Neocolloid印模材料在临床中应用

Neocolloid是意大利Zhermack金玛克公司生产的一种超高清晰度藻酸盐印模材料,具有高流动性、可注射、超高清晰度,具有高触变性、并且含有薄荷味、橙色。适用于各种活动义齿和固定义齿的修复。我们采用该印模材料取印模,获得了表面光滑,清晰度高,准确度高的模型。使制作出来的固定修复体和活动修复体与机体的组织更加密合,提高了固定义齿及活动义齿的修复质量。现将结果报告如下:1材料和方法1.1临床资料随机选取门诊患者128例。其中前牙桩金属烤瓷冠35例,金属冠桥23例,后牙铸造桥及铸造全冠修复60例,大活动桥10例。男性70人,女性58人,年龄为…     

伪影减少模式对不同材料全冠继发龋检测的影响

目的:探讨在不拆除固定义齿的情况下,伪影减少(artefact reduction,AR)模式对不同材料全冠修复体下继发龋检测能力的影响.方法:将8颗因龋坏拔出的第三磨牙用蜡块充填修复后,根据全瓷冠的预备要求完成牙体预备,每颗基牙制作钴铬金属、纯钛金属、铸瓷及氧化锆全瓷的冠部固定修复体.通过锥形束计算机断层成像(con...     

不同种类的固定修复体市场需求分析

目的探讨不同种类固定修复体的市场需求和需求变化。方法收集四川华西义齿修复制作中心2009—2011年生产的95 789件固定修复体为研究对象,统计产量构成比、绘制产量趋势图,分析固定修复体的市场需求及变化,采用季节指数分析固定修复体的产量规律。结果金属烤瓷修复体的构成比达到90%以上,钯银合金烤瓷修复体是主要的修复体选择类别,镍铬合金烤瓷修复体产量逐年降低,钴铬合金烤瓷修复体、种植体固定修复体、全瓷修复体产量保持稳定增长,金铂合金烤瓷修复体稳定在一定水平呈上下波动;季节指数的高峰为7月,指数达到1.155 56,低谷为2月,指数达到0.840 79,季节指数最高和最低月份相差0.314 77。结论金属烤瓷修复体占市场需求的主导地位,镍铬合金烤瓷修复体的产量逐年降低并逐渐被钴铬合金烤瓷修复体代替,固定修复体的产量存在季节波动,应优化资源配置并积极推广新技术。     

牙科应用材料的选择及其性质(Ⅵ及Ⅷ)

6 牙科合金及有关材料口腔用金属材料的重要要求之一是耐腐蚀。为此产生的大多数牙科合金不外乎这两类:1.含有不少于75％的贵金属,如金、铂、钯的合金,2.含有足够量的降低化学活性的铬,如不锈钢、钴铬和镍铬合金。牙科金属修复体可以用合金铸造加工,如制作嵌体、冠、桥和部分义齿。此外,用成品合金可制作合金丝、杠,它也可制作成不锈钢义齿基托。     

瓷面的后牙固定部份义齿

全瓷复盖的后牙固定部份义齿和冠,已是目前较通用的一种修复体。这种广泛磨除咬(牙合)面的修复体,在戴入的时候,常已获得了咬(牙合)协调。在制作冠和固定部份义齿时,     

Cerec2 CAD/CAM全瓷修复体的临床研究

目的：采用Cerec2 CAD／CAM系统制作各类修复体，并对其近期临床效果进行评价。方法：本研究共选取65名患者，用Cerec2 CAD／CAM系统按照标准程序制作各类全瓷修复体106个，其中贴面32个，嵌体4个，高嵌体33个，全冠30个，种植全冠2个，连桩全冠5个。记录修复体加工时间，修复后一周复诊时，填写修复体满意度调查表。并由两位医师每半年按照改良的USPHS标准对修复体进行评价。结果：修复体的加工时间平均在20min以内，其中贴面所需时间最少，嵌体需要时间最长。患者的总体满意率达到93％。83％的修复体各项检查标准都达到了USPHS标准的A类。结论：Cerec CAD／CAM系统操作独立，简单，制作修复体快捷。整个修复过程一次就诊就能完成。研究显示Cerec全瓷修复体有着广泛的应用范围。     

