局部数字化印模应用于单颗磨牙种植修复中的临床研究

目的:比较使用局部口内扫描数字化印模技术与传统硅橡胶制取印模技术在单颗后牙种植修复中的临床效果。方法:选择2021年6月～12月需行第一磨牙种植修复的患者86名,按照取模方式随机分为2组。分别使用局部口内扫描数字化印模技术(A组)和传统硅橡胶制取印模技术(B组)制取种植印模,由此制作氧化锆全瓷修复体。记录修复体调磨时间,按照改良的美国公共卫生署(United states public health service, USPHS)修复体标准对修复体进行评价,并使用Geomagic软件对修复体调磨量进行量化,视觉模拟量表(visual analogue scale, VAS)评估患者满意度。结果:2组印模的临床调磨时间有显著统计学差异;A组修复体边缘密合显著优于B组(P<0.05)。A组咬合面调磨量与B组有显著差异(P<0.05)。患者对数字化印模(A组)的偏好度更高,2组修复体满意度VAS评分则无统计学差异。结论:在种植后牙单冠制作中,相较于传统印模,采用局部口内扫描数字化印模技术不仅节省了临床操作时间,制作的修复体精度更高,同时患者满意度也更高,能达到与传统硅橡胶印模相似...     

硅橡胶印模与口内扫描印模在口腔临床教学中的比较

目的：通过本科实习医师制取硅橡胶印模及数字化口内扫描印模的教学实践,对比2种取模方式的操作时间、学习的难易程度和患者的接受程度等。方法：6名本科实习医师分别作为医师和患者进行取模练习,由专人记录操作时间,并用视觉模拟量表（VAS）记录患者满意度。采用SPSS 23.0软件包对数据进行统计学分析。结果：在取模时间、学习总时间、总体舒适度方面,硅橡胶印模优于口内扫描印模,两者之间有显著差异(P<0.05)。结论：采用硅橡胶取模,患者的就诊体验更好。采用口内扫描印模技术,需要医师具有更熟练的操作技能。应用角色扮演的方式,实习医师可以更好地学习到不同取模方式的操作要点及注意事项。     

ICam4D摄影测量技术应用于全牙弓种植固定终修复的临床研究

目的：探讨ICam4D摄影测量技术在全牙弓种植固定修复终印模制取中的临床效果。方法：选取需进行终修复的全牙弓种植固定修复患者30名。对照组及实验组各15名,分别采用传统夹板印模技术制取硅橡胶开窗印模及ICam4D摄影测量技术获取数字化印模完成最终固定义齿修复。患者填写印模制取舒适度及修复体满意度视觉模拟量表（Visual Analogue Scale,VAS）,比较两组制取印模耗时、患者舒适度、修复体就位及边缘适合性、修复体满意度及修复后随访差异,评估ICam4D摄影测量技术在全牙弓种植固定修复中的临床效果。结果：全部终修复体均精准被动就位,边缘适合性均为I级;印模制取耗时对比,实验组（15.67±2.77）min显著少于对照组（51.47±5.88）min,差异有统计学意义（P<0.05）;印模舒适度（VAS）评分对比,实验组（94.60±13.64）显著高于对照组（55.13±13.64）,差异有统计学意义（P<0.01）;两组修复体咀嚼、美观、发音满意度（VAS）评分均无显著性差异（P>0.05）;两组随访,螺丝松动及折裂率、支架折裂率均为0%,种植体成功率均为...     

数字化印模联合全瓷冠修复牙体缺损的临床疗效分析

目的: 分析数字化印模联合全瓷冠修复牙体缺损的临床疗效。方法: 选择2018年6月—2020年6月东风口腔医院120例牙体缺损患者,随机分为硅橡胶印模和数字印模2组,每组60例。硅橡胶印模组采用硅胶印模联合全瓷冠修复,数字印模组采用数字印模联合全瓷冠修复,观察2组的修复效果,牙体修复前、戴牙时和戴牙后6个月牙龈指数（GI）、牙周指数（PI）、邻面接触情况、咬合度合格率及不良反应。采用SPSS 22.0软件包对数据进行统计学分析。结果: 2组患者对修复体评价均选择A级和B级,数字印模组选择A级的人数多于硅橡胶印模组,但无显著差异（P>0.05）。戴牙后6个月,2组患者的GI、PI指数均增高,硅橡胶印模组显著高于数字印模组（P<0.05）。戴牙时和戴牙后6个月,数字印模组邻面接触合格率显著高于硅橡胶印模组（P<0.05）。戴牙时,数字印模组患者咬合度显著高于硅橡胶印模组（P<0.05）。戴牙后6个月,2组患者咬合度无显著差异（P>0.05）。制取模型时,数字印模组患者不良反应发生率显著低于硅橡胶印模组（P<0.05）。结论: 运用数字化印模联合全瓷冠对牙体缺损患者进行修复,能有效提高工作效率,改善患者GI、PI指数,提升牙体邻面接触及咬合度合格率,降低不良反应发生率。     

