牙列重度磨耗患者经热压铸瓷修复后的短期临床评价

用IPS e.max Press热压铸瓷对16例牙列重度磨耗患者(共398个牙单位)进行咬合重建.针对口腔具体条件,分别选择贴面、咬合罩面、全瓷冠桥修复,随访6 ～12个月,参照改良的美国公共卫生署评价标准进行评价,对数据进行非参数统计学分析.390单位修复体成功,成功率97.9％,所有修复体边缘密合、色泽自然、外形协调,在各评价项目均无统计学差异(P＞0.05).在筛选合适病例的前提下,用IPS e.max Press热压铸瓷为牙列重度磨耗患者进行咬合重建的短期效果良好.     

IPS e. max Press热压铸陶瓷的临床应用体会

目的探讨IPS e. max Press热压铸陶瓷的临床修复效果。方法采用IPS e. max Press热压铸陶瓷技术制作70例163件全瓷修复体,并进行一年多的随访。结果制作的163件全瓷修复体色泽自然,边缘密合,牙龈组织健康。随访一年多成功159件,失败4件,成功率为97.6%,其中1件为崩瓷,3件为粘接脱落。结论IPS e. max Press热压铸陶瓷具有良好的临床修复效果。     

IPS e.max Press全瓷贴面在前牙修复中的应用

目的 评价IPS e.max Press全瓷贴面在前牙美容修复应用中的临床疗效.方法 对52例患者的103颗前牙进行IPS e.max Press全瓷贴面修复,于修复体粘接后每半年进行复查评价其临床效果.结果 经过2年的复查,有1个瓷贴面发生折裂,2个出现裂纹,2颗贴面修复的基牙有轻度的牙龈炎症,无瓷贴面脱落.结论 IPS e.max Press全瓷贴面修复能有效保存牙体组织,获得满意的美学修复效果,在前牙美容修复中具有良好的应用前景.     

热压铸全瓷高嵌体应用于前磨牙修复的临床研究

目的 评价IPS e.max press热压铸全瓷高嵌体在前磨牙修复中的临床效果.方法 选择经完善根管治疗的102颗牙冠缺损的前磨牙,制作IPS e.max press热压铸全瓷高嵌修复体,追踪观察36个月.结果 102件IPS e.max press热压铸全瓷高嵌体仅1件修复失败,成功率为99.02％.结论 IPS e.max press热压铸全瓷高嵌体修复前磨牙具有良好的修复效果,值得推广.     

IPS e.max Press 热压铸后牙全瓷冠的临床研究

［摘要］ 目的 评价后牙IPS e.max press 全瓷铸造冠的临床效果。方法 共选取1 217例1 533颗后牙IPS e.max Press 铸瓷全冠修复体,修复3~24个月后,按照美国公共健康协会的修正标准进行修复体评估。结果 96.6%的修复体保持完整,未出现破裂、崩瓷、脱落、基牙冠折等并发症,患者满意度较高。结论 IPS e.max Press 全瓷修复体的近期修复效果良好。     

IPS e.max Press铸瓷全冠近期修复效果的临床观察

目的：对IPS e.max Press铸瓷全冠近期修复效果进行观察和评价。方法：共选取35例56个IPS e.max Press铸瓷全冠修复体,修复3-18个月后,按照美国公共健康协会（APHA）的修正标准进行修复体评估,并记录患者满意度。结果：修复体颜色、形态、功能、舒适度各项满意率为94%以上,有96%的修复体颜色、形态、边缘着色、边缘密合度、继发龋各项检查达到A级。结论：IPS e.max Press是一种修复效果较好的全瓷修复材料。     

重度磨耗微创咬合重建的临床效果分析

目的：研究微创咬合重建治疗对重度磨耗患者颞下颌关节症状的改善及位置变化的效果分析。方法：用IPS e.max Press瓷贴面冠对20例纳入研究的牙列重度磨耗患者行微创咬合重建,在治疗前、永久性修复2周后行颞下颌关节弹响及咀嚼肌触诊疼痛检查,拍摄锥形束CT扫描,获得颞下颌关节各间隙数值,分析咬合重建治疗前、后髁突位置的变化。结果：微创咬合重建治疗能显著改善重度磨耗患者肌肉症状（P<0.05）,但在改善关节疼痛和关节弹响,改变关节各间隙大小方面无明显统计学差异（P>0.05）。通过计算In(PS/AS)值发现,咬合重建升高咬合后,髁突向前移位,后位比例减少至35%。结论：重度磨耗患者微创咬合重建治疗能较好地恢复口腔功能改变髁突位置,改善咀嚼肌的症状。     

牙列重度磨损咬合重建修复治疗方法的探讨

目的 探讨牙列重度磨耗患者行固定义齿咬合重建修复的可行性.方法 结合1例牙列重度磨耗患者,咬合垫佩戴3个月后,制作过渡性修复体,口内观察1年,然后行上下颌固定义齿最终修复,经过这一序列诊疗过程完成咬合重建.结果 患者使用最终修复体2年,美观满意,咀嚼效率良好,无咀嚼系统肌肉及颞下颌关节不适症状.结论 牙列重度磨耗的固定义齿咬合重建修复是一个复杂的序列治疗过程,治疗效果是满意的.     

