个性化全瓷基台在前牙种植修复中的应用

目的探讨个性化全瓷基台在前牙区种植修复的美学效果。 方法临床上收集51例前牙缺失患者（共植入60枚种植体）作为研究对象,根据患者意愿,26例选择个性化金属纯钛基台纳入对照组即：个性化钛基台+全瓷冠修复（30枚）;25例患者选择个性化全瓷基台纳入实验组即：个性化全瓷基台+全瓷冠修复（30枚）。通过两组对照研究,术后1、6、12个月复诊,分别记录红白复合美学指数、牙龈指数及菌斑指数,将数据进行统计学分析。 结果术后1、6个月红白美学指数差异无统计学意义;术后12个月比较：（1）红色美学指数：实验组（30例）高于对照组（28例）,差异有统计学意义（χ²= 6.696,P= 0.020）;（2）白色美学指数：实验组（30例）高于于对照组（29例）,差异有统计学意义（χ²=6.634,P= 0.021）。术后1个月菌斑指数和牙龈指数差异无统计学意义;术后6个月两组比较菌斑指数（t= 3.128,P= 0.003）和牙龈指数（Z=-3.537,P= 0.000）差异均有统计学意义;术后12个月两组比较菌斑指数（t= 3.027,P= 0.004）和牙龈指数（Z=-6.785,P= 0.000）差异均有统计学意义。 结论在前牙种植美容修复中,个性化全瓷基台较钛基台优势明显,值得临床推广。     

Cements and adhesives for all-ceramic restorations

Dental cements are designed to retain restorations, prefabricated or cast posts and cores, and appliances in a stable, and long-lasting position in the oral environment. Resin-based cements were developed to overcome drawbacks of nonresinous materials, including low strength, high solubility, and opacity. Successful cementation of esthetic restorations depends on appropriate treatment to the tooth substrate and intaglio surface of the restoration, which in turn, depends on the ceramic characteristics. A reliable resin cementation procedure can only be achieved if the operator is aware of the mechanisms involved to perform the cementation and material properties. This article addresses current knowledge of resin cementation concepts, exploring the bonding mechanisms that influence long-term clinical success of all-ceramic systems.     

Bonding-cementation of all-ceramic restorations

The objective of this article is to synthesize the current scientific data relating to the bonding of ceramic restorations in order to present a reliable and reproductive clinical method for the general practitioner. The different ceramic treatments are explained with a distinction between those which can be etched and the others. A precise check list is suggested for the conditioning of dental tissues and ceramic surfaces.     

Recent advances in materials for all-ceramic restorations

The past 3 years of research on materials for all-ceramic veneers, inlays, onlays, single-unit crowns, and multi-unit restorations are reviewed in this article. The primary changes in the field were the proliferation of zirconia-based frameworks and computer-aided fabrication of prostheses, and a trend toward more clinically relevant in vitro test methods. This article includes an overview of ceramic fabrication methods, suggestions for critical assessment of material property data, and a summary of clinical longevity for prostheses constructed of various materials.     

全瓷修复的牙体预备

多种全瓷系统可用来进行全冠、固定桥、嵌体、贴面等几乎所有类型的固定修复。全瓷修复的基牙预备牙体预备应兼顾牙齿健康,功能,美观三方面的要求。不同类型的修复体对聚合度、轴面预备形式、边缘线的位置及形式和宽度等都有特定的要求。     

数码全瓷修复技术的现状及展望

近二十多年口腔瓷材料的物理机械性能和操作工艺得到了巨大的发展,全瓷修复技术因具有良好的美观效果和生物相容性,正在逐渐取代金瓷修复技术.数码全瓷修复技术是指采用计算机辅助设计和计算机辅助制造(CAD/CAM)技术制作完成全瓷修复体的技术,目前大量的全瓷修复体都是采用数码技术完成的,是近年来研究和临床应用的热点.本文将从数...     

全瓷修复与烤瓷修复临床效果比较的Meta分析

目的：：通过Meta分析系统评价全瓷修复与烤瓷修复的临床效果。方法：计算机检索PubMed、Cochrane Library、EMbase、SinoMed、中国知网和万方、维普数据库,按标准纳入比较全瓷与烤瓷修复临床效果的随机对照研究,进行资料提取及偏倚评价,采用RevMan 5.3软件进行Meta 分析。结果：最终纳入15篇文献,其中全瓷修复体768例,烤瓷修复体1386例。 Meta分析结果显示：相比于烤瓷修复,全瓷修复能显著降低牙龈炎症(RR=0.30,95%CI=0.10-0.90,P=0.03)的发生风险。还能减少基牙继发龋、改善修复体的龈缘着色及边缘适合性,但无统计学差异。二者颜色匹配及修复体崩瓷状况相当。全瓷修复易导致牙髓炎症及牙髓失活,且固定桥修复时全瓷桥支架断裂(RR=6.24,95%CI=1.20-32.41,P=0.03)的危险性显著增高。结论：现有的有限证据表明,全瓷修复的临床效果要优于烤瓷修复,在临床应用中占有一定优势,但全瓷桥的强度有待提高。     

全瓷修复体修复后可能出现的问题分析

随着齿科陶瓷材料性能的不断改进，全瓷修复体已经成为现在固定修复中一种重要的修复方式。如何提高全瓷修复体在临床上的修复效果，避免修复失败是口腔全瓷修复中的一个重点。本文就在临床修复过程中，全瓷修复体初戴后可能出现的问题及其预防方法作一综述。     

Spectral reflectance and color of dentin ceramics for all-ceramic restorations

OBJECTIVE: The study was conducted to observe the spectral reflectance curves, and evaluate the color coordinates (CIELAB) of VM7 dentin ceramics (VITA, Germany) across the whole 3D-MASTER shade system. METHODS: Three disc samples, 13 mm in diameter and 1.4mm in thickness, were produced for each shade by firing following the manufacturer's instructions. Each fired disc was ground to a thickness of 1.0 mm and both faces were polished. Spectral reflectance data in the visible spectrum under the standard illuminant D65 were collected at 1 nm intervals by using a computer-controlled spectrophotometer. Color coordinates, L*, a*, b*, C*, h, in the three-dimensional CIELAB color space were obtained. RESULTS: (1) Spectral reflectance in the short-wavelength range systematically decreased with increasing chroma number (M1, M2, and M3) when compared within the same value (lightness) group (1M, 2M, 3M, 4M, and 5M). (2) Spectral reflectance decreased systematically across the whole visible spectrum with increasing value group when compared within the same chroma group. (3) A negative relationship was recognized between lightness (L*) and chromaticity index a* (red-green direction). That is, a* coordinate increases from approximately 1 for the 1M1 sample to approximately 13 for the 5M3 sample, the corresponding lightness systematically decreased from 87 to 69. (4) With increasing a* coordinate, hue angle (h) significantly decreased from 85 degrees for the 1M1 sample to 69 degrees for the 5M3 sample. (5) Lightness apparently increased with increasing hue angle (h) throughout the whole range of the 3D-MASTER shade system. (6) A strong positive relationship between chroma (C*) and chromaticity index b* (yellow-blue direction) was found, demonstrating that the chroma of the present ceramic is mainly controlled by the b* coordinate. SIGNIFICANCE: Systematic variations in spectral reflectance and color coordinates of VM7 dentin were observed throughout the 3D-MASTER shade system and were suggested to be caused by the fine structure of the sample which can interfere with shorter wavelengths in the visible spectrum.