改良树脂夹板在种植体开窗式印模技术中的应用研究

目的:介绍一种改良的种植体开窗式印模转移杆的树脂夹板,并评估其临床应用效果。方法:选择牙列缺损患者18例共44枚种植体,制取印模前于体外制作改良的个性化丙烯酸树脂夹板,返回口内连接固定开窗式印模转移杆,制取印模并制作18件修复体。安装修复体时检测边缘适合性,修复完成后第1、3、6和12个月复诊,以后每12个月复诊一次。复诊时检测种植体周围边缘骨吸收量、软组织健康状况及各种机械并发症。结果:18件修复体边缘适合性均良好,随诊时间12-36个月,平均22个月,第一年平均骨吸收量为0.82mm,随诊期内所有种植体周围软组织健康状况良好,未发现机械并发症。结论:本研究中改良树脂夹板应用于种植体开窗式印模技术精确性高,修复体临床效果良好。     

2种不同印模方法制取间接桩核的临床效果评价

目的比较硅橡胶印模法与琼脂/藻酸盐联合印模法制取铸造间接桩核的临床效果。方法将牙体大面积缺损、根管治疗后要求桩核冠修复的389颗牙随机分为A、B组,A组采用硅橡胶印模法制取间接桩核,B组采用琼脂/藻酸盐联合印模法制取间接桩核,对2种印模法制取间接桩核的效果进行评价。结果硅橡胶印模法制取间接桩核的临床成功率高于琼脂/藻酸盐联合印模法,二者之间差异具有统计学意义（P<0.05）。其中,2种不同印模方法制取前牙间接桩核的成功率之间差异无统计学意义（P>0.05）,制取前磨牙和磨牙间接桩核的成功率之间差异有统计学意义（P<0.05）。结论采用硅橡胶印模法制取间接桩核的临床效果优于琼脂/藻酸盐联合印模法。     

个齿托盘对硅橡胶印模颈缘清晰度影响的临床研究

目的:研究探讨个齿托盘取模在固定修复体印模制取中的临床效果。方法:选择需行上颌前牙全冠修复的患者120例,随机分为3组,分别采用硅橡胶一次(A组)、二次(B组)、个齿托盘取模法(C组)制取印模,按照印模颈缘评定标准进行评价并对比。结果:经统计学检验,3组颈缘清晰度有显著性差异(P<0.05),C组印模的优秀率及优良率明显高于其他2组(P<0.05)。结论:个齿托盘取模法复制基牙预备体肩台下解剖结构的效果优于常规取模方法,可以提高修复体的边缘适合性。     

模型置换印模技术修复下颌游离端牙列缺损的临床研究

目的：探讨模型置换印模技术对双侧下颌游离端缺牙患者的修复效果。方法：在解剖式印模上常规制作铸造支架,在铸造支架上制作自凝暂时基板,经口内肌功能修整并制取咬合记录后于口内取功能性印模。经模型置换后常规完成义齿。结果：90.2%的患者用模型置换印模技术制作的义齿疗效良好。结论：模型置换印模作为游离端可摘部分义齿的重要功能印模方法,可以有效改善义齿修复质量。     

不同数字印模方式影响全瓷冠边缘适合性的研究

目的 研究硅橡胶印模扫描、直接光学印模和传统的物理印模对计算机义齿辅助设计与制作全瓷冠边缘适合性的影响。方法 用数控车床制备聚甲基丙烯酸甲酯材质下颌第一磨牙标准全冠预备体16个,采用硅橡胶制取精细印模,超硬石膏灌注翻制成石膏模型。分别采用扫描全冠预备体、硅橡胶印模和石膏模型获取数字化模型,制作48个氧化锆全瓷冠。采用间隙印模测量法评价3组冠的边缘间隙,应用SPSS 17.0软件对实验数据进行统计分析。结果 直接扫描组、硅橡胶印模组、超硬石膏组的全瓷冠边缘间隙测量结果分别为（69.18±9.47）、（81.04±10.88）、（84.42±9.96） μm。直接扫描组与硅橡胶印模组、超硬石膏组差异有统计学意义（P<0.05）,硅橡胶印模组与超硬石膏组之间差异无统计学意义（P>0.05）。结论 直接扫描、硅橡胶印模扫描、石膏模型扫描法全瓷冠的边缘适合性均在临床可接受范围之内,硅橡胶印模扫描可作为临床上获取数字模型的方式之一。     

