三种不同类型嵌体修复后牙II类洞的疗效对比

目的 研究3种不同类型嵌体修复后牙II类洞的疗效。方法 选取130例(患牙150颗）后牙II类洞患者,按随机数法随机分为3组：A组50颗患牙给予复合树脂嵌体修复;B组51颗患牙给予CAD/CAM全瓷嵌体修复;C组49颗患牙给予Ceramage聚合瓷嵌体修复,评估牙体修复后的预后情况。结果 C组患者修复效果明显优于A组和B组。C组患者的GI、PI和SBI评分显著低于A组和B组。修复一年后,各组GI和PI评分与刚修复后相比均增加,且C组评分显著低于B组和C组(P<0.05）;C组牙体磨损和边缘着色发生率显著低于A组和B组(P<0.05）。结论 Ceramage聚合瓷嵌体修复效果明显优于复合树脂嵌体修复和CAD/CAM全瓷嵌体修复效果,可以有效保护牙周健康,且预后良好。     

CEREC瓷嵌体的临床评价

ＣＥＲＥＣ瓷嵌体的临床评价何玉林（第二军医大学长征医院口腔科）～～～～～～～～～～～～～～～～～～～～在临床修复应用中，瓷嵌体作为银汞合金的替代物，得到了充分的发展。传统的瓷嵌体修复需要一间接的技术方法，运用印模和模型在实验室制作完成。随着光学扫描方...     

粘结复合树脂嵌体的3年纵向临床观察

目的：①评价signum复合树脂嵌体的3年临床表现：②比较前磨牙和磨牙树脂嵌体修复的临床效果；③评价单、双面及多面嵌体的差异。材料与方法：30名患者的113个嵌体入选本研究．临床上由一名医师设计戴入，所有嵌体由同一名技师使用同一种复合树脂材料（signum．Heraeus Kulzer）制作完成．采用三步粘结系统和同一种树脂粘结水门汀进行粘结。嵌体戴入后，由另一名不知情的医师按照改良美国公共卫生服务标准（USPHS）对修复体进行评估。结果：3年后．113个嵌体中有3个进行了重新修复．总失败率为26％。基线时，各项评价指标中被评为完好（A）的嵌体有88．5％～100％．3年后，嵌体的表面粗糙度、边缘解剖形态、边缘完整性和嵌体完整性与基线比较均存在显著的统计学差异（P〈0.05）。除了边缘解剖形态和边缘完整性以外，前磨牙与磨牙，单、双面与多面嵌体的临床效果比较无显著差异。结论：复合树脂嵌体的3年成功率很高（97．4％）．修复体的大小和牙位对其临床修复效果均无显著影响。     

金属嵌体与复合树脂修复治疗垂直型食物嵌塞的疗效比较

目的：比较嵌体和复合树脂直接充填修复治疗垂直型食物嵌塞的临床疗效。方法：选择68例垂直型食物嵌塞病例82个牙,随机分组,分别应用金属嵌体和复合树脂直接充填修复进行治疗,进行1年的临床随诊观察,通过对患牙邻接关系,牙龈健康状况及边缘密合度进行比较。结果：两组病例在边缘密合性及牙龈健康状况方面无显著性差异,而在邻接关系方面差异具有统计学意义。结论：嵌体修复在治疗垂直型食物嵌塞时较复合树脂充填修复效果好。     

全瓷嵌体修复后牙牙体缺损166例疗效分析

目的:全瓷嵌体修复后牙牙体缺损166例,分析其临床疗效.方法:全瓷嵌体应用于后牙牙体缺损修复,并与复合树脂嵌体作对照,从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂、颜色匹配等方面进行比较.结果:经过3年的临床观察,全瓷嵌体在边缘着色、基牙继发龋、解剖形态、颜色匹配等方面的临床疗效优于复合树脂嵌体.结论:全瓷嵌体是一种较好的新型牙体缺损修复体.     

瓷嵌体与树脂嵌体边缘微渗漏的对比研究

目的：对比研究Ceramage聚合瓷嵌体和复合树脂嵌体、铸瓷嵌体的边缘微渗漏情况.方法：40颗离体牙按嵌体备洞原则制备近中邻（牙合）Ⅱ类洞,随机分为4组,每组10颗.分别用Ceramage、Z350、P60、IPS EmpressⅡ制作嵌体后使用Single Bond 2和Rely X ARC进行粘接.经冷热循环500次后品红染色,金刚砂片平行于牙体长轴沿近远中方向将修复体纵向剖开2次,在体式显微镜下测量染料渗入轴壁、龈壁的深度.结果：4种材料微渗漏长度经单因素方差分析有统计学意义（轴壁：F=6.667,龈壁：F=11.1,P＜0.01）,q检验进行组间两两比较,IPS EmpressⅡ的微渗漏值高于Ceramage、Z350、P60,差异有统计学意义（P＜0.05）,其他三组间差异无统计学意义（P＞0.05）;同材料组的龈方渗漏程度均显著高于轴壁,配对t检验显示差异有统计学意义（P ＜0.01）.结论：从微渗漏深度进行评价,Ceramage聚合瓷是临床上制作树脂嵌体较理想的材料;     

