树脂类粘结剂边缘厚度对全瓷冠边缘微渗漏的影响

目的：研究树脂类粘结剂边缘厚度与全瓷冠边缘微渗漏的相关关系。方法：16颗上颌第三磨牙经标准牙体制备，制作IPS－Empress 2全瓷冠，分两组用多组份树脂粘结剂和自炽结多聚酸改性树脂炽结剂粘固，经温度循环试验后，用扫描电镜测量边缘粘固剂厚度，再将样本浸入2％品红溶液24小时，系列切片，用体视显微镜观测边缘微渗漏程度。结果；两种树脂粘结剂边缘粘固剂厚度与牙－粘固剂界面和全瓷冠－粘固剂界面边缘微渗漏程度均无相关关系（P＞0．05）。结论：树脂类粘结剂边缘粘固剂厚度若在理想的临床要求范围内，不足以影响全瓷冠边缘微渗漏程度。     

CAD/CAM氧化锆全瓷冠修复前牙的临床观察

目的观察计算机辅助设计/制造（computer-aided design/computer-aided manufacturing,CAD/CAM）技术制作氧化锆全瓷冠修复前牙的临床效果。方法对8例需烤瓷冠修复前牙的患者,进行CAD/CAM氧化锆全瓷冠修复。随访1-2年观察全瓷冠修复体的色泽稳定性、牙龈健康状况和边缘密合性。结果12个全瓷冠修复体均无变色、崩瓷和裂纹,边缘密合,牙龈健康状况良好,无红肿出血、牙龈黑线。结论CAD/CAM氧化锆全瓷冠生物相容性好,美观耐用。     

CAD/CAM氧化锆全瓷冠修复临床疗效评价

目的：探讨CAD／CAM氧化锆全瓷冠的修复效果。方法：选择82例（192颗患牙）,分别在CAD／CAM氧化锆全瓷冠粘接后1、3、6、12个月进行随访观察。采用美国公共健康协会的修订标准对修复体的临床效果进行评价。结果：观察期间失访4例,随访78例共181件修复体,结果显示CAD／CAM全瓷冠颜色达到好以上91．2％,CAD／CAM氧化锆全瓷冠的崩瓷率2．76％,与修复体部位有明显相关性（P〈0．01）,在粘接12个月后有1个修复体的边缘密合度欠佳,所有复诊患者在12个月的临床观察中均未见边缘着色,继发龋和基牙松动。结论：氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意。     

改良CAD/CAM全瓷嵌体对微渗漏影响的实验研究

目的:比较传统法和改良法制作CAD/CAM氧化锆基底全瓷嵌体发生微渗漏的差异。方法:离体磨牙30个随机分成对照组与实验组,均按Ⅱ类洞制备箱状洞型,实验组洞缘预备短斜面并于相应部位制作氧化锆边缘,对照组洞缘不预备短斜面,边缘用饰瓷封闭。两组样本进行疲劳循环和冷热循环试验,染色法检测微渗漏情况。结果:实验组嵌体边缘微渗漏小于对照组,有显著性差异。结论:采用改良法制作CAD/CAM全瓷嵌体能有效减少边缘微渗漏。     

CAD/CAM氧化锆全瓷冠修复在前牙美学修复中的应用

目的分析CAD/CAM氧化锆全瓷冠修复在前牙美学修复中的应用。方法前牙缺损患者61例(患牙81颗),分为研究组(n=31,共41颗患牙),对照组(n=30,共40颗患牙),研究组患者采用CAD/CAM氧化锆全瓷冠修复,对照组患者采用银钯合金烤瓷全冠修复,并随访12个月。结果研究组患者颜色匹配度Ⅰ级率、边缘密合度优率均高于对照组患者;修复后,两组患者TNF-α、IL-6水平均高于修复前,研究组患者修复前、后GCF水平无显著差异,对照组患者修复后GCF水平高于修复前;修复后,研究组患者GCF、TNF-α、IL-6水平均低于对照组。结论 CAD/CAM氧化锆全瓷冠修复在前牙美学修复中有较高的颜色匹配度、边缘密合度高,对牙周组织损伤较小。     

CAD/CAM氧化锆及Empress全瓷冠修复三年临床效果比较

目的:比较CAD/CAM氧化锆及Empress全瓷冠修复3年的临床效果。方法:选择350例患者共838个全冠修复体(其中CAD/CAM氧化锆全冠428颗、Empress铸瓷全冠410颗),平均观察期36.2±5月,随访检查基牙和修复体情况,分别对两组全瓷冠的存留率和修复成功率进行统计学分析。结果:观察期内共有41颗全瓷冠(19颗为氧化锆,22颗为Empress铸瓷)完全失败,需重新制作。氧化锆全瓷冠和Empress铸瓷全冠的存留率分别为95.1%和95.8%,成功率分别为90.7%和91.2%,其差异均无统计学意义。结论:CAD/CAM氧化锆和Empres铸瓷全冠均能满足临床需要,有较好的修复效果。     

