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1.
彭敏  费伟 《上海口腔医学》2013,22(2):219-223
目的:应用一种新的小型分光光度计,对上前牙种植支持式全瓷修复与金瓷修复的边缘牙龈的龈色改变进行比较,为临床选择修复材料提供依据。方法:选择口腔种植修复后复查患者18例(男7例,女11例),共计上前牙区种植支持式单冠29例(全瓷修复11例,钛合金基台金瓷修复9例,金合金基台金瓷修复9例)。通过仪器采集图片并输入计算机,应用相关软件测量种植冠颈部边缘牙龈与对照天然牙牙龈的CIELab颜色差异。另由医师对冠缘龈色改变进行临床牙龈变色指数(GDS)评价。采用SPSS 17.0软件包对数据进行统计学分析。结果:分光光度计测量结果显示,上前牙种植支持式全瓷修复组(3.4±1.8)与金瓷修复组(4.9±3.4)引起的龈色改变无统计学差异。其中,全瓷修复与钛基台金瓷修复方式(3.5±2.5)之间的差异和钛基台金瓷修复与金基台金瓷修复方式(6.3±3.8)之间的差异均无显著性,但全瓷与金基台金瓷修复方式之间的差异具有统计学意义(P=0.037)。此外,全瓷组与金瓷组间的主观牙龈变色指数(GDS)无统计学差异,临床牙龈变色指数与分光光度计测得的牙龈变色值之间具有相关性(rs=0.426,P=0.021)。天然中切牙、侧切牙和尖牙在牙龈色彩的明度上无显著差异,但在红绿色轴饱和度和黄蓝色轴饱和度方面,尖牙高于中切牙和侧切牙。结论:全瓷组与金瓷组的龈色改变在分光光度计评价和临床评价上均无显著差异,但高金合金基台联合金瓷冠修复方式引起的种植冠边缘牙龈色差显著大于全瓷修复方式。  相似文献   

2.
目的评价贵金属烤瓷、氧化锆全瓷单冠修复对种植体周围组织的影响。方法选择2008年6月—2010年12月间完成种植单冠修复的患者78例共120颗种植体,贵金属烤瓷修复与氧化锆全瓷修复各60颗。分别于修复后12个月复诊,检测种植体周围边缘骨吸收量(MBL)、牙周探诊深度(PD)、改良菌斑指数(mPLI)、改良龈沟出血指数(mSBI)、龈乳头指数等临床指标,以及调查患者对种植义齿的满意度。结果贵金属烤瓷与氧化锆全瓷修复在MBL、PD、mPLI、mSBI、龈乳头指数以及患者满意度方面的差异均无统计学意义(P>0.05)。结论贵金属烤瓷与氧化锆全瓷修复对种植体周围组织的影响无差异,均能取得较好的临床修复效果,长期效果有待于进一步观察。  相似文献   