3D打印陶瓷技术在口腔医学领域的研究进展

全瓷修复体具有良好的生物相容性、美观性及力学性能,备受患者青睐,已成为固定修复的主流方式。以数控切削成型为代表的减材制造和失蜡铸造为代表的等材制造工艺发展成熟,但仍有不足之处。随着数字化时代的到来,运用3D打印技术制造的烤瓷修复体、可摘局部义齿、种植导板已应用于临床,而3D打印全瓷修复体尚处于研究阶段。文章将简要介绍各种3D打印陶瓷技术的工作原理、研究现状及优缺点,并对其发展进行展望。     

《口腔修复实用技术》征订

《口腔修复实用技术》由第四军医大学口腔医学院吴景轮主任技师主编,即将由山东科学技术出版社出版。该书共14章,全面介绍了义齿、口腔颌面修复体、矫治器制作的理论和方法,既注重实用性,又着眼于今后的发展。在对全口义齿、可摘部分义齿、固定义齿和人造冠作系统介绍的同时,还特别加强了瓷修复技术、硬质冠桥树脂修复技术、铸造技术和焊接技术等方面的内容;将牙颌畸形矫治器的制作     

HIP工艺氧化锆固定义齿——3年的临床效果观察

目的：对3～6个单位氧化锆固定义齿应用3年以上的临床效果进行前瞻性临床评价。方法和材料：自2002年8月,对18名患者采用传统全瓷固定义齿进行修复。修复体总数为22个．其中21个用树脂改良玻璃离子水门汀粘固。修复体基底由一个通用CAD／CAM生产系统来制作,氧化锆的切割是在致密渗透阶段完成的。修复体支架位于前牙区和后牙区,其中14个为3单位,3个为4单位,2个为5单位．3个为6单位。一种新型的渗透用玻璃陶瓷作为表面饰瓷材料。在戴牙当天及其后的6、12、24和36个月,主要观察这21个固定义齿是否存在基底折断和表面饰瓷的崩瓷。此外,还观察了基牙的牙周状况、牙齿敏感性、美观效果以及继发龋的发生率。结果：平均观察超过39个月之后,未出现固定义齿的基底折断,有2例出现表面饰瓷的崩瓷。结论：氧化锆基底的全瓷固定义齿临床修复效果令人满意。     

不同基底材料的瓷修复体用于种植修复时抵抗压力载荷的比较

目的比较不同基底材料的瓷修复体用于种植修复时的抗压强度。方法分别基于离体牙(对照组)和种植基台制作钴铬合金烤瓷、钛烤瓷、贵金属烤瓷(75%Au合金)和全瓷修复体,粘接后在咬合面进行循环加载,直至出现修复体瓷层破坏,记录最大加载次数。结果四种修复体,用于离体基牙时出现破坏的最大加载次数(万次)分别为159.3±6.7,147.7±2.4,149.5±3.3和138.6±7.1;用于种植基台时分别为167.6±2.7,149.7±6.5,152.8±4.3和122.0±4.6。钴铬烤瓷修复用于种植基台时比用于离体基牙时可承受更多的加载次数(P<0.05),而全瓷修复体则相反(P<0.05);用于种植基台修复时,钴铬烤瓷承受加载次数较多,而全瓷修复体可承受的加载次数最少,均有统计学意义(P<0.05),钛烤瓷及贵金属烤瓷居中。结论针对种植体基台瓷修复体,较高弹性模量的钴铬合金烤瓷抗压强度最好,全瓷修复相对较差。     

Esthetic potential of single-implant provisional restorations: selection criteria of available alternatives