CAD/CAM全瓷冠边缘适合性的评价

目的：研究采用计算机辅助设计及制作系统（Kavo Everest）制作的氧化锆全瓷冠的边缘适合性。方法：选取1颗无龋的离体前磨牙行牙体预备,双重印模法取模,翻制20个相同尺寸的超硬石膏代型,将代型随机分为2组,分别制作10个金属烤瓷冠和10个Kavo Everest氧化锆全瓷冠。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AutoCAD2006软件对其厚度进行测量。结果：利用失蜡铸造法制作的金属烤瓷冠的垂直边缘间隙（69.6±29.7）μm,水平边缘间隙（56.1±20.8）μm,绝对边缘间隙（91.1±28.8）μm;利用CAD/CAM制作的氧化锆全瓷冠的垂直边缘间隙（51.4±19.9）μm,水平边缘间隙（41.1±16.8）μm,绝对边缘间隙（66.2±21.9）μm。两种系统制作的冠的水平边缘间隙、垂直边缘间隙、绝对边缘间隙均具有显著性差异（P〈0.05）。结论：利用Kavo Everest系统制作的全瓷冠具有良好的边缘适合性。     

3种黏固剂对CAD/CAM氧化锆全瓷冠粘接强度的比较

CAD/CAM氧化锆全瓷冠因其具有美观、坚固、良好的生物相容性等优点而受到越来越多的青睐，然而氧化锆全瓷冠与不同黏固剂粘接力大小的比较却鲜有研究，这种高强度的冠修复体是否需要使用含粘接成分的黏固剂来增强固位也有待探索。本研究旨在模拟临床环境的条件下，用不同的黏固剂来粘接氧化锆全瓷冠，并比较其粘接强度的大小。     

CAD/CAM一体化氧化锆桩核的临床评价

目的:观察CAD/CAM一体化氧化锆桩核在修复前牙残冠、残根中的临床效果。方法:本研究对45颗残冠、残根使用自凝塑料在口中制作桩核模型,应用CAD/CAM技术切削出一体化氧化锆桩核,运用一体化氧化锆桩和全瓷冠修复所有残冠、残根,经3年的临床跟踪,观察其临床效果。结果:观察期间失访2例患者,因此只对剩余43件修复体进行复查,其中中切牙28例,侧切牙7例,尖牙8例。2例患牙在第6个月时出现牙龈炎。1例右上中切牙氧化锆桩核修复体在第12个月后出现I-II°松动,1例右上侧切牙桩核修复体在第18个月后松动脱落。24个月和30个月时分别有1例患牙出现根折。所有复诊患者在36个月的临床观察中均未见桩核折断、边缘着色和继发性根尖周炎,并且所有修复体均获得满意美观效果。结论:CAD/CAM一体化氧化锆桩具有良好的美学效果和生物相容性,近期临床效果满意。     

不同表面处理方法对CAD/CAM氧化锆种植体表面显微形貌的影响研究

目的：：研究采用不同表面处理方法对CAD/CAM氧化锆种植体表面显微形貌特征及粗糙度的影响。方法：通过CAD/CAM技术加工氧化锆圆盘与一段式氧化锆种植体( Y-TZP, WIELAND),根据表面处理方式分为终烧结表面、喷砂表面及喷砂加热酸蚀处理表面;标准对照组选用BEGO钛种植体表面。各组圆盘试件及种植体用扫描电子显微镜及Keyence 3D激光显微形貌测量显微镜进行表面显微形貌观察与测量。采用单因素方差分析比较各组统计学差异。结果：各组CAD/CAM氧化锆试件表面显微形貌观察显示,喷砂后表面出现边缘锐利的凹坑及沟槽;喷砂加热酸蚀处理后,氧化锆表面可见纳米级的微小孔隙及沟纹。氧化锆种植体粗糙度测量结果显示：终烧结组的表面粗糙度值(Ra=0.69μm)显著低于其他3组(P<0.001),喷砂组Ra值(Ra=1.30μm)显著低于喷砂加热酸蚀组(Ra=1.49μm)及BEGO钛种植体组(Ra=1.57μm)(P<0.01),而喷砂加热酸蚀组与BEGO钛种植体组则无显著差异(P=0.196)。结论：CAD/CAM氧化锆试件终烧结后喷砂或喷砂加热酸蚀处理均可获得较为理想的表面粗糙度,热酸蚀处理能够改变氧化锆表面的纳米级微观结构。     

Influence of porcelain veneering on the marginal fit of Digident and Lava CAD/CAM zirconia ceramic crowns

PURPOSE

Marginal fit is a very important factor considering the restoration''s long-term success. However, adding porcelain to copings can cause distortion and lead to an inadequate fit which exposes more luting material to the oral environment and causes secondary caries. The purpose of this study was to compare the marginal fit of 2 different all-ceramic crown systems before and after porcelain veneering. This study was also intended to verify the marginal fit of crowns originated from green machining of partially sintered blocks of zirconia (Lava CAD/CAM system) and that of crowns obtained through machining of fully sintered blocks of zirconia (Digident CAD/CAM system).

