| ObjectiveIn this paper,patients with periodontitis and tooth loosening Ⅱ°-Ⅲ °were selected and treated with Cerec crowns.The changes of PD,AL,PLI,BI,TM and other periodontal indexes were examined,and the changes of masticatory efficiency and occlusal function were measured and studied.The changes of alveolar bone height and density before and after Cerec fixation were analyzed by CBCT,and compared with those of patients with conventional all-ceramic fixation.To provide a clinical basis for the application of Cerec crowns in the restoration of periodontitis patients with tooth loosening,and further analyze the factors affecting the oral health-related quality of life of patients with Cerec crowns fixed by OHIP-14 questionnaire,and to explore the effectiveness of Cerec crowns as fixed periodontal splints in the restoration of loose teeth.Methods1.A total of 120 patients with periodontitis and tooth looseness Ⅱ°-Ⅲ°were selected from our hospital.All patients received complete periodontal basic treatment,and their conditions were fully assessed and combined with their wishes.60 patients received Cerec combined crown fixation as the study group,and 60 patients received routine all-porcelain combined crown fixation as the control group.2.The periodontal status of the patients was examined at the first visit(T0)and 3 months(T1),6 months(T2),12 months(T3)and 24 months(T4)after treatment.Clinical parameters such as attachment loss(AL),probing depth(PD),plaque index(PLI),gingival index(GI),bleeding index(BI)and tooth mobility(TM)were recorded.3.The changes of alveolar bone height and density in the two groups were measured and analyzed by imaging examination before and after treatment.4.The masticatory efficiency was evaluated by absorbance method and sieving weighing method before and after treatment.The occlusal force percentage of posterior teeth,occlusal time and occlusal force asymmetry index were analyzed using an occluder.5.Two years after treatment,the total effective rate of the two groups was analyzed.The modified United States Public Health Service criteria and the Periodontal splint Satisfaction Scale were used to evaluate the effect of fixed periodontal splint restoration.6.A questionnaire survey was conducted on patients,including general condition,oral health behavior,oral health status,and oral health impact scale,etc.,to analyze the factors affecting the OHRQo L of patients after Cerec fixation.Results1.There was no statistical significance in periodontal indexes of T0 stage between the two groups(P > 0.05);PD,AL,PLI,BI,GI and TM in stage T1,T2,T3 and T4 were significantly improved compared with stage T0,and the difference was statistically significant(P < 0.05).Compared between groups,AL,PLI and TM in stage T2,T3 and T4 were significantly lower in the study group than in the control group.The difference was statistically significant(P <0.05).The improvement of PD,BI and GI in T1,T2,T3 and T4 stages was significantly higher in the study group than in the control group,and the difference was statistically significant(P < 0.05).2.The alveolar bone height of the two groups was basically unchanged in the four periods after treatment compared with the T0 period,and the difference was not statistically significant(P > 0.05);The alveolar bone mineral density of the two groups increased significantly in the four stages after treatment compared with the T0 stage,the difference was statistically significant(P < 0.05).Compared between groups,the increase rate of alveolar bone mineral density in the study group was higher than that in the control group,the difference was statistically significant(P < 0.05).3.The statistical results obtained by absorbance spectrophotometry and screening and weighing method were consistent: the mastication efficiency of the two groups in the four periods after treatment was higher than that of the T0 period,the difference was statistically significant(P < 0.05);the mastication efficiency of the study group was significantly higher than that of the control group,the difference was statistically significant(P < 0.05).4.Occlusal function(1)Compared with T0,the percentage of occlusal force of posterior teeth increased and AOF index decreased in the two groups at four periods after treatment(P < 0.05).Compared with the control group,the percentage of occlusal force and AOF of posterior teeth in the two groups at T2,T3,T4 were improved better,and the differences were statistically significant(P < 0.05).(2)The OT of the study group and the control group decreased significantly at the four periods after treatment as compared with that at T0(P< 0.05).The reduction of the occlusion time in the study group was greater than that in the control group at T2 and T3(P < 0.05).5.Two years of follow-up showed that the total effective rate of the study group(96.67%)was significantly higher than that of the control group(80%),and the difference was statistically significant(P < 0.05).The masticatory function score,comfort score,and aesthetic score of the two groups at four periods after fixation were significantly higher than those at T0(P < 0.05),and the difference between the two groups was statistically significant(P < 0.05).After two years of Cerec combined crown treatment,the patients in the study group had better marginal fit of prosthesis,good gingival health,and no secondary caries.Compared with the control group,the difference was statistically significant(P < 0.05).6.The scores of OHIP-14 of the two groups after treatment were analyzed by independent sample T test,and the results showed that: Compared with the T0 period,the scores of four dimensions and the total score of OHIP-14 in the two groups were lower than those in the T0 period.The scores of four dimensions and the total score of OHIP-14 in the study group were significantly different from those in the T0 period(P < 0.05).The difference was not statistically significant(P > 0.05).7.The factors affecting the OHRQo L of patients after Cerec fixation were analyzed by one-way ANOVA and independent sample T test,and the results showed that: There was no significant difference in the score of the scale between the two groups(P > 0.05).Age,gender,education,family economic level,food impaction,unilateral chewing,hard bite habit,dental floss,and oral odor were not statistically significant(P > 0.05).There were significant differences in the scores of OHIP-14 between the two groups(P < 0.05),including smoking,brushing frequency,mental tension or stress in the past three months,tooth sensitivity,gingival bleeding and dental calculus.Further study found that smoking,brushing teeth less than twice a day,tooth sensitivity,gingival bleeding,and dental calculus had a negative impact on the OHRQo L of Cerec patients with fixed crowns(P < 0.05).ConclusionsPeriodontitis can cause alveolar bone absorption,periodontal pocket formation,and even lead to tooth loosening,displacement and loss,which affects the physical and mental health of patients.Cerec crown restoration of loose teeth can evenly disperse the pressure on the loose teeth,maintain the position of the loose teeth,maintain the stability of tooth function,promote the recovery of periodontal tissue,and improve the chewing efficiency and occlusal function of patients.To establish a stable occlusion relationship,promote the balance of the stomatognathic system,shorten the treatment time of patients,improve the comfort and satisfaction of patients,and improve the oral health and quality of life of patients. |
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