无牙颌下颌开窗式印模技术

重度吸收的无牙颌下颌牙槽嵴,其表面常被覆有过度增生的条索状黏膜组织,如何制取这些组织的精确印模是临床常见难题之一。本文介绍了1种无牙颌下颌开窗式印模制取方法。首先通过在无牙颌个别托盘相应区域开窗,充分显露出增生黏膜组织,使得医师可以在取模过程中随时准确观察这些组织状况。其次本文应用了2种新的印模材料——流体印模蜡与聚硫硅橡胶材料,分别用于制取正常黏膜组织与增生黏膜软组织区域的印模,获得了精确的下颌无牙颌印模。这种开窗式印模的特点是印模操作时间充分,两步式取模方式不会挤压组织变形,能够准确反映下颌无牙颌组织形态。     

Marginal gap of monolithic zirconia endocrowns fabricated by using digital scanning and conventional impressions

Statement of problemThe digital scanning technique has been introduced as an alternative to the conventional impression technique for the fabrication of fixed restorations. However, adequate information is not available on the efficacy of digital scanning for the fabrication of endocrowns regarding their marginal accuracy.PurposeThe purpose of this in vitro study was to compare the marginal gap of endocrowns fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) technology and digital scanning and conventional impression techniques.Material and methodsAn endodontically treated mandibular molar tooth was prepared to receive an endocrown. The impressions were made by using the conventional impression technique with polyvinyl siloxane material (n=11) and digital scanning by using an intraoral scanner (n=11). Endocrowns were fabricated from monolithic zirconia blocks by using a milling machine. Each restoration was seated on the prepared tooth, and the marginal gap was measured by using a video measuring machine at 8 points under magnification. The mean marginal gap for each restoration and the overall mean marginal gap for each group were calculated. Data were analyzed by using a statistical software program. Marginal gaps were compared with the Mann-Whitney U test (α=.05).ResultsThe mean marginal gap was 74 μm for the conventional impression group. A similar mean marginal gap (70 μm) was found for the digital scanning group. No statistically significant difference was found between the groups (P=.375).ConclusionsThe digital scanning technique and the conventional impression technique yielded crowns with comparable marginal adaptation.     

两种结合口内数字化印模技术制作的氧化锆全冠修复前牙临床效果研究

目的    比较研究结合口内数字化印模技术制作的全解剖式多层氧化锆全冠与3D打印氧化锆饰瓷冠在上颌单颗前牙修复中的临床效果。方法    选取2019年6月至2020年6月于沈阳市口腔医院修复二科行上颌前牙氧化锆单冠修复患者52例,随机分为FC组和PV组,每组26例。所有患者均使用3Shape Trios口内扫描仪获取数字化印模,FC组切削制作全解剖式多层氧化锆全冠;PV组切削制作内冠,并结合3D打印技术制作氧化锆饰瓷冠。修复完成后,按照改良美国公共卫生署（United States Public Health Service,USPHS）标准对修复体进行评价;修复2个月后检查基牙的牙周情况,并使用视觉模拟量表（visual analogue scale,VAS）调查两组患者满意度。结果    修复体临床评价显示,两组修复体在边缘适合性、外形、颜色匹配、表面质地方面比较,差异均无统计学意义（均P > 0.05）。牙周情况检查表明,修复前与修复后2个月,两组基牙菌斑指数（PLI）、出血指数（BI）比较,差异均无统计学意义（均P > 0.05）。患者满意度VAS评分显示,FC组患者对就诊时间的评分高于PV组,差异有统计学意义（P < 0.05）;两组患者对修复体外形、颜色、舒适度方面的评价比较,差异均无统计学意义（均P > 0.05）。结论    两种结合口内数字化印模技术制作的氧化锆全冠在上颌单颗前牙修复中均能达到良好的修复效果。     

Accuracy of digital and conventional impression techniques and workflow

Objectives

Digital impression techniques are advertised as an alternative to conventional impressioning. The purpose of this in vitro study was to compare the accuracy of full ceramic crowns obtained from intraoral scans with Lava C.O.S. (3M ESPE), CEREC (Sirona), and iTero (Straumann) with conventional impression techniques.