MATERIALS AND METHODS

20 crowns were made per each system and the marginal fit was evaluated through a light microscope with image processing (Accura 2000) at 50 points that were randomly selected. Each crown was measured twice: the first measurement was done after obtaining a 0.5 mm coping and the second measurement was done after porcelain veneering. The means and standard deviations were calculated and statistical inferences among the 2 groups were made using independent t-test and within the same group through paired t-test.

RESULTS

The means and standard deviations of the marginal fit were 61.52 ± 2.88 µm for the Digident CAD/CAM zirconia ceramic crowns before porcelain veneering and 83.15 ± 3.51 µm after porcelain veneering. Lava CAD/CAM zirconia ceramic crowns showed means and standard deviations of 62.22 ± 1.78 µm before porcelain veneering and 82.03 ± 1.85 µm after porcelain veneering. Both groups showed significant differences when analyzing the marginal gaps before and after porcelain veneering within each group. However, no significant differences were found when comparing the marginal gaps of each group before porcelain veneering and after porcelain veneering as well.

CONCLUSION

The 2 all-ceramic crown systems showed marginal gaps that were within a reported clinically acceptable range of marginal discrepancy.     

97例CAD/CAM氧化锆基底冠桥修复体制作效果评价

目的评价运用CAD/CAM技术制成的氧化锆修复体的制作效果,探讨影响效果的相关因素。方法选择97例CAD/CAM氧化锆冠桥基底修复的临床病例,观察修复体制作的过程,分析其边缘适合性、颜色、固位、折断或破损情况,综合评价制作效果。以70例贵金属烤瓷冠作为对照组进行研究。结果 97例修复体的制作过程中,发现有1例在切削加工时从包埋蜡中脱落,1例上前牙4单位桥在完成烧结后有小幅度翘动,1例上前牙3单位桥体在切削过程中破裂,上述3例修复体通过返工重做解决问题。所有制作的氧化锆支架,通过饰面瓷的堆塑可使修复体获得较好的美观效果。两种修复方式在边缘适合性、固位和破损率上均无统计学差异(P>0.05),而CAD/CAM氧化锆基底冠的颜色良好率要优于贵金属基底冠(P<0.05)。结论高强度氧化锆全瓷修复体的制作效果能符合临床要求,可以考虑用于全瓷修复。     

不同粘接剂对金属烤瓷冠边缘微渗漏影响的研究

目的 评价4种不同粘接剂在金属烤瓷冠修复中的微渗漏情况.方法 制作16个金属烤瓷冠,随机分成4组,分别采用玻璃离子黏固剂、树脂加强玻璃离子黏固剂、PanaviaF粘接剂和super-Bond C&B粘接剂黏固于前磨牙,经温度循环试验后,将样本浸入2%品红溶液中24 h,用体视显微镜观察牙-黏固剂界面边缘微渗漏状况,并进...     

Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns

PURPOSE

All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident.

MATERIALS AND METHODS

Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns.

RESULTS

The mean fracture strengths were as follows: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain.

CONCLUSION

The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.     

CAD/CAM氧化锆全瓷在口腔修复领域的应用

回顾全瓷修复的发展历史．其美观逼真的修复效果早已被广大医生和患者所认可。而其强度一直是人们关注的焦点。目前全瓷材料的种类较多,如白榴石、锂基瓷、氧化铝、氧化锆等,制作方法也各有不同,如渗透陶瓷、热压铸造陶瓷、瓷沉积、计算机辅助设计与计算机辅助制作（CAD／CAM）等,其强度也越来越高,修复适应证也越来越广。在所有全瓷修复材料中,以CAD／CAM二氧化锆全瓷的抗弯强度最高㈣。CAD／CAM修复技术是将光电子技术、计算机技术及自控机械加工技术合并用于口腔修复的新技术。该技术起于20世纪70年代。但应用范围有限,效果也不尽人意。随着电子计算机技术与修复材料的迅速发展。有关该技术的研究越来越多㈤．其在口腔修复中的应用也越来越广。我国从2004年开始在临床上应用CAD／CAM氧化锆全瓷修复技术。     

Marginal fit of anterior 3-unit fixed partial zirconia restorations using different CAD/CAM systems

PURPOSE

Few studies have investigated the marginal accuracy of 3-unit zirconia fixed partial dentures (FPDs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) system. The purpose of this study was to compare the marginal fit of zirconia FPDs made using two CAD/CAM systems with that of metal-ceramic FPDs.

