烤瓷贴面临床效果相关影响因素的回顾性研究

目的：评价完成修复1-8年的310颗长石质烤瓷贴面的远期临床效果,对临床效果相关影响因素进行分析。方法：对完成修复1-8年的310颗前牙或前磨牙长石质烤瓷贴面进行复查,采用改良的瓷贴面评价标准对修复体完整度、修复体磨耗、颜色满意度、边缘染色、边缘适合性、继发龋、牙本质敏感症状及牙龈指数8项指标进行评估,统计烤瓷贴面修复的存败率,logistic回归分析对影响临床效果的相关因素进行分析。结果：烤瓷贴面修复1-8年的总存留率为90．65％。患者具有咀嚼系统不良习惯、修复后使用不当、口腔卫生状况差,患牙为年轻恒牙、着色程度严重,修复体颈缘位于龈下、前伸耠早接触是影响修复效果的危险因素。结论：烤瓷贴面修复技术的远期临床效果良好,存在的影响修复效果的危险因素尚待临床上克服。     

1232件烤瓷熔附金属修复体远期效果的分析

目的：了解烤瓷熔附金属（ＰＦＭ）修复体的远期疗效。方法：对第四军医大学口腔医学院修复科１９８５－０５～１９９３－０６期间１０５６例患者１２３２件ＰＦＭ修复体的临床资料进行调查分析。结果：ＰＦＭ修复体７年以上修复成功率为９０．５％。导致失败的主要原因为松动脱落、瓷崩和基牙病变。结论：为确保ＰＦＭ修复体长远疗效，应从适应证、牙体预备、铸件试合、烤瓷工艺、咬合恢复、医嘱等方面严加注意     

烤瓷贴面在前牙修复中的临床应用

目的探讨烤瓷贴面在前牙修复时发生折裂、脱落、微渗漏、粘接等技术问题的解决方法。方法确定适应证及禁忌证。预备牙体,在牙唇面磨出2条纵行固位沟,在耐火包理科模型上分层涂瓷。贴面的内表面经5％氢氟酸处理及徐偶联剂后.取相应包号的光固化树脂粘接。结果118颗瓷贴面修复的前牙,经3个月至1年的观察,无脱落破损、无染色、变色及着色,无龈炎发生,效果满意。结论在牙唇面制备2条纵行固位沟、唇面边缘磨出浅凹粮形的牙体预备方法,可增强粘接剂与牙体组织之间的粘接力。贴面的内表面经氢氟酸处理及牙表面涂布偶联剂,也可增强两者之间的粘接强度。     

微创全瓷贴面修复临床应用初探

目的 通过分析微创全瓷修复体的美学效果和成功率,初步评价该修复形式的临床应用价值.方法 对30例前牙美学缺陷患者的44颗患牙进行0.5 mm厚度以内的牙体预备或不进行牙体预备,采取长石质陶瓷材料制作全瓷修复体,应用树脂粘接剂粘接.修复后患者采用视觉模拟评分法(visual analogue scales,VAS)评价美学效果满意度;同时,3名修复专业医师对修复后照片进行美学效果评价(边缘美观效果、颜色、形态、半透明度).修复后6、12、24个月复查评价成功率.结果 修复后患者对修复体美学效果的满意度为9.2±0.4;医师美学效果评价中修复体的边缘美观效果、颜色、形态、半透明度优秀率分别为89％(39/44)、91％(40/44)、98％ (43/44)和93％(41/44).修复后6、12、24个月成功率分别为100％(44/44)、98％(43/44)和91％(40/44).结论 微创全瓷贴面修复体具有优秀的美学效果和满意的成功率,在严格掌握适应证的前提下,牙科美学治疗中可采用这种治疗方式.     

Wol-CeramELC全瓷沉积技术的临床应用

目的：探讨Wol-CeramELC瓷沉积全瓷冠的临床效果。方法：以在原始石膏代型上瓷沉积30sec形成内冠-玻璃渗透-常规堆饰面瓷的方法,制作完成28例共109个全瓷冠的修复,观察全瓷冠的完整性、色泽、边缘吻合性和对牙龈的影响。结果：经3-17个月的观察,除1颗活髓牙有过敏症状,2例4个冠因美观不佳而重做外,其他病例修复效果满意。修复体色泽自然逼真,未出现烤瓷冠破裂、脱落、基牙冠折根折等并发症,边缘密合,牙龈颜色形态自然,无龈炎,变色牙遮色效果好。结论：Wol-CeramELC瓷沉积是一种使用成熟材料的创新技术,使全瓷修复技术得到了极大的提升和完善。它强度高,边缘密合性好,使用范围广,临床效果优良,是极有发展前途的全瓷修复技术。     

