摘要目的 观察树脂与烤瓷贴面修复氟斑牙的临床改变,为氟斑牙的修复提供依据.方法 2005-2008年,在哈尔滨医科大学附属口腔医学院口腔修复科,将56名重度氟斑牙患者分为烤瓷组和树脂组,烤瓷组应用烤瓷贴面法修复,共25人,162颗牙;树脂组以复合树脂贴面修复,共31人,201颗牙.在修复完成时应用Easyshade电脑比色仪检测2种贴面的颜色;在修复后18个月,除用电脑比色仪检测贴面颜色外,还检查贴面的边缘密合度、固位、基牙继发龋情况,并按颜色、外形、功能、感觉对临床效果进行综合评价.结果 烤瓷组、树脂组在修复完成时色差值分别为0.27±0.20、0.21±0.15,18个月后分别为0.28±0.21、0.77±0.68.树脂组修复完成时的色差值低于修复后18个月(t=-13.55,P<0.01);18个月后,烤瓷组的色差值低于树脂组(t=-12.60,P<0.01).烤瓷组修复后18个月,牙齿密合度A级百分比[100%(162/162)]高于树脂组[91.04%(183/201),χ2=15.26,P<0.01].烤瓷组的临床效果分别为优、一般、失败的牙齿数分别为158、4、0,树脂组分别为148、56、4,烤瓷组的临床效果优于树脂组(χ2=44.24,P<0.01).结论 烤瓷贴面颜色比树脂贴面持久性好;烤瓷贴面的边缘密合度和临床效果优于树脂贴面,但两种修复方法的远期疗效,尤其是树脂贴面有待进一步研究.

abstractsObjective To observe the clinical changes in resin and porcelain veneer in restoring dental fluorosis in order to provide a basis for the repair of dental fluorosis. Methods Fifty six severe dental fluorosis patients were divided into porcelain and resin teeth group in the department of Prosthetics, school of Stomatology, Harbin Medical University during 2005 to 2008. All 162 teeth of 25 patients in porcelain group were veneered with porcelain. 201 teeth of 31 patients in resin group were repaired with resin. To evaluat the clinic effect, the veneer surface color was detected by the Easyshade computer-aided colorimeter when the repair was completed and 18 months afterward. The edge of veneer adaptation, retention, secondary caries and abutment were examined after 18 months, and classified by color, shape, function and feeling. Results The color difference between the porcelain and resin teeth group was 0.27±0.20 and 0.21±0.15 when it was completed, and it was 0.28±0.21 and 0.77± 0.68 respectively after 18 months. The color difference value of the porcelain teeth group was lower when it was completed than 18 months later(t=-13.55, P<0.01). The color difference value of the resin teeth group was lower than the porcelain teeth group after 18 months(t=-12.60, P<0.01). The percentage of level A of veneer adaptation in the porcelain group[100%(162/162)] was higher than the resin group[91.04% (183/201), χ2=15.26, P< 0.01) after 18 months. The clinical effect was divided into three degrees of excellent, moderate or failed, into which the number of the teeth catergorized was 158, 4 and 0 in porcelain group, 148, 56 and 4 in resin group respectively. The clinical effect of the porcelain group was superior to the resin group(χ2=44.24, P<0.01). Conclusions The surface color of porcelain veneer last 16nger than the resin veneer, the adaptation and clinical effect is also superior to the resin veneer. But the long-term efficacy of two methods needs further study, especially of the resin veneer.