Abstract:

Objective To evaluate the effect of repairing posterior teeth with subgingival defects with onlays after deep margin elevation and to provide a reference for clinical application.Methods Eighty-six cases of posterior teeth with subgingival defects were treated with resin filling to elevate the subgingival margin to the superior gingival margin and were then restored with onlays of cast porcelain. Patients were followed up at 1 week, 6 months and 12 months. The wear and tear of the restorations, fractures of the restorations, loss of the restorations, marginal closeness, marginal staining, secondary caries and gingival health were examined. Assessment of efficacy with reference to American public health service standards was conducted. Results One week after the operation, there was no loss of follow-up. Eighty-six cases of onlays had no prosthetic wear, prosthetic fracture, prolapse of the prosthesis, edge adhesion, edge coloration, secondary caries, etc., and the gums were healthy. At 6 months after surgery, 2 patients were lost to follow-up and 4 of the remaining 84 onlays were detached. After re-adhesion, there was no shedding. At 12 months after surgery, 5 cases were lost to follow-up and 81 cases of onlays demonstrated no further prosthetic wear, prosthetic fracture, prolapse of the prosthesis, edge adhesion, edge coloration, secondary caries, etc., and the gums were healthy. The success rate after 12 months of repair was 95.1% (77/81).Conclusion For posterior teeth with a subgingival defect, onlays of cast porcelain have the advantages of a high success rate, convenient clinical operation and no influence on periodontal health to restore posterior teeth after deep margin elevation.

Key words: molar, tooth defect, deep margin elevation, resin, all-ceramic onlay, margin sealing property, periodontal health, secondary caries

摘要：

目的 对龈壁提升后高嵌体修复龈下缺损后牙的效果进行评估,为临床应用提供参考。方法 86例有龈下缺损的后牙,用树脂充填将龈下边缘变为龈上边缘进行龈壁提升后再用铸瓷高嵌体修复,修复1周、6个月、12个月复诊,检查修复体磨耗、修复体折裂、修复体脱落、边缘密合性、边缘着色、继发龋、牙龈健康状况,参照美国公众卫生健康服务标准评估疗效。结果 术后1周复查,无失访,86例嵌体无修复体磨耗、修复体折裂、修复体脱落、边缘着色、继发龋等情况,牙龈健康。术后6个月,失访2例,84例嵌体有4例嵌体脱落,重新粘固后,随访至今无脱落。术后12个月,失访新增3例,81例嵌体均未发生修复体磨耗、修复体折裂、修复体脱落、边缘着色、继发龋等情况,牙龈健康。修复后12个月成功率为95.1%（77/81）。结论 对于龈下缺损后牙,龈壁提升后用铸瓷高嵌体修复后牙具有修复成功率高、临床操作方便、不影响牙周健康的优点。

关键词: 磨牙, 牙体缺损, 龈壁提升, 树脂, 全瓷高嵌体, 边缘密合性, 牙周健康, 继发龋