改良铸瓷高嵌体用于后牙根管治疗后牙体修复的临床研究

目的探讨IPS e.max Press全瓷改良高嵌体修复根管治疗后牙的临床效果。方法选择179例患者的182颗根管治疗后牙为观察对象,采用IPS e.max press全瓷改良高嵌体修复。6~48个月后进行回访检查,采用改良USPHS评估标准进行修复体质量分级评估,Kaplan-Meier方法做统计学分析。结果 4例修复体的边缘嵴处发生局部崩瓷,未影响邻接关系,观察期结束时,修复体完整性均未发生进一步损坏。未观察到彻底失败的病例。Kaplan-Meier估计修复体4年的功能性生存率为100%,完全性修复率97.8%(SE=0.01)。根据改良USPHS评估标准,大多数病例的修复体质量达到临床优良的等级,无临床不满意或差的病例。结论 IPS e.max Press全瓷改良高嵌体可作为后牙根管治疗后牙体修复的一种可靠的修复方式。     

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.     

两种材料CAD/CAM髓腔固位的高嵌体修复无髓后牙缺损的临床对比研究

目的 比较计算机辅助设计与制造(computer aided design and computer aided manufacturing,CAD/CAM)IPS e.max CAD髓腔固位的高嵌体和Lava Ultimate髓腔固位的高嵌体修复根管治疗后牙体缺损的临床效果.方法 选取根管治疗后缺损磨牙90颗,随机均...     

CAD/CAM全瓷髓高嵌体在牙体缺损中的临床应用研究

目的　观察CAD/CAM全瓷髓高嵌体在牙体缺损中的临床效果。方法　选择71例病例(患牙82颗),其中男33例,女38例,年龄20~50岁,均采用IPS e.max CAD全瓷髓高嵌体进行后牙修复。随访24个月,观察修复体的颜色、形态、折裂、边缘密合度、基牙继发龋及邻接食物嵌塞的情况。结果　82颗修复体即刻满意度在85%以上。随访24个月中,失访4颗,78颗修复体形态和基牙继发龋方面均达到A级标准。1颗修复体轻微折裂,4颗出现邻接食物嵌塞,95%以上的修复体均达 A 级。结论　IPS e.max CAD全瓷髓高嵌体用于根管治疗的后牙短期修复效果良好。     

CAD/CAM全瓷高嵌体修复根管治疗后牙体缺损的临床评价

目的:采用瓷睿刻计算机辅助设计与制作(CAD/CAM)系统制作全瓷高嵌体修复根管治疗后的后牙牙体缺损,观察其1年期床疗效。方法::选取46例根管治疗后的后牙,使用瓷睿刻(CEREC)系统,IPS e.max CAD材料,制作全瓷高嵌体,双固化树脂水门汀粘结。修复后1年,采用改良USPHS标准对修复体、牙体、牙周等各方面指标进行评价,同时评价患者满意度。结果:87 ％的修复体各项检查标准都达到了USPHS 标准A类,患者满意率92％。CEREC 全瓷高嵌体1年期疗效确切。结论:使用瓷睿刻(CEREC)系统制作的 IPS e.max CAD全瓷高嵌体可作为根管治疗后后牙牙体缺损的有效修复方案。     

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 CAD全瓷冠修复的短期临床评价

目的 对IPS e.max CAD全瓷冠近期修复效果进行观察和评价。 方法 共选取469例542颗前、后牙IPS e.max CAD全瓷冠修复体,修复3~12个月后,按照美国加州牙科协会(CDA)制定的全瓷修复临床评定标准进行修复体评估。 结果 97.2%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 CAD全瓷修复体的近期修复效果良好。     

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。     

全瓷材料的透明度及不同背景下色度学变化的实验研究

目的 比较 4种全瓷材料修复体的透明度参数（TP）及其在模拟不同颜色的四环素染色牙背景下的色差ΔE,评价其美学修复效果。方法 制作4种不同全瓷材料（包括IPS e. max、Cercon、Lava、Girrbach）的修复体样本（n=8）,用 Datacolor 600型分光测色仪测得每组样本在白色及黑色背景下的颜色参数,计算 TP。用彩色打印机打印出黄、灰、深灰、暗红和亮红色 5组颜色以模拟四环素染色基牙,并以此为背景,测得每组样本与 2M2色瓷片的色差ΔE。结果 IPS e. max、Cercon、Lava、Girrbach组样本的 TP值分别为 15.67±0.58、7.56±0.43、9.55±0.25、9.73±0.43;IPS e. max组的TP值明显大于其他3组（P<0.001）。IPS e. max组在黄色背景下的ΔE为1.33 NBS;Lava组和Girrbach组在灰、深灰、暗红和亮红色背景下的ΔE值在 0.75~1.47 NBS之间。结论 IPS e. max组具有良好的透明度;在修复偏黄四环素染色牙时,IPS e. max的美学效果较好;而在修复灰、深灰、暗红和亮红色四环素染色牙时,Lava和Girrbach的美学效果较好。     

