口腔疾病防治 ›› 2019, Vol. 27 ›› Issue (3): 198-201.DOI: 10.12016/j.issn.2096-1456.2019.03.011

• 综述 • 上一篇    下一篇

根管治疗后牙齿的微创修复

詹爱平,曾利伟()   

  1. 南昌大学附属口腔医院修复一科,江西省口腔生物医学重点实验室,江西 南昌(330006)
  • 收稿日期:2018-02-25 修回日期:2019-01-26 出版日期:2019-03-20 发布日期:2019-03-20
  • 通讯作者: 曾利伟
  • 作者简介:詹爱平,医师,在读硕士研究生,Email:1036404058@qq.com
  • 基金资助:
    南昌市科技计划项目(HZCG2013HZCG026)

Minimally invasive restoration of endodontically treated teeth

ZHAN Aiping,ZENG Liwei()   

  1. Department of Prothosdontics, Affiliated Stomatological Hospital of Nanchang University, The Key Laboratory of Oral Biomedicine, Nanchang 330006, China
  • Received:2018-02-25 Revised:2019-01-26 Online:2019-03-20 Published:2019-03-20
  • Contact: Liwei ZENG

摘要:

根管治疗后的牙齿修复目标是保护余留牙体组织,恢复牙齿形态、功能和美观,防止细菌微渗漏,保证牙周健康,防止修复体的折裂以及降低对颌牙齿的磨损,本文就根管治疗后剩余牙体组织保存和微创修复方式进行综述。文献复习结果表明,根管治疗后牙齿抗折性降低;余留牙体组织量是影响根管治疗后修复成功重要因素,牙颈部是牙体组织应力集中区,传统的全冠和桩核冠对健康的颈部牙体组织都有一定量的磨除,会进一步降低牙齿的抗折性,增大牙折的风险;随着粘接技术、复合树脂材料以及陶瓷材料的发展,树脂、嵌体、高嵌体、超嵌体及嵌体冠修复牙体缺损时磨除牙体组织较少,可以更好地保存余留牙体组织,特别是颈部牙体组织。根管治疗后牙齿只存在开髓洞形可以直接树脂修复;当存在边缘嵴的缺失,可以根据边缘嵴缺失的数目及剩余牙体组织的厚度选择嵌体、高嵌体、嵌体冠等微创修复方式。

关键词: 牙体缺损, 根管治疗, 嵌体, 高嵌体, 微创, 计算机辅助设计/计算机辅助制造

Abstract:

The aims of tooth restoration of endodontically treated teeth are to protect the remaining dental tissue; restore coronal morphology, functions and aesthetics; prevent bacterial microleakage and ensure periodontal healthy; prevent fracture of the restorations and reduce the wear from antagonist teeth. This article reviews the preservation and minimally invasive restoration of endodontically treated teeth. The results of the literature review show that tooth fracture resistance decreases after root canal treatment, the amount of remaining tooth tissue is an important factor affecting the success of root canal treatment, and the neck is the stress concentration area of tooth tissue, the traditional full crown and postcore crown have a certain amount of abrasion on the healthy neck teeth tissue, which will further reduce the bending resistance of the teeth and may cause the teeth to fracture. With the development of bonding technology, composite resin materials and ceramic materials, there are fewer molar tissues removed when resin, inlay, onlay, overlay and inlay crown are used to repair tooth defects, which can better preserve the remaining tooth tissues, especially the neck tooth tissues. After root canal treatment, only the pulp cavity of the tooth can be directly repaired by resin. When the marginal ridge is absent, minimally invasive restoration methods, such as inlay, onlay, and inlay crown, can be selected according to the number of marginal ridges removed and the thickness of the remaining dental tissue.

Key words: Tooth defect, Root canal treatment, Inlay, Onlay, Minimally invasive, Computer aided design/computer aided manufacturing

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