Objective: To study the clinical effects of three kinds of restorations with different ways of retention for mandibular posterior residual crowns with low occlusogingival dimension. Methods: Sixty-five cases of posterior residual crowns after RCT in 42 young patients were restored with PFM crowns with cast post retention (group 1), PFM inlay-crowns with pulp chamber retention(group 2) and PFM inlay-crowns with pulp chamber and distal root retention (group 3), respectively. All these cases were followed up for 3 and 6 months after cementation. Modified USPHS Criteria was utilized to evaluate the clinical effects of all cases, followed by statistic analysis performance. Results: After two years, the numbers of fracture, disadaptation, secondary caries and marginal gingivitis in group 1 and group 3 were 3/1, 2/2, 5/1, 2/2, respectively, while adverse reactions mentioned above were not found in group 2. Conclusion: PFM inlay-crowns with pulp chamber retention should be used to restore young mandibular posterior residual crown with low occlusogingival dimension.%目的:探讨利用桩核固位的烤瓷冠、利用髓室固位的嵌体烤瓷冠及利用髓室和远中根管固位的嵌体烤瓷冠三种方式修复(牙合)龈距短的年轻患者下颌磨牙残冠的临床效果.方法:选择解放军第309医院口腔科门诊42例患者,年龄18-24岁,共65颗牙体大面积龋损的下颌磨牙,其中第一磨牙61颗,第二磨牙4颗.经完善根管治疗后,根据修复方式分为三组,分别采用桩核固位的烤瓷冠修复、髓室固位的烤瓷嵌体冠修复及利用髓室和远中根管固位的烤瓷嵌体冠修复.在修复后的6个月、12个月、24个月进行临床追踪观察,根据评价标准做出临床修复效果评价.统计学分析研究结果,评价不同方法的优缺点.结果:经2年的随访,结果显示桩核固位组出现崩瓷3例,修复体边缘不密合2例,继发龋5例和边缘性龈炎2例;髓室和远中根管固位组出现崩瓷1例,修复体边缘不密合2例,继发龋1例和边缘性龈炎2例.而髓室固位组则未出现上述情况.结论:年轻下颌(牙合)龈距较短的磨牙残冠宜采用髓室固位的嵌体烤瓷冠修复.
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