复合树脂嵌体充填牙体窝洞5年疗效观察

目的 观察复合树脂嵌体的远期疗效。方法 用光固化复合树脂制成嵌体应用于后牙,并以单纯光固化复合树脂充填的后牙作对照,观察治疗5a后的效果。结果 复合树脂嵌体有很好的远期疗效。结论 复合树脂嵌体是一种很好的新型牙体修复体。     

树脂嵌体修复儿童第一磨牙大面积缺损的临床疗效观察

目的：观察树脂嵌体用于修复儿童第一磨牙牙体大面积缺损的临床效果。方法：采用间接法复合树脂嵌体修复技术,修复儿童第一磨牙牙体大面积缺损28例,随访观察18个月以上。采用USPHS评价标准,分别从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂方面进行评价。结果：观察18个月以上,除一例出现牙体部分折裂外,其余27例临床效果满意。结论：应用复合树脂嵌体修复第一磨牙牙体大面积缺损,能有效恢复年轻恒牙牙体外形和邻接关系,临床效果满意。     

后牙复合树脂嵌体的研究进展

近十几年来，随着光固化复合树 脂应用于后牙，人们寻求多种材料和方法克服其不足，如磨损和微泄漏等方面的缺陷。但目前还滑有一种材料和方法守全克服其不足，在众多材料和方法中，混合填料的光固化复合树脂嵌体不失为一种行之效的方法。本文就光固化复合树脂嵌的理论基础，适应证，制备方法及其有关的物理性和嵌体的优点作一综述。     

A one-year clinical study of indirect and direct composite and ceramic inlays

The aim of this study was to evaluate the clinical performance of four types of tooth-colored inlays. The systems included 15 direct ceramic inlays (CEREC Vita-Blocks), 15 direct composite inlays (Brilliant D.I., Coltène), 14 indirect ceramic inlays (Vita Dur N), and 14 indirect composite inlays (Estilux) in 37 patients. The inlays were evaluated clinically 1 wk (base line) and 6 and 12 months after cementation. The clinical assessments were supported by bitewing radiographs. One Vita Dur N inlay fractured after 1 yr of service, and one Brilliant D.I. inlay had to be replaced because of secondary caries. No apparent increase in plaque accumulation or gingival inflammation could be related to treatment with inlays. At base line and throughout the observation period, the Vita Dur N inlays received the highest ratings for morphology and color match. The Brilliant D.I. inlays showed the smoothest surface texture, whereas the Estilux inlays showed the roughest texture. After 6–12 months of observation, all types of inlays showed varying degrees of disintegration of the composite luting cement. Within the observation period, all inlay systems appeared to be clinically acceptable.     

The clinical performance of ceramic inlays: a review

The availability of improved ceramic materials, bonding techniques, new technology and issues of amalgam safety have led to a revival of interest in ceramic inlays in dentistry over the past ten years. Clinical studies have been carried out during this time using various evaluation techniques to assess the clinical performance of these restorations. In this paper, recent clinical studies are examined and a review of the current state of knowledge regarding the clinical performance and survival statistics of ceramic inlays is presented. The major problems associated with ceramic inlay therapy appear to be fracture, hypersensitivity, degree of fit, maintenance of marginal integrity, microleakage, bond failures and cement wear. Other areas which also affect the clinical performance of ceramic inlays are ceramic wear, opposing tooth wear, plaque accumulation, gingivitis, secondary caries, colour stability, anatomic form and radiopacity. Recommendations based on the findings of clinical studies are also presented and whilst no specific material or technique has been shown to be clearly superior, certain principles which predispose to success can be identified. When compared with other forms of aesthetic intracoronal restorations, ceramic inlays perform well. However, their high cost and extreme technique sensitivity would appear to restrict their use to certain limited clinical situations.     

Evaluation of fracture resistance of endodontically treated maxillary premolars, restored with ceromer or heat-pressed ceramic inlays and fixed with dual-resin cements

The aim of this study was to evaluate the fracture resistance of endodontically maxillary premolars restored with mesio-occlusal-distal (MOD) inlays made with ceramic (IPS-Empress 2) and ceromer (Targis) and luted with three different dual-cured resin cements (Enforce, Variolink II, Panavia F). Sixty maxillary premolars were randomly distributed into six groups, according to their mesio-distal and facio-lingual dimensions. The teeth were endodontically treated and MOD cavities prepared. After the restorations were cemented, the samples were thermocycled and submitted to an axial compressive load by the action of a rounded end steel cylinder contacting the incline planes of occlusal surfaces of the teeth. The mode of fracture was analysed with a microscope. The best results were found with the combinations (cement/restorative material) Enforce/Targis (107.57 kgf) and Enforce/Empress (90.21 kgf) followed by Variolink II/Targis (86.44 kgf)-Variolink II/Empress (84.07 kgf) and Panavia F/Targis (82.43 kgf)-Panavia F/Empress (76.73 kgf). Analysis of variance (P < 0.05) showed a significant difference between Enforce and Panavia cements regardless of the restorative material. Considering the same luting agent there was no statistically significant difference between the restorative materials. Fracture of lingual cusps occurred in 55 of the 60 teeth and most of them were of the cohesive type.     