3.
在口腔修复中对美观效果的追求已逐渐成为非常重要的话题,人们不仅希望牙冠颜色、外形接近自然牙,同时还期望修复体能与周边软组织间相互协调,对人体无刺激及损伤。金瓷、全瓷及树脂类美学修复材料已被广泛用于临床。烤瓷熔附金属全冠—俗称金瓷冠。是由不同金属铸造成内冠,再在其表面用与天然牙颜色相似的瓷粉堆制出与邻牙相似的外形、经真空烤瓷炉烧结而成的金属—瓷复合体。由于含有金属内冠,金瓷修复体坚固耐用,适于口内任何部位,多单位缺牙的修复,此外,金瓷修复体还具有边缘密合、遮色效果好等优点。但正是由于其含有金属内冠,修复后易发生牙龈变色,部分人有过敏反应。此外,其对光的通透效果较差,不易完全模拟天然牙齿的颜色。根据金属内冠选用材料的不同又可分为贵金属烤瓷冠和非贵金属烤瓷冠。主要适用于修复变色牙,修复牙体缺损,牙列缺损的基牙,修复牙龈、牙槽嵴缺损,修复异形牙,修复错位牙,关闭牙间隙,种植体修复,附着体修复的基牙等。是目前较为常用的美学修复方法。全瓷冠是覆盖全部牙冠表面,且不含金属内冠的瓷修复体。由于内冠不再使用金属,而采用与牙齿颜色相近的高强度瓷材料制成,因此较金属基底烤瓷修复体更美观,半透明度与天然牙近似,修复后牙龈边缘表现更加自然,可达到仿真效果,且具有对周边组织无刺激等优点,已被广泛用于临床,尤其在前牙美学修复时常被选用。根据制作材料不同全瓷冠又可分为:(1)玻璃陶瓷类全瓷冠。其特点为颜色美观,具有半透明效果,但遮色效果及强度稍差,更适合前牙美学区单冠、瓷贴面或较短固定桥的修复。(2)氧化铝、氧化锆全瓷冠,通过应用CAD/CAM技术研磨完成氧化铝、氧化锆内冠,再通过分层堆瓷技术添加外层饰瓷,制作完成的全瓷冠或无外层饰瓷的全锆冠。氧化铝、氧化锆全瓷冠坚固、耐用,遮色效果佳,主要适用于后牙区单冠、较长固定桥的修复及前牙重度变色牙和金属桩核的修复,但其美学表现不如玻璃陶瓷类全瓷修复体。全锆冠主要适用于后牙功能区,恢复咀嚼功能。近年,全瓷材料已被广泛用于临床。其美学疗效已被临床应用证实。但有文献报道全瓷冠的远期修复成功率明显低于金属基底烤瓷冠。复合树脂类修复材料可经直接或间接的方式修复患牙。但此类材料的强度较低,易磨损、变色,美学表现及持久性不如瓷材料,通常被用于临时修复或过渡修复。近年,随着修复材料的不断更新和完善,尤其瓷粉类添加材料被加入其中,使复合树脂修复的适用范围不断扩大,可被用于直接充填或制作单冠,简单固定桥、嵌体及种植体的上部结构等;此外,可用于CAD/CAM研磨的树脂材料也被用于临床,其长远疗效有待近一步观察。  相似文献   

4.
目的探讨不同瓷系统对金瓷修复体颜色的影响.方法用Ni-Cr非贵金属体系烤瓷合金(德国)制作金属基底,选用Vita VMK 95 METALL KERAMIK A2瓷粉和Shofu Vintage A2瓷粉这2种不同系统的瓷粉,在相同的金属基底上分别制作金瓷试件(金属基底厚为0.3mm,遮色瓷厚度为0.2mm,瓷厚度为1mm).用Shde eye EX(松风,日本)电脑比色仪检测试件的颜色.结果①2种不同瓷系统对金瓷修复体的颜色、色相、和明度均无影响(P>0.05).②2种不同瓷系统对金瓷修复体的彩度(饱和度)有影响,并有显著差异(p<0.01).结论Vita和Shofu这2种瓷粉颜色之间比较,除了Shofu系列瓷粉的彩度比Vita瓷粉高外,颜色的明度和色相无明显的差异.如要增加金瓷修复体颜色的彩度,可选用Shofu系列瓷粉,以达到再现自然牙颜色的目的.  相似文献   

5.
牙位对牙冠颜色影响的研究   总被引:3,自引:0,他引:3  
目的:从不同的部位比较前牙牙冠之间颜色的差别,方法:采用CIE1976La.b色度参数,应用带光纤探头的人体牙齿颜色测量系统对1944颗颗被测前牙的切,中,颈部进行测量分析,结果:(1)牙冠颜色与牙位 有关:(2)左右侧前牙的颜色对称;(3)上牙以上中切牙明度最大;尖牙明度最小颜色最黄且偏戏,上前牙颈1/3明度相近,上切牙间切1/3,颈1/3色相彩色相同,中1/3除上中切牙与侧切牙在a上较接近外,明度,色相均有差别;(4)下切牙明度大于上切牙,上下尖牙在颈1/3明度基本按近,上下切牙间在切1/3颜色基本接近,(5)下切牙间在中1/3,切1/3处明度相近,而在颈1/3处有差别,在中1/3,颈1/3处b值相近,在切1/3处b值有判别,结论:左右侧前牙在颜色上对称。牙 冠民牙位有关。  相似文献   