临床常用四种全瓷贴面材料光学性能的比较

目的 比较4种临床常用全瓷贴面修复材料的色彩参数和透光率,以期为临床提供参考.方法 制作IPS Empress(R) CAD(高透光率A2色)、IPS e.max(R) Press(高透光率A2色)、IPS e.max(R)CAD(高透光率A2色)及VITABLOCS(R) MarkⅡ(A2色)4种瓷材料的片状试件,分别设为A、B、C、D组,每组10个试件,打磨抛光后控制试件厚度为(1.00±0.01) mm.使用分光测色计和透光率测试仪测量每组试件明度(L*值)、红绿色品(a*值)和黄蓝色品(b*值)及可见光积分透射比(T),计算彩度(C*ab值)以及各组试件与A2色标准比色片的色差(△E).结果 A和D组L*、a*、b*及C*ab值间差异均无统计学意义(P＞0.05),但与B、C组L*、a*、b*及C*ab值间差异均有统计学意义(P＜0.05);B、C组b*及C*ab值间差异均无统计学意义(P＞0.05),但两组L*及a*值间差异均有统计学意义(P＜0.05).A、B、C、D组瓷材料与A2色标准比色片的色差(△E)分别为6.05±0.12、5.11±0.27、3.73±0.27和6.30±0.38;T依次为(29.69±0.31)％、(25.83±0.36)％、(28.92±0.47)％和(26.94±0.33)％.结论 4种瓷贴面材料的色彩参数存在一定差异,均有较高的透光率.瓷材料C与A2色标准比色片的色差最小.     

基于逆向工程技术的贴面计算机辅助设计

目的 探索符合形态美学要求的贴面计算机辅助设计(computer aided design,CAD)方法,为贴面专用CAD平台的开发提供方法学基础.方法 选择1例右上中切牙变色需贴面修复的患者,取牙体预备前与预备后两副超硬石膏模型,牙体预备成切端对接型,经三维激光扫描仪三维数据采集、三维重建、使用逆向工程软件Surfacer10.5与Geomagic Studio 8.0进行贴面CAD.结果 在逆向工程软件基础上确立了贴面CAD的技术路线,完成后的贴面表面光顺,与对侧同名牙对称协调,符合形态美学仿真修复要求.结论 基于逆向工程技术进行贴面CAD,方法简便可行,为自主知识产权贴面CAD软件的开发提供了必要的方法学基础.     

树脂粘接剂色调对牙体瓷贴面美学效果的影响

目的 比较树脂粘接剂与同色调试色糊剂颜色效果的一致性,评价树脂粘接剂色调对牙体瓷贴面美学效果的影响,以期为临床提供参考.方法 选用48颗树脂右上颌中切牙,用随机化数字表随机分为8组(每组6颗),模拟临床贴面牙体预备.制作二硅酸锂压铸陶瓷贴面,分别使用8种色调(LV-3、LV-2、MV、HV+2、HV+3、WO、TR、A3色)试色糊剂试色,并用同色调树脂粘接剂粘接于树脂牙上.使用比色仪测量瓷贴面粘接前、试色时及粘接后的色度参数,并计算粘接前后贴面色差值(△E1)和试色时与粘接后贴面色差值(△E2).结果 8种色调树脂粘接剂△E1范围为0.93～ 6.79,其中LV-3、HV+3和WO色调树脂粘接剂△E1分别为3.31、4.90和6.79.除HV+3色调树脂粘接剂△E2为3.65外,其余色调树脂粘接剂粘接后与试色时的瓷贴面色差值在0.72～ 1.79之间.结论 LV-3、HV+3和WO色调树脂粘接剂能改变贴面的最终颜色.除HV+3色调外,其余色调树脂粘接剂与同色调试色糊剂对瓷贴面颜色的影响有较好的一致性.     

1807例烤瓷熔附金属修复体的临床分析

烤瓷熔附金属修复体(简称金瓷修复体)因其强度高,耐磨损,色泽稳定、美观等优点,近年来国内日渐开展。金瓷修复体乃属一种高技术的修复,它需要在临床和技术操作中熟悉和掌握一定的理论知识和技能,并须严格遵循     

烤瓷贴面和计算机辅助设计与计算机辅助制作瓷贴面的应用效果比较

目的通过对烤瓷贴面和计算机辅助设计（computer aided design，CAD）与计算机辅助制作（computer aided manufacture，CAM）瓷贴面修复3年后的临床观察和比较，评价CAD—CAM瓷贴面的临床效果。方法选取23例患者制作CAD—CAM瓷贴面65个，25例患者制作烤瓷贴面105个。修复3年后采用改良加利弗尼亚牙科协会一瑞格标准对两种贴面的各项临床指标、存留率及患者满意度进行比较分析。结果烤瓷贴面和CAD—CAM瓷贴面3年存留率分别为96．2％和93．8％；患者满意度分别为92．4％和90．8％。两种贴面在颜色匹配、边缘着色、边缘适合性方面差异无统计学意义。CAD—CAM瓷贴面表面质地优于烤瓷贴面。结论CAD—CAM瓷贴面是一种成功的修复方式。     