An 8-year evaluation of sintered ceramic and glass ceramic inlays processed by the Cerec CAD/CAM system

The purpose of this study was to evaluate Cerec CAD/CAM inlays processed of two industrially made machinable ceramics during an 8-yr follow-up period. Each of 16 patients received two similar ceramic inlays. Half the number of the inlays were made of a feldspathic (Vita Mark II) and the other of a glass ceramic (Dicor MGC) block. The inlays were luted with a dual resin composite and evaluated clinically using modified USPHS criteria at baseline, 8 months, 2, 3, 5, 6 and 8 yr, and indirectly using models. At baseline, 84% of the inlays were estimated as optimal and 16% as acceptable. Postoperative sensitivity was reported by one patient for 8 months. Of the 32 inlays evaluated during the 8 yr, 3 failed due to fracture of the material. No secondary caries was found adjacent to the inlays. No significant differences in the clinical performance were found between inlays made of the two ceramics. It can be concluded that the CAD/CAM inlays processed of the two ceramics functioned well during the 8-yr follow-up period.     

嵌体适合性分析的实验方法

嵌体是修复牙体!面、颈部以及轴面缺损的常用冠内修复体。修复体的适合性是影响修复体使用寿命的重要因素。本文就分析嵌体适合性的体外实验方法及评价指标作一综述。     

树脂微拉伸粘结强度测试法的影响因素

目前常用微拉伸强度测试法对树脂的粘结强度进行评估。微拉伸强度测试法较传统的剪切强度测试有许多独特优点,然而该测试法会受到诸多因素的影响,使之不能准确反映树脂与牙体组织之间的粘结强度。这些影响因素主要包括离体牙储存方式、样本预备、不同的粘结系统以及固化方式等,已有学者对其进行了相关研究,该文就其研究成果作一综述。     

复合树脂外源性染色的影响因素

复合树脂在牙科学领域应用广泛,然而其颜色长期稳定性不佳成为复合树脂修复最大缺点之一。复合树脂成分、聚合程度、染色物质、表面粗糙度、染色去除方法等是影响复合树脂外源性染色的主要因素。本文对上述影响因素作一综述。     

两种全瓷材料用于后牙嵌体修复的疗效评价

目的 对比研究IPS Empress可铸陶瓷系统和In-ceram全瓷系统用于后牙嵌体修复的临床疗效。方法 分别制作IPS Empress瓷嵌体28件和In-ceram瓷嵌体30件。在戴用修复体0.5-3年后，比较两种瓷嵌体的颜色，形态，基牙龋患率，修复体边缘的密合度，修复体的磨耗及折断情况。结果 IPS Empress瓷嵌体的透明度和颜色优于In-ceram瓷嵌体，而In-ceram瓷嵌体的磨耗，折断情况优于IPS Empress瓷嵌体，在修复体的形态，基于龋患率，修复体边缘密合度方面两者差别无显著性（P＞0．05）。结论IPS Empress瓷嵌体用于美观要求较高时效果较好In-ceram瓷嵌体则适合修复He力较大的情况。两种瓷嵌体都是一种修复效果好的全瓷材料。     

铸瓷嵌体修复短冠磨牙牙体缺损的临床效果观察

目的 对铸瓷嵌体修复短冠磨牙牙体缺损效果进行评价,为临床提供理论依据。方法 选自2015年9月至2016年9月期间,在我院采取铸瓷嵌体修复的短磨牙139例患者的168颗患牙,应用美国健康协会修正标准,评价其粘接后,修复后3个月、修复后6个月及修复后12个月时的形态、边缘适合性、颜色、周围龋和磨损程度及折裂情况。结果 修复后3个月内有3个嵌体出现裂纹和折裂的情况,进行了重新制作。3~6个月间有1个嵌体脱落。12月内有4颗患牙出现龈缘炎。其余均取得良好的修复效果,在边缘适合性、形态、颜色、周围龋和磨损程度及折裂等性能方面,在戴用3个月、6个月和12个月后较即刻均无显著性改变（P>0.05）。结论 利用铸瓷嵌体修复短冠磨牙牙体缺损是一种简单易行,效果良好的修复方法。