数字化口腔修复（18）--CAD／CAM全瓷冠与个性化基台的适合性

目的：比较不同计算机辅助设计和制造（ computer aided design／manufacture,CAD／CAM）全瓷冠与氧化锆个性化基台的边缘和内部适合性。方法：用CAD／CAM分别设计和加工氧化锆个性化基台和全瓷冠3组（ IPS e． max、Enamic和Suprinity）,每组各5个全瓷冠。通过微机断层扫描（ micro computed tomography,micro?CT）测量全瓷冠与氧化锆个性化基台的绝对边缘差异（ absolute marginal discrepancy,AMD）、轴面间隙（ axial gap,AG）、咬合间隙（ oc?clusal gap,OG）,比较不同材料全瓷冠与氧化锆个性化基台的边缘和内部适合性。结果：Enamic组分别与IPS e． max组和Suprinity组AMD之间的比较差异均具有统计学意义（P＜0．05）;而IPS e． max组与Suprinity组AMD之间的差异则无统计学意义（P＞0．05）。 Suprinity组分别与IPS e． max组和Enamic组AG之间的比较差异均具有统计学意义（P＜0．05）;IPS e． max组与Enamic组AG之间的差异不具有统计学意义（P＞0．05）。 Suprinity组、IPS e． max组和Enamic组3组OG之间的比较差异具有统计学意义（P＜0．05）。结论：不同的CAD／CAM全瓷冠材料影响其边缘和内部适合性。 Suprinity和IPS e． max陶瓷材料的边缘适合性优于Enamic材料,Suprinity材料全瓷冠的轴面间隙和咬合间隙最小。     

CAD/CAM氧化锆全瓷与IPS e.max Press铸瓷固定局部义齿修复的临床对比研究

目的：比较不同全瓷系统用于前牙及前磨牙区固定桥修复的临床效果。方法选取20～60岁因前牙或第一前磨牙缺失而行3单位固定桥修复的患者,随机分成CAD/CAM氧化锆和IPS e.max Press两组,分别在修复体戴入后3、6、12个月,临床观察其是否发生脱落、折裂、崩瓷、修复体边缘密合性及牙龈表现,参照改良美国公共卫生署评价标准进行疗效评价,并进行统计学分析。结果随着时间的延长,两种全瓷材料的固定修复成功率均有所下降,但均在90%以上,两者之间差异无统计学意义（P＞0.05）。结论在严格控制临床适应证的前提下,CAD/CAM二氧化锆与IPS e.max Press两种全瓷材料均能达到良好的修复效果。     

两种粘接剂对氧化锆全瓷冠粘接效果的比较

目的 比较树脂加强型玻璃离子和自粘接树脂型水门汀粘接剂对氧化锆全瓷冠的临床粘接效果.方法 选取66例患者100颗需要进行氧化锆全瓷冠修复的患牙,随机分为两组(n=50),分别采用3M RelyXTMLuting树脂加强型玻璃离子粘固剂(RelyX L组)和3M RelyXTM U200通用自粘接树脂水门汀(RelyX U组)粘接.两年后复查,检查修复体的固位情况及边缘密合性,比较两组修复的成功率.结果 RelyX L组修复成功率98.0％;RelyX U组修复成功率100.0％,两组间差异无统计学意义.结论 在进行氧化锆全瓷冠修复时,采用树脂加强型玻璃离子和自粘接树脂型水门汀粘接剂均能取得良好的临床粘接效果.     

饰面瓷表面粗糙度对全瓷修复体颜色及透射率的影响

目的：探讨不同饰面瓷表面粗糙度对全瓷修复体颜色及透射率的影响。方法：将Cercon氧化锆陶瓷材料和IPS e.max铸瓷材料分别制作成厚2.0 mm、直径15 mm的圆盘状试件,各分为4组,每组5个试件,试件表面分别用水砂纸打磨至400#、600#、800#、1000#,测量其表面粗糙度Ra值、L*a*b*颜色参数及透射率。结果：随着饰面瓷表面粗糙度的增加,Cercon氧化锆的明度L*值呈增大趋势,b*值呈减小趋势,IPS e.max热压铸瓷的L*、a*、b*值无明显变化趋势;可见光透射率呈上升趋势。结论：不同饰面瓷表面粗糙度对Cercon氧化锆和IPS e.max全瓷修复体的颜色及透射率有一定影响。     