MATERIALS AND METHODS

Artificial resin maxillary central and lateral incisors were prepared for 3-unit FPDs and fixed in yellow stone. This model was duplicated to epoxy resin die. On the resin die, 15 three-unit FPDs were fabricated per group (45 in total): Group A, zirconia 3-unit FPDs made with the Everest system; Group B, zirconia 3-unit FPDs made with the Lava system; and Group C, metal-ceramic 3-unit FPDs. They were cemented to resin dies with resin cement. After removal of pontic, each retainer was separated and observed under a microscope (Presize 440C). Marginal gaps of experimental groups were analyzed using one-way ANOVA and Duncan test.

RESULTS

Mean marginal gaps of 3-unit FPDs were 60.46 µm for the Everest group, 78.71 µm for the Lava group, and 81.32 µm for the metal-ceramic group. The Everest group demonstrated significantly smaller marginal gap than the Lava and the metal-ceramic groups (P<.05). The marginal gap did not significantly differ between the Lava and the metal-ceramic groups (P>.05).

CONCLUSION

The marginal gaps of anterior 3-unit zirconia FPD differed according to CAD/CAM systems, but still fell within clinically acceptable ranges compared with conventional metal-ceramic restoration.     

CAD/CAM玻璃陶瓷全冠在后牙义齿修复中的运用

目的:研究CAD/CAM全瓷冠在后牙义齿修复中的应用。方法:35例患者47个后牙经完善根管治疗后,使用CAD/CAM氧化锆全冠修复。结果:随访3~18个月,45个牙冠修复体的固位、边缘密合度、牙周状况均良好,1个冠咬合面出现隐裂,1个牙冠修复体出现松动。结论:CAD/CAM氧化锆全冠在后牙义齿修复中能够提供较好的固位及美学效果。     

CAD/CAM全瓷冠在后牙种植修复中的临床应用

目的:通过对CAD/CAM与传统金属烤瓷后牙种植的修复效果的回顾性调查,评价不同修复方式的临床效果,以探讨更有利于种植体修复的全瓷修复技术。方法:选取上后牙CAD/CAM全瓷冠修复种植病例30例作为实验组。修复三年后复查,填写修复体满意度调查表,依照改良的USPHS标准对修复体进行评价。结果:在费用方面,实验组患者的满意度为33%,对照组为78%。在就诊时间和次数上实验组患者的满意度为100%,对照组为63%。在外形方面实验组明显优于对照组(P<0.05),而在边缘适合性、表面质在及颜色匹配三方面无统计学差异(P>0.05)结论:CAD/CAM系统操作简便,制作修复体快捷且外形美观,与传统方法相比更有利于种植体的修复。     

CAD／CAM制作瓷全冠边缘适合性的评价

目的研究采用第二代计算机辅助设计及制作系统(CERECⅡ)制作的瓷全冠的边缘适合性。方法在离体牙上制备标准的全瓷全冠预备体,采用CERECⅡCAD/CAM系统制作瓷全冠并就位,用工具显微镜测量瓷全冠与预备体之间的间隙。结果所有全冠均能顺利就位,平均边缘间隙在肩台为56±26μm,牙合面为64±21μm,轴面为81±31μm,其所有测量点的平均值为64±28μm。结论CERECⅡ系统制作的标准瓷全冠就位顺利,边缘适合性达到临床应用要求。     

Effect of span length on the fit of zirconia framework fabricated using CAD/CAM system

PURPOSE

The purpose of this study was to evaluate the effect of the span length on the fit of zirconia framework fabricated using CAD/CAM system.

MATERIALS AND METHODS

Abutments for single, 4-unit and 6-unit fixed partial prostheses were fabricated. Ten zirconia frameworks were fabricated for each group. The marginal and internal gap were presented by means of replica technique and measured by measuring microscope (AXIO®, Carl Zeiss, Rochester, NY) and software (I-solution®, IMT i-solution Inc., Vancouver, BC, Canada). The results were statistically analyzed by multivariate analysis test and Dunnett T3 test for post hoc test (α=.05).

RESULTS

There were statistically significant differences at 2, 4, 7, 8 points (mesio-distal section) and b, d, e, f, g (labio-lingual section). In some marginal reference points of 6-unit group (P<.05), the marginal gap were larger than 120 µm.

CONCLUSION

Span length of zirconia core may have an influence on marginal and internal fit. Within the limitation of this study, the increase of span length of zirconia framework of 6 or more-unit fixed partial denture may decrease the marginal and internal fit.