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目的:应用一种新的小型分光光度计,对上前牙种植支持式全瓷修复与金瓷修复的边缘牙龈的龈色改变进行比较,为临床选择修复材料提供依据。方法:选择口腔种植修复后复查患者18例(男7例,女11例),共计上前牙区种植支持式单冠29例(全瓷修复11例,钛合金基台金瓷修复9例,金合金基台金瓷修复9例)。通过仪器采集图片并输入计算机,应用相关软件测量种植冠颈部边缘牙龈与对照天然牙牙龈的CIELab颜色差异。另由医师对冠缘龈色改变进行临床牙龈变色指数(GDS)评价。采用SPSS 17.0软件包对数据进行统计学分析。结果:分光光度计测量结果显示,上前牙种植支持式全瓷修复组(3.4±1.8)与金瓷修复组(4.9±3.4)引起的龈色改变无统计学差异。其中,全瓷修复与钛基台金瓷修复方式(3.5±2.5)之间的差异和钛基台金瓷修复与金基台金瓷修复方式(6.3±3.8)之间的差异均无显著性,但全瓷与金基台金瓷修复方式之间的差异具有统计学意义(P=0.037)。此外,全瓷组与金瓷组间的主观牙龈变色指数(GDS)无统计学差异,临床牙龈变色指数与分光光度计测得的牙龈变色值之间具有相关性(rs=0.426,P=0.021)。天然中切牙、侧切牙和尖牙在牙龈色彩的明度上无显著差异,但在红绿色轴饱和度和黄蓝色轴饱和度方面,尖牙高于中切牙和侧切牙。结论:全瓷组与金瓷组的龈色改变在分光光度计评价和临床评价上均无显著差异,但高金合金基台联合金瓷冠修复方式引起的种植冠边缘牙龈色差显著大于全瓷修复方式。
OBJECTIVE: To compare the changes in the gingival color of the marginal gingiva supported by porcelain restoration supported by anterior teeth supported by a new miniature spectrophotometer, and to provide a basis for the clinical selection of prosthetic materials. Methods: Twenty-eight patients (7 males and 11 females) underwent dental implants repair. A total of 29 patients were supported by a single crown on the anterior teeth area (11 cases with all-ceramic restoration, 9 cases with titanium alloy abutment gold porcelain restoration, Gold alloy abutment gold porcelain repair in 9 cases). The images were collected by the instrument and input into the computer. The related software was used to measure the CIELab color difference between the gingival margin of the cervical margin and the control natural tooth gum. Another clinical gingival color changes by the doctor for clinical gingival discoloration index (GDS) evaluation. Data were statistically analyzed using SPSS 17.0 software package. Results: The results of spectrophotometer showed that there was no significant difference in the gingival color changes caused by the porcelain restoration group (3.4 ± 1.8) and the porcelain restoration group (4.9 ± 3.4). Among them, the difference between all-ceramic restoration and titanium-based porcelain restoration (3.5 ± 2.5) and the difference between porcelain-based titanium-based restoration and gold-based porcelain restoration (6.3 ± 3.8) were not significant , But the difference between all-ceramic and gold-based porcelain restoration was statistically significant (P = 0.037). In addition, there was no significant difference in subjective gingival discoloration index (GDS) between all-porcelain group and porcelain group. The clinical gingival discoloration index was correlated with the gingival discoloration value measured by spectrophotometer (rs = 0.426, P = 0.021 ). There was no significant difference in the color of the gum between natural incisors, lateral incisors and canines, but the canines were higher than the central incisors and lateral incisors in terms of red-green axis saturation and yellow-blue axis saturation. CONCLUSION: There is no significant difference in gingival color between all-ceramic group and gold-porcelain group on the evaluation and clinical evaluation of spectrophotometer. However, the gingival color difference at the edge of implant crown caused by high gold alloy abutment combined with porcelain- Repair method.