IPS e.max Press铸瓷全冠修复效果的临床观察

目的:评价IPS e.max Press铸瓷全冠的临床修复效果。方法:对41例患者127颗前牙和前磨牙进行IPS e.maxPress热压铸瓷全冠修复,修复后12～42个月(平均28个月),参照美国公共卫生服务修正标准对修复体的颜色匹配、边缘着色、修复体折裂、继发龋、边缘适合度以及牙龈健康情况进行评价。结果:在颜色匹配方面,94.49%的修复体表现为A级,5.51%表现为B级;1.57%的全冠出现边缘着色;1颗(0.79%)修复体出现饰面瓷折裂;未发现继发龋;94.49%的修复体边缘适合度表现为A级,5.51%表现为B级;在牙龈健康方面,93.70%的修复体表现为A级,4.72%表现为B级,1.58%表现为C级。结论:在平均28个月的临床观察中,IPS e.max Press铸瓷全冠临床修复效果优良。     

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。     

IPS e.max牙合面瓷贴面修复后牙牙合面缺损的3年临床观察

目的:考察热压铸瓷牙合面瓷贴面在后牙缺损的短期临床效果。方法:对28例患者的35个后牙牙体缺损,包括18个重度磨耗活髓后牙和17个根管治疗术后牙合面牙体缺损后牙,采用热压铸瓷牙合面瓷贴面修复。根据改良USPHS修复体评价标准,分别于修复后完成当日和1、6、12、24、36个月对牙合面瓷贴面进行随访复查,结果采用χ²检验分析。结果:后牙热压铸瓷牙合面瓷贴面的修复体外形、边缘适合性、牙龈状况、继发龋和邻面接触点在观察期间表现良好。有2例下颌前磨牙牙合面瓷贴面在粘结2年后出现脱落,χ²检验分析修复体固位的A级成功率在6个时间节点间差异无统计学意义。36个月内各项评估A级成功率在90%以上。结论:热压铸瓷牙合面瓷贴面用于重度磨耗活髓后牙与根管治疗术后牙合面牙体缺损后牙短期修复效果良好,为后牙牙体缺损微创修复提供了一种方式,但其远期效果仍有待进一步观察。     

铸瓷髓腔固位冠修复根管治疗后牙齿的临床效果评价

目的:评价IPS e. max Press铸瓷髓腔固位冠修复经根管治疗的后牙牙体缺损的效果。方法:选择由牙体牙髓专业一年级研究生完成的铸瓷髓腔固位冠修复病例26例,均为行完善根管治疗后的后牙,18~24个月后回访检查。参考美国公共健康服务(USPHS)标准,对患牙继发龋、牙龈炎、牙折、修复体边缘完整性、边缘染色、修复体折裂/脱落情况进行评估。结果:26例病例中,1例修复体折裂,2例边缘完整性轻度受损,1例咬合面轻度缺损,其余未发现明显修复体的缺陷或因修复体引起的牙体、牙周等问题。结论:铸瓷髓腔固位冠修复根管治疗后的后牙牙体缺损可以取得满意的效果。     

IPSe.max铸瓷贴面美学修复的临床评价

目的：评价IPSe.max铸瓷贴面在前牙美容修复的临床效果。方法：对13例患者（总计63颗）行IPS e.max铸瓷贴面修复。1个月、3个月、12个月、24个月后复诊检查,根据改良Ryge评价标准评价临床效果。结果：63例瓷贴面均完整未脱落;1例出现边缘渗漏着色;3颗患牙出现牙本质敏感现象。结论：IPS e.max铸瓷贴面是前牙较理想的美学修复方法,能满足患者对美观的要求,取得良好的临床效果。     

