分别对义齿的完全存活率、功能存活率、基牙牙槽骨高度进行记录和评估,分析失败原因.采用完全随机的单因素方差分析及卡方检验分析基牙骨高度变化.结果 修复1～3年后,每年分别出现义齿连接体折裂1例,经过树脂修补后继续使用.第3、4年各有1例连接体再次折裂后义齿整体脱落.4年随诊后,30例玻璃纤维增强复合树脂粘接义齿的完全存活率为83％ (25/30),功能存活率为93％ (28/30).22％ (13/60)的邻牙骨高度降低,而另外78％ (47/60)的邻牙骨高度增加,与修复后第1年相比差异有统计学意义(P＜0.05),邻牙牙周状况得到改善.结论 4年临床观察显示,对于1～3颗前牙缺失合并邻近基牙牙周支持受损的患者,玻璃纤维增强复合树脂粘接义齿是一种可行的固定修复方式.Objective To evaluate the clinical performance of glass fiber reinforced resin-bonded fixed partial denture(GFR-RBFPD) as a periodontal splint on abutment teeth with reduced periodontal support.Methods Thirty fixed-fixed GFR-RBFPD were delivered to restore anterior partial edentulous dentitions.The adjacent abutment teeth had severely reduced periodontal support and were not indicated for full crown retained FPD.The success rate and functional survival rate had been recorded and the periodontal condition had been evaluated for 4 years.The results were statistically analyzed with single factor variance analysis and chi square test(α=0.05).Results In the first,second,and third year following restoration,one connector fractured in each year and they were repaired with adhesive resin and the pontics were kept in place for function.In the third and fourth years after restoration,there was one pontic displacement with fracture of connectors.The total survive rate was 83％(25/30) and the functional survival rate was 93％ (28/30) at the end of the fourth year.The main reason of failure was fracture of connector.About 22％(13/60) of the adjacent teeth showed marginal bone height decrease,while the other 78％ (47/60) increased with statistic significant difference from one year after the restoration to the end of the observation term(P＜0.05).The periodontal condition of the adjacent teeth was improved after the restoration.Conclusions The four years clinical evaluation indicates that the GFR-RBFPD may be used as fixed prostheses to replace lost one to three anterior teeth with reduced periodontal support of abutment teeth.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)276-805