二氧化锆全瓷冠修复的临床观察

目的:探讨临床使用二氧化锆全瓷冠修复的治疗效果。方法:选择55例患者共73颗牙,采用二氧化锆全瓷冠进行修复。之后随访观察,按照美国公共健康协会制定标准评估修复情况。结果:73颗二氧化锆全瓷冠的边缘完整性,牙龈状态,颜色等方面表现良好,有3例4个全瓷冠出现崩瓷。结论:二氧化锆全瓷冠临床上的修复效果良好,值得临床推广使用。     

A 5-year evaluation of semipermanent composite resin crowns

ABSTRACT – The use of composite resin crowns in the restoration of traumatized and hypoplastic permanent incisors has proved to be of great clinical and aesthetic value for the pedodontic practice. Due to the composite resin materials and the acid etch technique, an easy method of making and retaining the restorations is at hand. The present study deals with long-term observations of composite resin crowns in restoring Ellis Class II and Class III coronal fractures of traumatized permanent incisors. In all, 253 composite resin crowns were controlled every year for a minimum of 5 years. In no case was an intermediate resin layer applied on etched enamel before the restoration material was placed. Surface, marginal and "body" discoloration, marginal leakage, marginal caries, abrasion, and fractures were controlled. The study demonstrated that discoloration of the surface of the restorations, and a discoloration of the restorative material not restricted to its surface ("body" discoloration) were the most frequent causes for considering the crowns as semipermanent restorations. The other factors seemed to be of minor clinical significance.     

全瓷冠用于前牙美容修复的临床效果体会

目的:探讨全瓷冠修复在牙列美容的应用效果。方法:随访观察和检查50件全瓷冠的颜色、颈部黑线、牙龈炎性反应、崩瓷情况。结果:全瓷冠颜色逼真,边缘密合,没有颈部变色和牙龈炎性反应,崩瓷也较少。结论:全瓷冠的前牙美容修复具有满意的临床应用效果,是值得推广的牙科修复材料。     

3种全瓷系统冠边缘适合性的比较(英文)

目的:比较临床常用3种全瓷系统(Kavo Everest、IPS e.max、In-Ceram alumina)冠的边缘适合性,为临床应用提供理论依据。方法:选取1颗无龋的离体前磨牙行牙体预备,其中牙合面预备2mm,颈部凹槽肩台,宽度为0.8mm,牙合聚合度为6°。双重印模法取模,每种系统分别制作10个冠修复体。然后采用双色硅橡胶印模法复制间隙模型,应用光学显微镜采集间隙图像及使用Auto CAD2006软件对其水平边缘间隙、垂直边缘间隙和绝对边缘间隙进行测量,将所得数据使用SPSS13.0软件包进行单因素方差分析。结果:3种全瓷系统制作的上颌前磨牙冠的水平边缘间隙的平均值在41.1～44.9μm,垂直边缘间隙的平均值在51.4～71.7μm,绝对边缘间隙的平均值在66.2～85.1μm。结论:本研究中,3种全瓷系统冠的绝对边缘间隙、垂直边缘间隙和水平边缘间隙均在临床可接受范围;然而,与In-Ceramalumina系统相比,IPS e.max和Kavo Everest系统制作的全瓷冠显示出较好的边缘适合性。     

Reliability testing of indirect composites as single implant restorations

Purpose: To investigate the reliability and failure modes of indirect composites as single‐unit implant crowns. Materials and Methods: Thirty‐eight custom‐milled titanium alloy locking‐taper abutments were divided into two groups (n = 19 each), and crown build‐up of a mandibular molar was accomplished using two indirect composite systems (Ceramage, Shofu, Kyoto, Japan; Diamond Crown, DRM, Branford, CT). Three crowns of each material were loaded until failure for determination of the step‐stress profiles. Reliability testing started at a load 30% of the mean load to failure and used three profiles with increasing fatigue loading (step stress). Weibull curves with 300 N stress and 90% confidence intervals were calculated and plotted using a power‐law relationship. Weibull modulus “Beta” and characteristic strength “Eta” were identified, and a contour plot was used (Beta vs. Eta) for examining differences between groups. Specimens were inspected in polarized light and scanning electron microscope for fracture analysis. Results: Use level Weibull probability showed fatigue being a damage factor only for the Ceramage group (β= 3.39) but not for the Diamond Crown group (β= 0.40). Overlap in the confidence bounds resulted in no statistical difference. Irrespective of composite system, fracture initiated in the region immediately below the contact between the indenter and the cusp, with the crack propagating toward the margins of cohesive failure. Conclusions: No significant differences were observed in life and Weibull probability calculations for Ceramage and Diamond Crown veneered onto Ti alloy abutments. Failure modes comprised composite veneer chippings.