氧化锆全瓷冠对上颌中切牙外伤性缺损修复后牙周健康及不良事件的影响评估

Effects of zirconia all-ceramic crowns on periodontal health and adverse events after restoration of traumatic defects in maxillary central incisors

摘要:

目的 评估氧化锆全瓷冠修复上颌中切牙外伤性缺损后的牙周健康及不良事件发生情况。方法 回顾性分析2022年6月—2024年10月在西安交通大学第一附属医院接受氧化锆全瓷冠修复治疗的104例上颌中切牙外伤性缺损患者的临床资料，根据治疗方式不同分为实验组（52例，采用氧化锆全瓷冠修复）和对照组（52例，采用金属桩钴铬烤瓷冠修复）。比较两组患者的牙周健康［菌斑指数（PLI）、牙龈指数（GI）、探诊出血（BOP）阳性率］、牙周生物标志物［基质金属蛋白酶-8（MMP-8）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）］、修复效果（美学指标、功能指标、生物学指标）、美学效果［红色美学指数（PES）、白色美学指数（WES）］及不良事件发生情况。结果 实验组治疗前后PLI、GI、BOP阳性率的差值均大于对照组（P <0.05）。实验组治疗前后MMP-8、TNF-α、CRP的差值均大于对照组（P <0.05）。实验组美学指标、功能指标和生物学指标评分均低于对照组（P <0.05）。实验组治疗前后PES、WES评分的差值均大于对照组（P <0.05）。实验组与对照组不良事件总发生率比较，差异无统计学意义（P >0.05）。结论 氧化锆全瓷冠在修复上颌中切牙外伤性缺损中具有较好的临床效果，能够显著改善牙周健康状况，安全性良好，具有较高的应用价值。

Abstract:

Objective To evaluate periodontal health and adverse events after restoration of traumatic defects in maxillary central incisors with zirconia all-ceramic crowns.Methods The clinical data of 104 patients with traumatic defects in maxillary central incisors who underwent restoration at the First Affiliated Hospital of Xi'an Jiaotong University between June 2022 and October 2024 were retrospectively analyzed. According to treatment, the patients were divided into an experimental group (n = 52; zirconia all-ceramic crowns) and a control group (n = 52; metal posts and cobalt-chromium porcelain-fused-to-metal crowns). Periodontal health [plaque index (PLI), gingival index (GI), and bleeding on probing (BOP) positivity], periodontal biomarkers [matrix metalloproteinase-8 (MMP-8), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP) ], restoration outcomes (esthetic, functional, and biological indices), esthetic outcomes [pink esthetic score (PES) and white esthetic score (WES) ], and adverse events were compared between the groups.Results The pre- to post-treatment changes in PLI, GI, and BOP positivity were greater in the experimental group than in the control group (P < 0.05). The changes in MMP-8, TNF-alpha, and CRP levels were also greater in the experimental group than in the control group (P < 0.05). Esthetic, functional, and biological index scores were lower in the experimental group than in the control group (P < 0.05). The changes in PES and WES were greater in the experimental group than in the control group (P < 0.05). The overall incidence of adverse events did not differ significantly between the groups (P > 0.05).Conclusion Zirconia all-ceramic crowns have good clinical efficacy for restoring traumatic defects in maxillary central incisors, improve periodontal health, and have a favorable safety profile.