Provisional implant restorations are essential tools used to optimize the esthetic outcomes for single-tooth implant restorations. This article describes three groups of available alternatives and the specific options within each group including removable prostheses (interim removable partial denture, vacuum-formed appliance), tooth-supported prostheses (bonded extracted or denture teeth, cast metal or fiber-reinforced resin-bonded fixed partial denture [FPD], wire-retained resin-bonded FPD, acrylic resin provisional FPD), and implant-supported fixed prostheses (implant-retained provisional restoration). Advantages and disadvantages as well as fabrication guidelines for each option are provided. The author proposes that the restorative dentist consider eight criteria in selecting the most appropriate type of provisional prosthesis for a specific patient situation including the esthetic potential, patient comfort, treatment time, laboratory cost, occlusal clearance, ease of removal, durability, and ease of modification. The patient's esthetic expectations are critical in determining the most suitable type of provisional restoration. Esthetically pleasing provisional restorations are part of the evolving implant continuum, making implant dentistry more appealing to practicing dentists and potential patients. CLINICAL SIGNIFICANCE: Provisional restorations for single implants have evolved from temporary expedients during osseous and soft tissue integration to critical therapeutic tools used to assess patient expectations, communicate with the laboratory, and optimize definitive implant treatment. The selection of the type of provisional restoration may significantly influence esthetics during the period of implant integration and soft tissue healing. However, it is unlikely that there is a direct correlation between the type of provisional restoration used and the esthetic outcome of the definitive prosthesis.     

Removable Partial Denture in Combination with a Milled Fixed Partial Prosthesis as Interim Restorations in Long-Term Treatment

Interim restorations are frequently used in prosthodontic treatments. Many complex situations require the combination of fixed and removable partial prostheses. An appropriate interim restoration design that accurately implements the treatment plan is necessary to prepare the oral cavity for the prostheses, and to contribute to the preservation and health of remaining natural teeth, bone support, and gingival tissues. This report describes a modified technique for construction of interim restorations with a combination of fixed and removable partial prostheses. The technique consists of the construction of a milled fixed prosthesis and removable partial denture with metallic framework for use during extensive treatment, improving masticatory function and esthetics and preserving the periodontal health of supporting structures. This interim restoration can also serve as a template for the definitive restoration, allowing patient and dentist to evaluate appearance and function and helping to ensure the success of the definitive restoration.     

In vivo evaluation of occlusalcontact area and maximum bite force in patients with various types of implant-supported prostheses

Abstract

Objective. To determine the effects of various implant retained and/or supported prostheses on number of occlusal contacts (NOC), occlusal contact area (OCA)and maximum bite force (BF). Patients and methods: In total, 56 patients were included in the study; five test groups and two control groups. The patients in the treatment groups received implant-supported/retained prosthesis; over-dentures retained with two individual attachments in occlusion with complete denture, with four individual attachments in occlusion with complete denture, with four individual attachments in occlusion with fixed partial dentures or natural dentition, 6-implant retained fixed bridges in occlusion with natural dentition and 8-implant retained fixed bridges in occlusion with natural dentition. The patients in control group 1 were wearing conventional complete maxillary and mandibular dentures, whereas in control group 2 they had fixed full-arch porcelain-fused to metal restorations prostheses for both arches. Dental Pre-scale was used measure the NOC, BF and OCA. Results. There was no statistically significant difference between the treatment and control groups, among the groups with regards to NOC. OCA demonstrated different results among the removable and fixed reconstruction groups. With regards to BF, removable dentures supported with four implants showed higher bite force values than controls and two implant over-dentures. Also, a fixed reconstruction using eight implants showed higher BF values than a fixed reconstruction using six implants. Conclusion. Use of implants for removable dentures and fixed reconstructions improve occlusal contact area and bite force.     

Treatment of edentulous maxillae with osseointegrated implants.

Edentulous maxillae can be restored with implant supported fixed restorations containing denture teeth on a metal framework, implant-retained removable overlay prostheses, or porcelain fused-to-metal fixed prostheses. Esthetics and hygiene access are two important factors in determining the restoration best suited for each patient. Treatment planning considerations and treatment procedures for the various techniques are discussed.     

Repair of a Removable Partial Denture Using Gold Occlusals

Limited interarch space causes maintenance problems with removable partial dentures. The problem of abrasion and breakage of acrylic resin teeth, the concomitant supraeruption of opposing natural teeth, and possible decrease of vertical dimension of occlusion can be prevented or minimized with cast-gold occlusals. Use of metal occlusals has been advocated on newly constructed removable partial dentures, but not on existing prostheses with severely worn or broken denture teeth. This article describes a repair procedure for a removable partial denture where minimal interarch distance resulted in wear and breakage of denture teeth. A thin, abraded denture tooth that had been repaired numerous times was prepared and covered with a cast gold restoration. The problem of abrasion and breakage of the acrylic resin tooth was solved and the service life of the prosthesis was extended.     