后牙瓷嵌体修复的临床应用

目的 研究IPS Empress可铸玻璃陶瓷系统用于后牙嵌体修复的临床疗效。方法 制作IPS Empress瓷嵌体51件，戴用0．5～2．0年后评价其颜色、形态、修复体周围龋、修复体边缘密合度、修复体磨耗及折断情况。结果 IPS Empress瓷嵌体修复体边缘适合性的合格率为96．1％，修复体形态的合格率是98．1％，修复体颜色的合格率为100％，磨损和折裂的合格率是94．1％，无修复体周围龋。结论 IPS Empress瓷嵌体是一种效果好的全瓷修复体。     

CAD/CAM全瓷高嵌体修复磨牙大面积牙体缺损的临床疗效评价

目的探讨CEREC 3D椅旁计算机辅助设计和制作(computer-aided design/computer-aided manufacture,CAD/CAM)系统制作全瓷高嵌体修复后牙牙体缺损的临床效果。方法对50例后牙牙体缺损患者,使用CEREC 3D椅旁CAD/CAM系统制作全瓷高嵌体,术后即刻和修复后6个月采用改良美国牙科协会评价标准对修复体进行评价,对患者进行满意度调查。结果修复后即刻检查边缘密合度、解剖外形、表面光滑度、色彩匹配度、牙龈健康和固位等6个方面达到满意比率分别为96%、98%、98%、94%、94%和100%,6个月后满意比率分别达到96%、98%、98%、94%、98%和100%。修复后6个月患者对全瓷高嵌体修复在形态、色彩和舒适性方面的满意度分别为88%、90%和92%。结论CEREC 3D椅旁CAD/CAM系统制作全瓷高嵌体修复后牙牙体缺损取得了较满意的初期临床效果,但是长期临床应用尚需进一步研究。     

Wear evaluation of the human enamel opposing different Y-TZP dental ceramics and other porcelains

PurposeThis study examined the wear resistance of human enamel and feldspathic porcelain after simulated mastication against 3 zirconia ceramics, heat-pressed ceramic and conventional feldspathic porcelain.Materials and methodsHuman teeth and feldspathic porcelain cusp were tested against ceramic discs. 5 brands were tested – 3 monolithic zirconia, Prettau, Lava, and Rainbow, one lithium disilicate, IPS e.max Press, and one feldspathic porcelain, Vita-Omega 900. The surface was polished using a 600 grit and 1200 grit SiC paper. Each group was loaded for 300,000 cycles in a chewing simulator. The wear resistance was analyzed by measuring the volume of substance lost. The wear surfaces were observed by scanning electron microscopy to determine the wear characteristics.ResultsVita-Omega 900 led to the greatest amount of enamel wears followed by IPS e.max Press, Prettau, Lava and Rainbow. There was a significant difference between Vita-Omega 900 and IPS e.max Press (p < 0.05). The wear values for human enamel were significantly greater than those for feldspathic porcelain, regardless of the surface roughness of the ceramic specimens (p < 0.05).ConclusionThe wear behaviour of human enamel and feldspathic porcelain varies according to the type of substrate materials. On the other hand, 3 zirconia ceramics caused less wear in the abrader than the conventional ceramic.Clinical significanceDental professionals should be aware of the wear effect of dental restorations on the opposing teeth or restorations. The amount of enamel wear was highest in feldspathic porcelains whereas zirconia ceramics caused less wear on the opposing teeth.     

铸瓷高嵌体修复后牙缺损的临床观察

目的：探讨全瓷高嵌体修复后牙缺损的应用及其保护作用。方法：选择牙体缺损较大，和／或已经过完善牙髓治疗的后牙48颗，制作全瓷高嵌体，追踪观察1-2年，用改良USPHS标准进行临床评价。结果：牙体、修复体完整性100％，边缘密合性83．3％，牙体外形、色泽及邻面接触关系恢复良好，仅1例有继发龋。结论：全瓷高嵌体是治疗后的牙体修复和保护牙体的的较理想的可靠修复方法。     

