上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (5): 496-503.doi: 10.19439/j.sjos.2025.05.008

• 论著 • 上一篇    下一篇

数字化钴铬合金烤瓷冠和氧化锆全瓷冠修复对牙体缺损患者牙周健康的影响及机制探讨

阿地力江·依米提1,*, 隋妹志1,*, 阿布都热依穆江·库尔班1, 李飞2#, 廖骞3#   

  1. 1.新疆维吾尔自治区喀什地区第二人民医院 口腔科,新疆 喀什 844000;
    2.上海交通大学医学院附属第九人民医院 口腔预防科,3.门急诊管理处,上海 200011
  • 收稿日期:2024-12-13 修回日期:2025-01-17 出版日期:2025-10-25 发布日期:2025-10-31
  • 通讯作者: 廖骞,E-mail: lqlqliaoqian@hotmail.com;李飞,E-mail: charlse123@163.com。#共同通信作者
  • 作者简介:阿地力江·依米提（1984-）,男,本科,副主任医师,E-mail: 289566020@qq.com;隋妹志（1991-）,女,硕士,主治医师,E-mail: 702151101@qq.com。*并列第一作者
  • 基金资助:
    “天山英才培养计划”青年拔尖人才项目—基层科技骨干人才（2023TSYCJC0054）; 自治区科技支疆项目计划（指令性）项目（2024E02052）

Effect and mechanism of digital cobalt-chromium alloy porcelain crowns and zirconia all-ceramic crowns restoration on periodontal health of patients with tooth defects

Adilijiang·Yimiti1, Sui Meizhi1, Abudureyimujiang·Ku'erban1, Li Fei2, Liao Qian3   

  1. 1. Department of Stomatology, Kashi Prefecture Second People's Hospitol. Kashi Prefecture 844000, Xinjiang Uygur Autonomous Region;
    2. Department of Preventive Dentistrye, 3. Outpatient and Emergency Management Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2024-12-13 Revised:2025-01-17 Online:2025-10-25 Published:2025-10-31

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摘要： 目的:探讨数字化钴铬合金烤瓷冠和氧化锆全瓷冠修复对牙体缺损患者牙周健康的影响及其机制。方法:选择2024年3月—6月在喀什地区第二人民医院就诊的牙体缺损患者26例,随机分为钴铬合金烤瓷冠组（13例）和氧化锆全瓷冠组（13例）。在修复完成6个月后,评估2组患者的牙周健康状况,检测指标包括牙龈指数、牙龈出血指数、菌斑指数、口内龋失补指数及附着丧失等。此外,采集患者的临床菌斑样本,进行16S rRNA测序和数据分析,比较两组样本中的差异菌群特征。进一步收集患者的龈沟液样本,利用蛋白质组学分析筛选差异表达蛋白,探讨其富集的生物学过程和功能通路。结果:修复完成后6个月,氧化锆全瓷冠组的牙龈指数、菌斑指数和口内龋失补指数显著低于钴铬烤瓷冠组（P<0.05）。两组菌斑样本中,α多样性指数无显著差异,但在菌群组成上存在一定差异,Scardovia、Granulicatella和Eikenella 在氧化锆全瓷冠组中显著富集,而Peptococcus和Treponema在钴铬烤瓷冠组中显著富集。此外,蛋白质组学分析共鉴定出105个差异表达蛋白,这些差异蛋白显著富集于脂肪酸代谢和氨基酸代谢等代谢相关生物学过程与功能通路中。结论:氧化锆全瓷冠修复对牙体缺损患者牙周健康影响优于钴铬合金烤瓷冠,对口腔微环境影响较小,具有较高的临床应用价值。差异菌群及差异表达蛋白的发现,为牙周疾病的早期预测及个性化治疗方案制定提供了潜在的生物标志物。

关键词: 牙体缺损, 钴铬合金烤瓷, 氧化锆全瓷冠, 16S rRNA 测序分析, 蛋白组学分析

Abstract: PURPOSE: To investigate the impact and underlying mechanisms of digital cobalt-chromium alloy porcelain crowns and zirconia all-ceramic crowns restoration on periodontal health in patients with tooth defects. METHODS: A total of 26 patients with tooth defects who were treated in the Second People's Hospital of Kashi Region from March to June 2024 were selected and randomly divided into cobalt-chromium alloy ceramic crown group (n=13) and zirconia all-ceramic crown group (n=13). After 6 months of restoration, the periodontal health status of the two groups was evaluated, including gingival index, gingival bleeding index, plaque index, caries loss index and loss of clinical attachment. In addition, clinical plaque samples from patients were collected for 16S rRNA sequencing and data analysis to compare the characteristics of different flora in the two groups of samples. The samples of gingival crevicular fluid were collected and proteomic analysis was used to screen the differentially expressed proteins, and the biological process and functional pathway of their enrichment were discussed. RESULTS: After 6 months of restoration, the gingival index, plaque index, and caries loss and repair index in the zirconia all-ceramic crown group were significantly lower than those in the cobalt-chromium porcelain crown group (P<0.05). Although there was no significant difference in the α-diversity indexes of the plaque samples between the two groups, significant differences were observed in the microbial composition: Scardovia, Granulicatella, and Eikenella were significantly enriched in the zirconia all-ceramic crown group, while Peptococcus and Treponema were enriched in the cobalt-chromium porcelain crown group. In addition, a total of 105 differentially expressed proteins were identified by proteomic analysis, and these differentially expressed proteins were significantly enriched in metabolic related biological processes and functional pathways such as fatty acid metabolism and amino acid metabolism. CONCLUSIONS: Zirconia all-ceramic crowns are superior to cobalt-chromium alloy porcelain crowns in terms of periodontal health for patients with dental defects, with less detrimental impact on oral microbiome, suggesting that zirconia crowns have a high clinical application value. The discovery of differential bacteria and differential expressed proteins provides potential biomarkers for early prediction of periodontal diseases and the development of personalized treatment plans.

Key words: Tooth defect, Cobalt-chromium porcelain crown, Zirconia all-ceramic crown, 16S rRNA sequencing analysis, Proteomic analysis

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