铸造桩核与纤维桩核的疗效比较

作者单位：浙江省南京军区杭州疗养院海勤疗养区,310002

[摘要]目的比较铸造桩核与纤维桩核对残根、残冠牙的修复效果。方法取根管治疗完善的残根，残冠牙142例。60例铸造桩核修复，82例纤维桩核修复，随访2年。从牙根松动，桩核脱落，根折，牙龈变色四方面观察其修复后疗效。结果 铸造桩核60例中，出现根折1例，桩核脱落3例，牙龈变色8例。纤维桩核82例中无不良症状。结论 纤维桩核与牙根组织结合较密切、均衡牙根应力分布及较好的美观性，疗效明显优于铸造桩核。

[关键词] 铸造桩核；纤维桩核；残根；残冠

[Abstract]  Objective To compare the effect of two restoratory systems to residual crown and residual root with pose core crown. Methods 142 cases with perfect RCT were taken, 60 cases are done with casting metal post core crown. Others are done with fiber post core crown. Then observe for 2 years. The effect was estimated from 4 aspects; the movability of root; the stability of the core; root fracture or not; and the gum around the prostheis. Results Within the 60 cases treated with casting metal post core crown, one happens root facture, three cores shed from root, and eight happen gingival discolor. But other 82 cases work well and have no adverse sign. Conclusion Fiber post core crown adhere to root stronger, it also can balance the stress, and further more achieve better beauty. The treatment with fiber post core crown is superior to the other method.

[Key words]  cast post and core; fiber post and core; residual root; residual crown

对有保留价值的残冠、残根，通常给予完善的根管治疗后，进行桩核冠修复。一般使用根管螺纹钉+树脂塑核、铸造桩核。近年来较多地使用纤维桩核进行修复。2005年以来，我科对铸造桩核与纤维桩核在临床应用中的近远期效果进行了比较，探讨铸造桩核与纤维桩核的优缺点。

1.资料与方法

1.1 临床资料 选择根管经过完善治疗的患牙142颗，年龄在20～56岁，男性46人，女性38人。其中铸造桩核60例：上颌31例，下颌29例，前牙29例，前磨牙24例，后磨牙8例。纤维桩核82例：上颌52例，下颌30例，前牙42例，前磨牙31例，后磨牙9例。

1.2 修复方法 对残冠、残根进行完善的根管治疗后观察2～3周，无临床症状后，根据患牙的不同位置，根管内牙胶尖充填的工作长度，参照X线片估计牙根的长度、方向，观察根管充填情况与根尖周情况，选择合适的器械，行桩核修复。根管内桩的长度：(1)保证桩处于牙槽骨内的长度>根在牙槽骨内总长度的1/2；(2)根尖封闭≥4mm；(3)保证让桩的长度≥临床冠的长度[1]。桩核修复后用烤瓷冠最终修复。