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??Objective    To explore whether IPS e.max CAD onlays with more sound tissue preserved had enough fracture resistance and better restoration effect compared with all-ceramic crowns when mandibular molars were in mesio-occlusal cavities after endodontic treatment. Methods    From August to October of 2015?? totally 32 extracted mandibular molars were collected in West China Hospital of Stomatology. All teeth were divided into four groups after being made pairs??which were G1??G2??G3 and G4. Subsequently??mesio-occlusal cavities were prepared with the same dimension??and endodontic treatment was conducted in all specimens. According to the restoration type and whether being exposed to thermomechanical cycles or not??the next process was as follows. G1??IPS e.max CAD crowns??no thermomechanical cycles??to simulate immediate state after restoration??G2??IPS e.max CAD crowns??with 1.2 million dynamic loadings and 1000 thermal cycles??to simulate 5-year functional state after restoration??G3??IPS e.max CAD onlays??no thermomechanical cycles??G4??IPS e.max CAD onlays??with 1.2 million dynamic loadings and 1000 thermal cycles. After that??all the specimens were loaded to failure??and failure modes were inspected and recorded. Results    The immediate fracture resistance of crowns and onlays was ??2269.49 ± 281.68??N and ??2357.91 ± 342.64??N??respectively??and there was no significant difference between them??P < 0.05??. After thermomechanical cycles??although the fracture resistance of both crowns and onlays decreased ???1738.30 ± 230.21??N and??2096.75 ± 216.75??N???they were higher than the mean masticatory force??100-250 N??and the maximum biting force??200-540 N??. The fracture resistance of onlays was higher than that of crowns and there was a significant difference between them??P < 0.05??. Conclusion    For mandibular molars with mesio-occlusal defect??both onlays and crowns achieve excellent immediate flexural strength. After thermomechanical cycles to simulate 5-year functional movement??they still have sufficient fracture resistance and onlays show better result than crowns.     

Energy dissipation capacities of CAD-CAM restorative materials: A comparative evaluation of resilience and toughness

Statement of problem

Well-balanced physical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) materials are important to ensure the clinical success and longevity of restorations. Therefore, the capacity of a material to dissipate destructive fracture energy by means of elastic and plastic material deformation is of interest. However, little information is available on how to quantify the resilience and toughness of CAD-CAM materials.

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。     

Fatigue resistance of ultrathin CAD/CAM ceramic and nanoceramic composite occlusal veneers

ObjectiveThe fracture resistance of different ultrathin occlusal computer-aided design/computer-aided manufacturing (CAD/CAM) veneers was investigated under cyclic mechanical loading to restore combined enamel-dentin defects.MethodsEighty-four molars were reduced occlusally until extensive dentin exposure occurred with a remaining enamel ring. Twenty-four molars were ground flat for examination of highly standardized specimens, of which 8 were treated with uniformly flat 0.3 mm IPS Empress CAD and 0.3 and 0.5 mm IPS e.max CAD restorations. Sixty-four molars were anatomically prepared until dentin exposure and were restored using occlusal veneers with fissure/cusp thicknesses of 0.3/0.5 mm from 3 different dental CAD/CAM materials: IPS Empress CAD, IPS e.max CAD and Lava Ultimate CAD/CAM. Teeth were etched with 37% phosphoric acid, and occlusal veneers were bonded using an adhesive luting system (Syntac Primer, Adhesive, Heliobond and Variolink II). Specimens were placed under cyclic mechanical loading in a chewing simulator (1 million cycles at 50 N) and were examined for cracks after each cyclic loading sequence. The anatomical 0.3/0.5 mm IPS e.max CAD specimens experienced an additional 1 million cycles at 100 N. Kaplan–Meier survival curves and log-rank tests were used for data analysis.ResultsAll highly standardized and 0.3/0.5 mm IPS e.max CAD specimens tolerated cyclic loading. One anatomical Lava Ultimate CAD/CAM and 10 IPS Empress CAD specimens showed cracks.SignificanceUltrathin occlusal veneers of lithium disilicate ceramic and nanoceramic composite showed remarkably high fracture strength under cyclic mechanical loading. These veneers might be a tooth substance preserving option for restoring combined dentin–enamel defects.     

不同全瓷材料和厚度的种植牙冠应力分布有限元分析

目的通过有限元方法比较不同全瓷材料和厚度在种植牙冠修复的应力分布情况,为临床冠部修复材料的选择和设计提供参考。方法建立下颌第一磨牙种植牙冠修复有限元模型,并进行6种冠厚度和4种不同冠修复材料,即树脂基陶瓷(Lava Ultimate和Vita Enamic)、二硅酸锂玻璃陶瓷(IPS e.max CAD)和氧化锆陶瓷(Cercon)进行组合。在下颌第一磨牙面加载600 N,使用有限元软件ANSYS 10.0分析应力分布。结果冠部应力分析显示,4 mm?Cercon组156.05 MPa最高,1 mm?Lava Ultimate组18.85 MPa最低。树脂水门汀应力分析显示,4 mm?Lava Ultimate组62.52 MPa最高,1 mm?IPS e.max CAD组16.74 MPa最低。使用成品基台时,Lava Ultimate组在冠修复体、树脂水门汀中的应力集中较相同冠厚度的个性化基台高。结论随着冠厚度增加,冠修复体和树脂水门汀中的最大主应力集中呈现上升趋势;树脂基陶瓷使用个性化基台更有利于减少应力集中。