金属烤瓷冠论文：三种金属材料烤瓷冠对龈沟液中碱性磷酸酶和天冬氨酸转氨酸转氨酶水平的影响.doc

金属烤瓷冠论文：三种金属材料烤瓷冠对龈沟液中碱性磷酸酶和天冬氨酸转氨酸转氨酶水平的影响【中文摘要】烤瓷熔附金属全冠(PFM)因其具有美观、舒适、色泽逼真稳定、咀嚼功能恢复好等优点而被广泛的应用于临床中。镍铬合金PFM由于其价格便宜应用最为广泛。但是局部牙周组织的健康成了薄弱环节,诸如牙龈炎症、变色等严重的影响了冠修复的长期效果。性质稳定极少对牙周组织产生不良影响金合金PFM又因为其昂贵的价格而限制了其临床应用。内冠镀金的镍铬合金PFM价格相对于金合金PFM便宜许多,是一种临床修复中折衷的方法。近年来,通过实验室研究对龈沟液中的一些炎症介质(如细胞因子、酶等)进行分析检测,并结合临床牙周检查,可以早期判断人造冠对局部牙周组织造成的影响,初步探索金属烤瓷冠修复后所出现的系列牙周破坏的发生机制,以便帮助选择合适的冠桥修复体,更好的指导临床应用,延长冠修复体的使用寿命,保障牙周健康。通过对镍铬合金、内冠镀金的镍铬合金、金合金三种材料制成的PFM修复后局部牙龈沟液(GCF)量及龈沟液内碱性磷酸酶(ALP)和天冬氨酸转氨酶(AST)水平进行测定,藉此了解它们对于牙周组织的影响程度,以及它们与牙周组织健康状况的关系。方法：选择临床病例81例,共90颗接受金属烤瓷冠修复的上颌切牙为实验对象,其中镍铬合金烤瓷冠30颗,内冠镀金的镍铬合金烤瓷冠30颗,金合金烤瓷冠30颗。所有病例均在牙冠制备前和粘固后12个月进行复诊,对患牙的牙周状况进行临床评价,检查指标包括菌斑指数(plaque index, PLI)、龈沟出血指数(sulcus bleeding index, SBI)、探诊深度(probing depth, PD)。另外,再分别汲取患牙及对照牙的龈沟液并对其定量,在实验室中对龈沟液样本中的天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP)浓度水平进行对比分析。所得结果用SPSS13.0软件包进行统计学分析。结果：1.镍铬合金烤瓷冠：与备牙前比较镍铬合金烤瓷冠组在粘固12个月后除PLI无明显差异之外,其余指标均有显著增加,明显高于内冠镀金组和金合金烤瓷组。2.内冠镀金的镍铬合金烤瓷冠：与备牙前相比粘固12个月后的各项指标是增加的：虽然粘固后12个月的GCF量、GCF-AST及GCF-ALP水平略高于金合金烤瓷冠组,但明显低于镍铬合金烤瓷牙组。3.金合金烤瓷冠：与备牙前相比粘固12个月后的各项指标均无显著性差异。结论：1.镍铬合金烤瓷冠和内冠镀金的镍铬合金烤瓷冠修复,多数检查指标与备牙前比较有不同程度的增高,对牙周组织的不利影响存在；而金合金烤瓷冠各项指标变化不明显,对牙周造成的不利影响较小。2.内冠镀金的镍铬合金烤瓷冠对牙周组织的影响好于普通镍铬合金烤瓷冠,但与金合金烤瓷冠相比,对牙龈的不利影响还在一定程度上存在。3.在本实验中,龈沟液中GCF-AST及GCF-ALP浓度可以较敏感地表达牙周(牙龈等)组织病变程度,从而对于监测各金属烤瓷冠的临床应用效果具有一定参考价值。【英文摘要】Porcelain-fused to metal crown (PFM), because of its good appearance, comfort, color fidelity and stability, good functional recovery was widely used in clinic. Ni-Cr alloy PFM because of its cheap is most widely used.But local periodontal condition is still a weakness of PFM crowns concentration.Such as gingivitis and gingival discoloration. As is known these periodontal damages must have been seriously influenced prosthetic effect. The stability of Au-Pt alloy PFM rarely has negative impact on the periodontal tissues. Because of the expensive price, not many patients choose them.The price of gold-plated Ni-Cr alloy PFM as opposed to Au-Pt alloy PFM is low, it is a compromise clinical repair approach. In laboratory, many inflammation mediators and enzymes have been checked up for the past few years. Then the clinical periodontal parameters were recorded for the restored teeth and matched ones. Based on above-mentioned researches we can early detect the effect of PFM crowns on the periodontal tissue, and revealed mechanism of periodontal damages after restorations. So these studies can instruct the clinic operation, lengthen the duration of restorations and promote the periodontal health.s:To investigate the changes of gingival crevicular fluid (GCF) quantity and the concentration of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in GCF after different alloys based PFM crowns restoration. Relationship between the