Materials and methods

A model of a simplified molar was fabricated. Ten 2-step and 10 single-step putty-wash impressions were taken using silicone impression material and poured with type IV plaster. For both techniques 10 crowns were made of two materials (Lava zirconia, Cera E cast crowns). Then, 10 digital impressions (Lava C.O.S.) were taken and Lava zirconia crowns manufactured, 10 full ceramic crowns were fabricated with CEREC (Empress CAD) and 10 full ceramic crowns were made with iTero (Copran Zr-i). The accessible marginal inaccuracy (AMI) and the internal fit (IF) were measured.

Results

For AMI, the following results were obtained (mean?±?SD): overall groups, 44?±?26 μm; single-step putty-wash impression (Lava zirconia), 33?±?19 μm; single-step putty-wash impression (Cera-E), 38?±?25 μm; two-step putty-wash impression (Lava zirconia), 60?±?30 μm; two-step putty-wash impression (Cera-E), 68?±?29 μm; Lava C.O.S., 48?±?25 μm; CEREC, 30?±?17 μm; and iTero, 41?±?16 μm. With regard to IF, errors were assessed as follows (mean?±?SD): overall groups, 49?±?25 μm; single-step putty-wash impression (Lava zirconia), 36?±?5 μm; single-step putty-wash impression (Cera-E), 44?±?22 μm; two-step putty-wash impression (Lava zirconia), 35?±?7 μm; two-step putty-wash impression (Cera-E), 56?±?36 μm; Lava C.O.S., 29?±?7 μm; CEREC, 88?±?20 μm; and iTero, 50?±?2 μm.

Conclusions

Within the limitations of this in vitro study, it can be stated that digital impression systems allow the fabrication of fixed prosthetic restorations with similar accuracy as conventional impression methods.

Clinical relevance

Digital impression techniques can be regarded as a clinical alternative to conventional impressions for fixed dental restorations.     

口内数字印模技术

口内数字印模技术是近年来口腔医学关注的焦点之一。与模型数字印模技术相比,口内数字印模技术具有方便、快捷、实时、灵活等特点,可大大提高患者就诊的舒适度,具有明显的技术优势。与此同时,口内光学印模技术也面临着口腔复杂扫描环境的严峻挑战,亟待解决若干光学扫描瓶颈问题的局限,寻求扫描精度上的新突破。本文详细列举口内数字印模技术的优势与局限性,阐述分析其临床适应证,用以指导临床应用;对主流技术的原理介绍和临床应用的现状介绍,可让读者对口内数字印模技术有较全面的认识和了解。     

不同粘固剂对 IPS-Empress 2后牙全瓷冠边缘适合性的影响

目的 :探讨不同粘固剂粘固的IPS Empress 2后牙全瓷冠的边缘适合性。方法 :采用印模复制和扫描电镜技术 ,测量磷酸锌粘固剂、PanaviaF树脂粘结系统和Dyracteompomer粘结剂粘固的IPS Empress 2后牙全瓷冠咀嚼模拟试验前后的边缘粘固剂厚度 ,并观察粘固剂表面状态。结果 :3种粘固剂粘固的全瓷冠边缘粘固剂厚度无显著性差异 (P >0 .0 5 ) ;磷酸锌粘固剂粘固的全瓷冠边缘粘固层有明显缺损 ,且咀嚼模拟试验后缺损增多 ,而另两种树脂类粘固剂未见明显缺损。结论 :PanaviaF树脂粘结系统和Dyractcompomer粘结剂粘固的IPS Empress 2后牙全瓷冠具有良好而稳定的边缘适合性     

Marginal Adaptation of CAD/CAM All‐Ceramic Crowns Made by Different Impression Methods: A Literature Review

All‐ceramic crowns for teeth are widely used for restoring teeth. Stone casts have been made from conventional impression methods; however, newer techniques have made this process easier and faster for both the patient and the practitioner. Laboratory CAD/CAM technology mainly involves scanning the die stone, while other systems permit impression or intraoral scanning; however, one major concern remaining is the marginal fit of the restorations made using different methods for recording the prepared teeth. This study aims to review studies evaluating the marginal fit of all‐ceramic crowns manufactured by CAD/CAM systems using different extra‐ and intra‐oral scanners compared to conventional impressions.     

聚合瓷高嵌体与全瓷冠在短冠后牙修复中的疗效比较

目的 对比观察聚合瓷高嵌体与全瓷冠在短冠后牙修复中的临床疗效.方法 对根管治疗后的短冠后牙完成45例聚合瓷高嵌体修复及45例二氧化锆全瓷冠修复,从修复体美观、修复体折裂及脱落、边缘密合度、基牙保存情况等方面进行临床比较.结果 在12个月的观察期内,聚合瓷高嵌体在修复后6个月有1例出现修复体脱落,而全瓷冠修复体则在6~12月后陆续发现8例修复体脱落,两者在修复体折裂及脱落方面的比较有统计学差异(x2=4.44,P<0.05).结论 聚合瓷高嵌体在短冠后牙修复中有较好的临床效果.     