铸瓷髓腔固位冠修复个别上前牙错位的疗效观察

目的探讨IPS e.max Press铸瓷髓腔固位冠在个别上前牙错位修复中的临床疗效。 方法选择15例个别上前牙错位的患者,经完善根管治疗和（或）牙周治疗,1~2周后制作IPS e.max Press铸瓷髓腔固位冠,树脂粘接剂粘固。并于6个月、1年后复查修复体的颜色、形态、边缘密合性、牙龈健康情况、基牙及修复体的保存情况。 结果1年内所有修复体边缘密合、牙龈健康、颜色美观;除1例基牙移位外,其余髓腔固位冠无松动移位。保存率100%（15/15）,临床可接受率为93.3%（14/15）。 结论IPS e.max Press铸瓷髓腔固位冠用于个别上前牙错位的修复可取得良好的效果。     

Full-mouth rehabilitation of a patient with severely worn dentition and uneven occlusal plane: a clinical report

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. Using mini-implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46-year-old man was referred for restoration of his worn and missing teeth. After diagnostic work-up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini-implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom-cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal-ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full-mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow-up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.     

The evaluation of direct composite restorations for the worn mandibular anterior dentition - clinical performance and patient satisfaction

This prospective split-mouth clinical trial evaluated the performance and patient satisfaction of 168 Herculite XRV direct composite restorations bonded to the worn anterior dentition of 18 patients with localized anterior tooth surface loss. One hundred and six of these restorations were placed on the mandibular anterior teeth. The restorations increased the anterior occlusal vertical dimension between 0.5 and 5 mm and the posterior occlusal contacts were restored after a mean duration of 6.2 months (range: 3-13 months) in 14 out of the 15 'Dahl' sub-group patients. The restorations were evaluated after 2.5 years of service by five examiners. Four patients and 23 mandibular restorations were lost to follow-up. Multiple clinical and restorative variables were assessed to determine their influence on restoration performance. Complete failure occurred in 6% of the restorations. Circumferential preparation and height of the restorative addition did not influence the performance of the restorations. A Visual Analogue Scale (VAS) was used to assess the patient's opinion regarding sensitivity, aesthetics, longevity and function of the worn mandibular anterior teeth. A statistically significant difference (95% CI) was found between the pre-operative and 1-month review VAS responses for aesthetics and longevity and this was maintained at the 2.5-year review. Direct composite restorations placed at an increased occlusal vertical dimension are a simple and time-efficient method of managing the worn mandibular anterior dentition. Patient's acceptance and adaptation to the technique is good and the results are accompanied with a high level of patient satisfaction that is maintained for the medium-term.     

Restoring esthetics and anterior guidance in worn anterior teeth. A conservative multidisciplinary approach

BACKGROUND: Developments in adhesive dentistry have given the dental profession new restorative materials and technology to restore esthetics and function to the worn anterior dentition. This article illustrates, through a clinical case study, the clinical requirements for restoring esthetic harmony and functional stability to the worn anterior dentition. CASE DESCRIPTION: The author presents the case of a 24-year-old man who sought esthetic dental treatment because he was unhappy with the appearance of his maxillary anterior teeth. The review of his dental history revealed that he ground his teeth at night. The author performed a complete evaluation of the causes of the patient's bruxism and created a diagnostic preview to, among other things, develop the relationship between the condylar and anterior guidance and to establish the esthetic requirements for the final restorations. Treatment included periodontal recontouring, tooth preparation and placement of temporary and then permanent restorations; the patient also was given an occlusal guard to protect the restorations against future bruxing. CLINICAL IMPLICATIONS: Whatever the cause of occlusal instability, it is important that the restorative dentist be able to recognize its signs--such as tooth hypermobility, tooth wear, periodontal breakdown, occlusal dimpling, stress fractures, exostosis, muscle enlargement and loss of posterior disclusion. When restoring the worn dentition, the clinician should bear in mind the five P's: proper planning prevents poor performance.     

The use of implants in the occlusal rehabilitation of a partially edentulous patient: a clinical report

This article describes the occlusal rehabilitation of a partially edentulous patient who did not want a removable partial denture. Implants and extensive fixed restorations were used to restore posterior support and treat severely worn dentition, respectively. The treatment offered the patient a functional and esthetic result.     

IPS e.max CAD LT低度透明瓷块修复后牙缺损的临床效果观察

目的评价应用IPS e.max CAD LT低度透明瓷块切割形成全解剖形态全冠修复后牙缺损的效果。方法选择我院就诊的54例IPS e.max CAD LT瓷全冠修复后牙患者、共计86颗牙单位为研究对象,修复后3、6、12个月根据美国公共健康协会的修正标准对修复体进行评价,并调查满意度。结果 12个月的追踪调查显示,86个修复体中,折断并脱落1个,96%的修复体颜色、形态、边缘着色、边缘密合度等各项检查达到A级,满意度达到94%。结论 IPS e.max CAD LT低度透明瓷块整体切割形成全解剖形态全冠修复体可获得理想的修复效果,具有较高的临床应用价值。