6.
目的:比较计算机辅助设计和计算机辅助制造(CAD/CAM)氧化锆全瓷桩、玻璃纤维桩修复上前牙残冠的临床效果。方法???随机选择18~55岁患者的40颗上前牙残冠为研究对象,在修复前行完善的根管治疗,其中CAD/CAM全瓷桩、纤维桩各20件,均采用CAD/CAM氧化锆全瓷冠修复。于修复完成后2年复查修复体、牙根及牙周情况。结果??全瓷桩组有1例全瓷冠崩瓷,1例桩核折断及1例牙龈炎症;纤维桩组有1例桩核松动脱落,1例桩核折断,2例牙龈炎症。2组患者的患牙均未出现根折和继发性根尖周炎。修复的临床效果无显著性差异(P>0.05)。结论??对于上前牙残冠的氧化锆全瓷冠修复,CAD/CAM全瓷桩与玻璃纤维桩在固位性,抗根折能力和牙周、牙髓疾病控制方面无显著性差异,均可取得较好的临床效果。  相似文献   

7.
目的探讨作为前牙美容修复的金-瓷、铸瓷修复体在应用Crystaleye电脑比色仪比色时颜色的再现效果。方法对使用Crystaleye电脑比色仪比色后制作的金-瓷、铸瓷修复体(各58个)与作为比色参考的天然牙进行色差分析,并评价医生和患者的满意度。结果金-瓷修复体与天然牙的色差△E为7.13±0.74,铸瓷修复体与天然牙的色差△E为1.47±0.84,二者之间的差异有统计学意义(P<0.01)。铸瓷修复体的医、患满意度均高于金-瓷修复体,其差异有统计学意义(P<0.05)。结论Crystaleye电脑比色仪可以为铸瓷提供良好的比色参考,而对金-瓷修复体则有一定的偏差。  相似文献   

8.
目的 研究金合金、金合金烤瓷、氧化锆全瓷等修复材料的导热性对牙髓健康的影响。方法 ①实验室测量金合金、金合金烤瓷、氧化锆全瓷、自体牙、树脂粘接剂的导热系数;②随访金合金烤瓷冠、金合金铸造冠(颊侧烤瓷)和氧化锆全瓷冠修复的158颗活髓牙2年;对比158颗自体邻牙,统计出现牙髓炎、根尖周炎的牙数,并与几种材料的导热系数对照。结果 树脂粘接后,86%金合金导热系数37.89W/(m?K),21颗活髓基牙出现3例牙髓炎;86%金合金烤瓷导热系数0.85W/(m?K),58颗活髓基牙出现1例牙髓炎;氧化锆全瓷导热系数0.82W/(m?K),79颗活髓基牙无牙髓炎、根尖周炎发生;天然牙导热系数0.66W/(m?K),158颗活髓基牙无牙髓炎、根尖周炎发生;86%金合金铸造冠修复的基牙牙髓炎、根尖周炎阳性率远远高于其他几种低导热系数冠修复材料基牙(P<0.01)。结论 冠修复材料的自身导热性能够影响基牙牙髓健康,如过高会对基牙牙髓健康不利。建议把导热系数最接近天然牙的氧化锆全瓷+树脂粘接剂组合作为冠修复材料的首选。  相似文献   

9.
目的 探讨前牙牙冠延长术后采用氧化锆全瓷和金属烤瓷(porcelain fused to metal, PFM)冠修复对牙周的影响。方法 选择2009—2011年惠州市口腔医院修复科收治的拟行牙冠延长术+冠修复患者18例(共108颗上颌前牙),分成两组(全瓷组和PFM组),每组54颗,均行牙冠延长术;术后6个月,全瓷组行氧化锆全瓷冠修复,PFM组行钴铬合金烤瓷冠修复。随访8 ~ 32个月,评价两组冠修复后的牙周状况。结果 PFM组有34颗(62.96%)修复后出现牙周病损,其中轻度病损25颗,中度病损5颗,重度病损4颗;而全瓷组仅2颗(3.70%)发生轻度牙周病损。经Ridit分析,两组间差异有统计学意义(P < 0.05)。结论 前牙牙冠延长术后采用氧化锆全瓷冠修复的牙周状况明显优于PFM冠修复。  相似文献   

