不同酸蚀技术用于恒切牙冠折断冠再接的临床观察

Clinical study on the reattachment of permanent incisor teeth with crown fracture using different etching adhesives

关键词:  断冠再接  全酸蚀粘结  自酸蚀粘结  选择性酸蚀

Key words:  reattachment  total etching adhesive  self-etching adhesive  selective etching

摘要:

目的　探讨3种不同酸蚀技术用于恒切牙冠折断冠再接的临床疗效。方法　63颗冠折恒切牙分为未露髓25颗，露髓38颗，按就诊顺序分别用随机数字表法各分为A、B、C 3组（每组两项共计21颗），其中A组未露髓8颗，B组8颗，C组9颗。根据牙髓暴露情况及牙根发育情况对牙髓做间接盖髓术、直接盖髓术、活髓切断术或根尖诱导成形术。应用“内部倒凹+舌侧排溢道+唇侧洞斜面”技术预备牙体组织与断冠。A组使用全酸蚀粘结技术（35%Gluma+Single Bond 2），B组使用自酸蚀粘结技术（3M Easy One），C组使用选择性釉质酸蚀加自酸蚀粘结技术（35%Gluma+3M Easy One）进行自体牙断冠再接。随访2年评价3组的成功率和术后1周的敏感状况。结果　3组的成功率分别为90.5%、85.7%和90.5%，术后一过性敏感率分别为25%、0%和0%，3组间比较差异均无统计学意义（P>0.05）。结论　不同酸蚀技术用于恒切牙冠折断冠再接的临床疗效是相同的。

Abstract:

Objective　To evaluate the clinical efficacy of three etching adhesives for the reattachment of crown fractured permanent incisor teeth.Methods　Using table of random number, 63 crown fractured permanent incisor teeth without pulp exposed and with pulp exposed were separately divided into group A, B and C, with 21 cases in each group. Group A, B and C without pulp exposed were 8 teeth, 8 teeth and 9 teeth, respectively. After protective measures for the pulp and teeth preparation (internal undercut + lingual row overflow Canal + lip side bevel) were completed, the reattachment was performed using three etching adhesives, which were group A (total etching adhesive), group B (self-etching adhesive) and group C (selectively etching enamel + self-etching adhesive), and was assessed clinically with 24 months follow-ups.Results　The success rates in group A, B and C were 90.5%, 85.7% and 90.5%, respectively, with no significant difference among them. The rates of transient sensitivity after operation in a week were 25%, 0% and 0%, respectively, with no significant difference among them.Conclusion　Three different etching adhesives have the same clinical efficacy in reattachment.