quantity of GCF、AST、ALP and the health of periodontal tissue was discussed, and the effect of PFM crowns of different materials on local periodontal tissue was explored.Methods:Among 81 patients,90 maxillary incisors with PFM crowns were selected for the study. There are 30 Ni-Cr PFM crowns,30 gold-plated Ni-Cr alloy PFM crowns and 30 Au-Pt PFM crowns. The patients were followed at before preparation the teeth and at 12 months after restoring crowns. Then the clinical periodontal parameters such as plaque index(PLI)、sulcus bleeding index(SBI) and probing depth(PD) were recorded for the test teeth. In addition, we collected and weighed the gingival crevicular fluid (GCF) samples of teeth, and analyzed ALP and AST of GCF in laboratory. All data in study were analyzed statistically by SPSS 13.0. 1. Ni-Cr alloy PFM:Compared with preparation of teeth, after cementation Ni-Cr alloy 12 month later only PLI index was insignificantly changed, PD、SBI index、the quantity of GCF、the concentration of GCF-AST and GCF-ALP in GCF increased significantly. Significantly higher than both gold-plated Ni-Cr alloy PFM and Au-Pt PFM group.2. Gold-plated Ni-Cr alloy PFM:The indicators are incremental from the teeth before operation to the teeth after concentration 12 months later. The quantity of GCF the concentration of GCF-AST and GCF-ALP in GCF of gold-plated Ni-Cr alloy PFM were slightly higher than the Au-Pt alloy ones, but significantly lower than that of Ni-Cr alloy ones.3. Au-Pt alloy PFM:Compared with the teeth before operation, the indicators of the teeth after concentration 12 months later were insignificantly different.Conclusions:1. After insertion Ni-Cr and gold-plated Ni-Cr alloy PFM crowns, the majority of results of tested teeth increased more or less than the teeth before operation. And both alloys are disadvantaged to local periodontal tissue. For Au-Pt PFM crowns, the data of the tested teeth and the controlled one changed insignificantly. So this alloy was not adversely to periodontium.2. Gold-plated Ni-Cr alloy PFM crowns are less harmful to periodontal tissue than Ni-Cr PFM. However, gold-plated Ni-Cr alloy PFM crowns are not so good at periodontium as noble alloy (Au-Pt) PFM crowns to a certain extent.3. In this test, the concentration of ALP and AST in GCF can express degree of periodontal disease sensitively, and these indexes can be used in studying clinical periodontal effect after restored PFM crowns.【关键词】金属烤瓷冠 龈沟液 碱性磷酸酶 天冬氨酸转氨酶【备注】索购全文在线加我：13.993.8848 同时提供论文辅导写作和学术期刊论文发表服务 本文为学术文献总库合作提供，无涉版权。作者如有异议请与总库或学校联系。【英文关键词】PFM crown GCF ALP AST【目录】三种金属材料烤瓷冠对龈沟液中碱性磷酸酶和天冬氨酸转氨酸转氨酶水平的影响摘要2-4Abstract4-5引言8-10第一章 材料与方法10-141.1 烤瓷合金材料101.2 主要试剂及实验仪器101.3 病例选择10-111.4 实验方法及过程11-14第二章 结果14-262.1 备牙前与粘固后12个月牙周状况的临床检查结果14-202.1.1 镍铬合金烤瓷组14-162.1.2 内冠镀