10.
目的探讨前牙牙冠延长术后采用氧化锆全瓷和金属烤瓷(porcelainfusedtometal,PFM)冠修复对牙周的影响。方法选择2009--2011年惠州市口腔医院修复科收治的拟行牙冠延长术+冠修复患者18例(共108颗上颌前牙),分成两组(全瓷组和PFM组),每组54颗,均行牙冠延长术;术后6个月,全瓷组行氧化锆全瓷冠修复,PFM组行钴铬合金烤瓷冠修复。随访8~32个月,评价两组冠修复后的牙周状况。结果PFM组有34颗(62.96%)修复后出现牙周病损,其中轻度病损25颗,中度病损5颗,重度病损4颗;而全瓷组仅2颗(3.70%)发生轻度牙周病损。经Ridit分析,两组间差异有统计学意义(P〈0.05)。结论前牙牙冠延长术后采用氧化锆全瓷冠修复的牙周状况明显优于PFM冠修复。  相似文献   

11.
《Pediatric Dental Journal》2021,31(2):136-144
BackgroundPreservation of the decayed primary anterior teeth is important until their natural exfoliation time as it acts as natural space maintainer. Two most common anterior aesthetic full coronal restorations, the strip crowns and the preformed zirconia crowns, are available options.ObjectiveTo evaluate and compare the clinical outcomes (gingival health, plaque accumulation, teeth wear of opposing dentition, color match and restoration failure) of strip crowns and preformed primary anterior zirconia crowns at one year follow up in 3-5 years old children.Material and methodsForty maxillary primary incisors were restored by either strip crown or zirconia crown. Permuted block randomisation method was used for allocation of participants. Gingival health, plaque accumulation, teeth wear of the opposing dentition, color match and restoration failure for crowns were assessed at one-year follow-up. Data was analysed using McNemar- Bowker test and Chi-Square test.ResultsAt one-year follow-up, gingival inflammation, plaque accumulation, restoration failure were significantly higher for the strip crowns (level of significance = 0.012, 0.013 and 0.0001, respectively) and, no statistically significant difference was found between the strip crowns and zirconia crowns for teeth wear of opposing dentition and color match evaluation (level of significance = 0.435 and 0.168, respectively).ConclusionOverall, zirconia crowns were found more successful than strip crowns for the rehabilitation of caries affected primary incisors.  相似文献   

12.
目的:比较两种不同材质的牙色改良高嵌体/冠修复中重度后牙缺损的临床疗效。方法:对46名患者51颗中重度缺损后牙分别采用CAD/CAM氧化锆全瓷改良高嵌体(冠)(A组)及钴铬烤瓷改良高嵌体/冠(B组)修复,在修复后12、24个月分别进行回访观察,比较其修复效果。结果:B组有1例在24个月回访时发现边缘瓷层崩瓷,边缘密合度增加,修复体未见损坏、松动,患牙未见继发龋及折裂,7颗修复体与患牙或邻牙颜色轻度不匹配。A组有3颗修复体与患牙或邻牙颜色轻度不匹配,其余未见异常。结论:两种不同材质的牙色改良高嵌体/冠用于中重度后牙缺损的修复效果均较理想,兼顾了修复体的强度与美观, 在选好适应症的情况下,简化了疗程,且临床疗效较好,但由于本研究观察期较短,远期效果有待进一步观察。  相似文献   