Comparative study of all-ceramic crowns obtained from conventional and digital impressions: clinical findings

Objective

To compare clinical aspects of all-ceramic crowns fabricated from conventional and digital impressions.

Methods

Thirty patients with 30 posterior teeth with the need of a crown restoration were selected. Zirconia-based ceramic crowns were made using an intraoral digital impression system (TRIOS®, 3shape) and two-step silicone impression technique. Two external blinded operators evaluated the all-ceramic crowns. Five selection items were assessed of which four were clinical: “marginal fit,” “occlusal contacts,” “interproximal contact points,” and “primary retention.” Then, the last selection item “final selection” was assessed when the operators considering all the variables had to select which of the digital or conventional crown had the best clinical conditions. Data was analyzed using Kappa index test and the Pearson’s chi-square test (α = 0.05).

Results

For the items marginal fit and interproximal contact points, moderate agreement between the two operators was described and significant differences were found between the two study groups. Conversely, for the variables primary retention and occlusal contacts, the agreement between the operators was fair and no significant differences were found. For the final selection, a substantial agreement was reached between the two operators and significant differences were found between the two groups (p &lt; 0.05).

Conclusion

In most cases and in a significant way, the digital crowns had better clinical conditions according to both evaluators. The digital crowns were statistically superior for the interproximal contact points and marginal fit. For the variables occlusal contacts and primary retention, no difference between the two groups was observed.

Clinical significance

Digital intraoral impressions can be used for manufacturing ceramic crowns, with the same or better clinical results as conventional impressions.

     

Comparison of intraoral scanning and conventional impression techniques using 3-dimensional superimposition

PURPOSE

The aim of this study is to evaluate the appropriate impression technique by analyzing the superimposition of 3D digital model for evaluating accuracy of conventional impression technique and digital impression.

MATERIALS AND METHODS

Twenty-four patients who had no periodontitis or temporomandibular joint disease were selected for analysis. As a reference model, digital impressions with a digital impression system were performed. As a test models, for conventional impression dual-arch and full-arch, impression techniques utilizing addition type polyvinylsiloxane for fabrication of cast were applied. 3D laser scanner is used for scanning the cast. Each 3 pairs for 25 STL datasets were imported into the inspection software. The three-dimensional differences were illustrated in a color-coded map. For three-dimensional quantitative analysis, 4 specified contact locations(buccal and lingual cusps of second premolar and molar) were established. For twodimensional quantitative analysis, the sectioning from buccal cusp to lingual cusp of second premolar and molar were acquired depending on the tooth axis.

RESULTS

In color-coded map, the biggest difference between intraoral scanning and dual-arch impression was seen (P<.05). In three-dimensional analysis, the biggest difference was seen between intraoral scanning and dual-arch impression and the smallest difference was seen between dual-arch and full-arch impression.

CONCLUSION

The two- and three-dimensional deviations between intraoral scanner and dual-arch impression was bigger than full-arch and dual-arch impression (P<.05). The second premolar showed significantly bigger three-dimensional deviations than the second molar in the three-dimensional deviations (P>.05).     

不同光学印模法对全瓷冠边缘和内部适合性影响的实验研究

目的研究Cerec 3D/Inlab MC XL系统不同光学印模法对Cerec Blocs全瓷冠边缘和内部适合性的影响。方法制备1个右侧下颌第一磨牙全冠预备体模型,复制32个石膏代型。采用随机抽样法,16个代型用于冠粘接,16个代型用于光学印模采集,其中直接法和间接法各选取8个,分别制作8个Cerec Blocs全瓷冠。采用修正美国公共卫生服务（USPHS）标准和扫描电镜（SEM）法评价冠的适合性,SAS 9.1软件对实验数据进行统计分析。结果修正USPHS法显示87.5%的边缘测试点临床可接受,直接法与间接法边缘适合性比较差异无统计学意义（P>0.05）;SEM法显示所有冠的边缘测试点均小于120 μm,直接法与间接法边缘和内部适合性比较差异均无统计学意义（P>0.05）,但直接法在近中、颊面、舌面、面的适合性优于间接法（P<0.05）;直接法远中轴面适合性较差,与近中轴面比较差异有统计学意义（P<0.01）。结论光学印模法对Cerec Blocs冠边缘适合性无影响,但对内部适合性有一定影响,全瓷冠边缘适合性均在临床可接受范围内。