Treatment planning: implant-supported partial overdentures

When multiple anterior teeth are missing, many options of replacement are available. Traditionally, the choice was between a fixed or removable prostheses. Today, with the predictability of dental implants, the options of tooth replacement range from removable partial dentures to implant-supported fixed prostheses. The choice of which restoration that will best provide occlusion and esthetics depends on multiple factors including the number and location of missing teeth, the residual ridge form in relation to the replacement teeth, the relationship of the maxillary and mandibular anterior teeth, the condition of teeth adjacent to the edentulous span, the amount of bone available for implant placement, the patients "smile line" and display of teeth, lip support, and financial constraints. When there is minimal loss of the ridge contour, restorations that emerge from the ridge are the most functional and esthetic restorations, adhesive-type fixed partial dentures, conventional fixed partial dentures, and implant-supported restorations can be indicated with the choice of restoration dependent on a risk benefit and cost benefit analysis. When there is a loss of ridge contour due to residual ridge resorption or trauma, the decision becomes more complex as not only does the tooth structure need to be replaced, the ridge form also has to be replaced. (Figures 1 and 2). This can be assessed clinically as illustrated by Figures 1 and 2 where a dis crepancy in arch form and ridge form in relation to the adjacent teeth and/or opposing arch can be observed. Other considerations are lip support and display of the teeth when smiling. This article presents a case and rationale for implant-supported par tial overdentures. Many authors have written on the merits of com plete overdentures. The complete overdenture has proven to be an improvement over conventional complete prostheses with respect to chewing efficiency, patient comfort and satisfaction. In partial edentulism, the implant-supported overdenture has several advantages, some in common with a removable partial denture.     

Wear of resin denture teeth in partial removable dental prostheses

PurposeTo investigate occlusal wear of resin denture teeth in partial removable dental prostheses worn by partially edentulous patients.MethodsThirty patients with partial removable dental prostheses were included in the study. Thirty-two patients with complete dentures served as a reference group. Occlusal wear after two years was evaluated indirectly using gypsum casts and a three-dimensional laser-scanner device. Overall wear of complete occlusal surfaces and maximum wear of occlusal contact areas were measured. Patient and prosthesis data were analyzed using univariate and multiple linear mixed models.ResultsOverall wear of denture teeth in partial removable dental prostheses was 91 (SD 85) μm, and maximum wear of occlusal contact areas was 329 (SD 204) μm (means and standard deviations). Average and maximum wear values for teeth in complete dentures were both lower than those for teeth in partial removable dental prostheses. However, differences between wear of different types of denture did not reach statistical significance after adjustment for gender, type of tooth, dental status of the opposing jaw, and antagonist material. Statistical analysis revealed that wear was greater for denture teeth occluding with ceramic crowns and/or fixed partial dentures as antagonists.ConclusionsResin denture teeth in partial removable and complete dental prostheses are subjected to clinically important occlusal wear that might destabilize occlusion and cause further problems. Patient-related factors and dental status affect wear behavior and should be taken into consideration when treating patients with removable dentures.     

Removable partial denture abutments restored with all-ceramic surveyed crowns.

All-ceramic crowns are used as alternatives to conventional metal-ceramic crowns for the restoration of single teeth. Traditionally all-ceramic restorations possessed physical properties that contraindicated their use in many treatment situations. The strength that zirconia ceramics exhibit seems to support the hypothesis that, in specific situations, an all-ceramic crown may be used to restore removable partial denture (RPD) abutments in areas previously reserved for metal or metal-ceramic restorations. Abutments for RPDs may now be fabricated with Procera AllZirkon with the classically prepared guide planes and rest seats. This article provides an overview of a technique for the fabrication of a zirconia-based crown to be used in conjunction with removable partial dentures using the Procera CAD/CAM technology.     

Use of an implant in repair of a fixed partial denture. A clinical report.

A repair technique for a fractured solder joint in a multiple-unit fixed partial denture has been presented. The advantages of this technique include (1) retention of part of an existing restoration; (2) provision of additional support to minimize future fracture; (3) removal of the implant crown for periodic evaluation and/or treatment; and (4) retention of a fixed partial denture where a removable prosthesis might otherwise be needed. The primary disadvantage of this technique is the time and expense associated with implant placement.