13.
STATEMENT OF PROBLEM: Matching a natural maxillary central incisor to a metal ceramic crown is one of the most difficult challenges in clinical dentistry due to the limitations of dental shade guides and the subjectivity of perceptual evaluation. PURPOSE: The purpose of this study was to assess the clinical effectiveness of a spectrophotometric shade-matching system on tooth color reproduction. MATERIAL AND METHODS: Two metal ceramic crowns were fabricated for a maxillary central incisor for 36 patients using 2 shade-matching techniques. The first technique was conventional visual matching using 3 shade guide systems, and the second was an instrument-based color-matching technique using a new spectrophotometric system. Color difference (DeltaE) values between the contralateral natural tooth and each of the 2 crowns were calculated in the cervical, middle, and incisal regions. The DeltaE values were compared using a Student's t test (alpha=.05). Three calibrated examiners evaluated the color match by ranking it from 1 to 10 (10 = perfect match; 1 = no match; < or =8, accepted; > or =7, rejected). McNemar's test was used to calculate the odds ratio of accepting restorations fabricated using a spectrophotometric system to conventional methods. RESULTS: Results revealed that the mean DeltaE values of crowns matched with the spectrophotometer were significantly lower than those using a conventional technique (P<.001). The odds ratio of 12.5 was calculated, indicating that conventionally matched crowns were more likely to be rejected than those matched using the spectrophotometer (P<.001). CONCLUSIONS: In this clinical study, crowns fabricated using a dedicated spectrophotometer had a significantly better color match and a lower rate of rejection due to shade mismatch compared to crowns fabricated with a conventional shade-matching method.  相似文献   

14.
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。  相似文献   

15.
纤维桩自推出以来以其良好的生物相容性、优良的机械性能、耐疲劳、耐腐蚀以及易拆除、根折发生率低等优点,在残根残冠的修复治疗中逐渐得到广泛的应用。有限元分析能对复杂形态、结构物体在各种载荷下的应力应变进行分析比较,是口腔生物力学研究中的重要手段。其中三维有限元分析因其模型的几何相似性和力学相似性,成为了纤维桩力学研究中的一种高效、精确、直观的方法。  相似文献   

16.
This study tested the shade match of single porcelain-fused-to-metal restorations with the adjacent dentition when the restorations were fabricated according to data from conventional visual shade matching or from a new spectrophotometric system. The samples of a Vita Classic shade guide were measured with the spectrophotometer to determine the CIE L*a*b* color parameters. Three clinicians independently selected the best match to a maxillary right or left incisor needing a restoration in 10 patients. The 10 incisors were then measured using a reflectance spectrophotometer. CIE L*a*b* coordinates were directly recorded on the spectrophotometer's detector area using a standard light source. Resulting conventional and spectrophotometric restorations were tested intraorally for best match with the adjacent incisor using conventional shade matching versus spectrophotometric measuring. Total color difference was calculated, and all groups were statistically analyzed. Initial shade evaluation matched for all three visual shade selections in two cases. In six cases only two evaluators matched, and in the remaining two cases all three visual selections differed. In contrast, in nine of 10 cases all three spectrophotometric shade selections matched. Additionally, in nine of 10 cases delta E values of visually assessed tooth shades were higher than spectrophotometrically assessed delta E values. Resulting delta E values for conventional crowns compared to spectrophotometric crowns were significantly higher. Finally, in nine of 10 cases spectrophotometric crowns were preferred over conventional crowns for definitive cementation when evaluated visually. Spectrophotometric shade analysis and communication can be used efficiently for fabrication of porcelain-fused-to-metal restorations.  相似文献   

17.
The aim of this study was to test the color-change effect of all-ceramic restorations compared with porcelain-fused-to-metal (PFM) restorations on marginal peri-implant soft tissue. Thirty patients were randomly divided into 2 groups of 15 subjects each. The all-ceramic group received all-ceramic crowns on aluminum oxide-based abutments, while the PFM group received crowns on titanium or gold abutments. A reflectance spectrophotometer was used to measure the color difference (deltaE(Implant)) between the midfacial peri-implant mucosa before and after restoration insertion. The color difference (deltaE(Tooth-implant)) between the midfacial peri-implant mucosa and the gingival margin of the corresponding neighboring tooth was tested. The mucosal thickness was measured midfacially around the implant (MT(Implant)) and neighboring tooth (MT(Tooth)). deltaE(Implant) values were similar for the all-ceramic (7.4 +/- 2.7) and PFM groups (7.6 +/- 2.8). The all-ceramic group induced significantly less visible mucosal color change (3.4 +/- 1.4) compared to the PFM group (5.2 +/- 2.3). The MT(Implant) value of the all-ceramic group was 3.4 +/- 0.8 mm, while that of the PFM group was 2.9 +/- 0.9 mm, which was not significantly different. Significant differences were found when comparing MT(Implant) (3.1 +/- 0.9) and MT(Tooth) (1.2 +/- 0.3) values for test and control groups. All-ceramic restorations revealed a better color match to the neighboring teeth than PFM restorations.  相似文献   

18.
ObjectivesColor matching still remains as one of the most challenging tasks in clinical dentistry. With the advancement of intraoral color matching instruments the importance of the development of color thresholds becomes increasingly important. The objective of this study was to set a gold standard for the color difference (ΔE) at which all-ceramic crowns cannot be distinguished from natural teeth.MethodAll-ceramic crowns with a zirconia coping (LAVA, 3M ESPE, St. Paul, MN, USA) and layered porcelain (Cerabien CZR, Noritake, Nagoya, Japan) fabricated to match contralateral maxillary central incisors were assessed by experienced observers. Eleven all-ceramic crowns (AC) were assessed as “excellent/perfect matches;” these crowns were then measured using a spectrophotometer and compared to their natural counterparts. Unrestored natural maxillary teeth (NT) were compared to unrestored contralateral teeth in 22 subjects. Six areas were measured in both groups to determine color differences (ΔE*).ResultsMean ΔE* value between the restorations and natural teeth was 1.6. Mean ΔE* between contralateral natural teeth was 0.9. Incisal areas of natural teeth exhibited greater differences in color than other compared areas.ConclusionA ΔE* = 1.6 represented the color difference that could not be detected by the human eye.  相似文献   

19.
目的:探讨CAD/CAM氧化锆、银钯合金和钴铬合金烤瓷全冠的修复效果及对牙周影响.方法:随机选择全冠修复患者46例49颗受试牙,采用3种材料进行修复(CAD/CAM氧化锆、银钯合金、钴铬合金).修复前、后进行GCF含量、TNF-α、IL-6检测,并对修复效果进行评价.采用SPSS 18.0软件包对数据进行统计学分析.结果:对照各组修复后效果,修复体颜色匹配和牙龈状况指标CAD/CAM氧化锆全瓷冠组均显著优于其他2组(P<0.05).各组修复后GCF含量、TNF-α和IL-6检测结果,CAD/CAM氧化锆全瓷冠组均显著优于其他2组(P.<0.01).结论:CAD/CAM氧化锆全瓷冠修复体修复效果好,且对患者牙周组织的破坏较小,优于银钯和钴铬合金烤瓷全冠修复体.  相似文献   

20.
目的:探讨钴铬合金、纯钛金属及二氧化锆不同烤瓷冠基底材料对局部龈沟液中肿瘤坏死因子-α(TNF-α)以及白介素-1β(IL-1β)表达水平的影响。方法:选择临床病例30例,分为3组,分别采用钴铬合金烤瓷冠、纯钛烤瓷冠、二氧化锆全瓷冠修复。在修复前、修复后1个月、3个月分别进行龈沟液(GCF)量、菌斑指数(PLI)、TNF-α和IL-1β表达水平的测定及统计分析。结果:修复前3组之间各检测指标无明显差异;修复后1个月、3个月时钴铬合金烤瓷冠组的GCF量、TNF-α和IL-1β表达水平均高于纯钛烤瓷冠和二氧化锆全瓷冠组;而纯钛烤瓷冠组与二氧化锆全瓷冠组的GCF量、TNF-α和IL-1β水平无显著变化且两组之间各项指标无明显差异。结论:钴铬合金烤瓷冠可导致GCF量及其成分变化,对牙周组织有一定的不利影响,而纯钛烤瓷冠和二氧化锆全瓷冠对牙周组织健康的影响相对较小。  相似文献   

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