瓷贴面生物力学研究及临床应用

贴面已经成为一种广泛应用于前牙美容的修复方法。本文主要总结近年来国内外学者在瓷贴面设计及操作方面的生物力学研究成果,以期更好地指导临床工作。     

美观区铸瓷贴面修复的临床效果观察

目的 评价美观区铸瓷贴面修复的短期临床效果.方法 美观区修复病例22例,共105颗IPS e·max铸瓷贴面,采用改良的瓷贴面评价标准评估修复后2年的修复体完整度、修复体磨耗、颜色满意度、边缘染色、边缘适合性、继发龋、牙本质敏感症状及牙龈指数共8项指标.结果 修复后2年,105颗IPS e·max铸瓷贴面,在修复体完整度一项有3颗贴面评估失败：1颗瓷贴面崩折,2颗出现明显影响美观的裂纹;其余7项指标的成功率均为100％.结论 IPS e·max铸瓷贴面应用于美观区修复的短期临床效果良好.     

不同切端设计类型瓷贴面的三维有限元应力分析

目的应用三维有限元法分析不同切端设计瓷贴面的应力分布。方法将上中切牙用环氧树脂包埋，精密机床逐层切削，数码成像。用pro-engineer软件生成瓷贴面模型，用pro-mecllanica软件进行有限元分析。结果切端包绕型和切端对接型瓷贴面在对刃He加栽条件下，其切端的应力值均为最高值。在正常覆He加栽时切端对接型瓷贴面的颈部内侧出现一高应力区，而切端包绕型瓷贴面未出现。在正常覆He加栽状态下，切端包绕型瓷贴面的应力值明显低于切端对接型；在对刃He加栽时，二者应力值接近；在深覆He加载时．切端对接型瓷贴面的应力值较切端包绕型低。结论在三种加载条件下，切端包绕型与切端对接型瓷贴面的应力分布不同。切端对接型瓷贴面在正常覆He加载时瓷贴面的颈部内侧有一高应力区。     

Influence of buccal cusp reduction when using porcelain laminate veneers in premolars. A comparative study using 3-D finite element analysis

Objectives

Based on a maxillary premolar restored with laminate veneer and using the 3-D finite element analysis (FEA) and μCT data, the aim of this study was to evaluate the influence of different types of buccal cusp reduction on the stress distribution in the porcelain laminate veneer and in the resin luting cement layer.

Methods

Two 3-D FEA models (M) of a maxillary premolar were built from μCT data. The buccal cusp reduction followed two configurations: Mt – buccal cusp completely covered by porcelain laminate veneer; and Mp – buccal cusp partially covered by porcelain laminate veneer. The loading (150 N in 45°) was performed on the top of the buccal cusp. The finite element software (Ansys Workbench 10.0) was used to obtain the maximum shear stress (τ_max) and maximum principal stress (σ_max).

Results

The Mp showed reduced the stress (σ_max) in porcelain laminate veneer (from −2.3 to 24.5 MPa) in comparison with Mt (from −5.3 to 27.4 MPa). The difference between the peak and lower stress values of σ_max in Mp (−6.8 to 26.7 MPa) and Mt (−5.3 to 27.4 MPa) was similar for the resin luting cement layer. The structures not exceeded the ultimate tensile strength or the shear bond strength.

Conclusions

Cusp reduction did not affect significant increase in σ_max and τ_max. The Mt showed better stress distribution (τ_max) than Mp.     

上颌中切牙不同厚度Empress瓷贴面的破坏力学分析

目的:研究不同厚度瓷贴面的破坏过程,探讨提高贴面复合体强度的方法.方法:经软件建模工具生成上颌中切牙矢状面解剖外形.选用临床常用的4种设计外型:开窗型、对接型、包饶型和贴面冠型,结合3种贴面厚度0.5mm,1.0mm和1.5mm,建立12种模型.应用RFPA系统软件处理程序对模型进行处理.比较不同厚度的瓷贴面复合体在负...     

Effect of provisional restorations on the final bond strengths of porcelain laminate veneers

The purpose of this in vitro study was to evaluate the effect of the different provisional restorations cementation techniques on the final bond strengths of porcelain laminate veneers (PLVs). Thirty-six extracted human central incisors were sectioned 2 mm below the cemento-enamel junction, and crown parts were embedded into self-cure acrylic resin. Standardized PLV preparations were carried out on labial surfaces of the teeth. Then the teeth were randomly divided into three groups of 12 each. In group 1, provisional restorations were cemented with eugenol-free cement. In group 2, prepared teeth surfaces were first coated with a desensitizing agent then provisional restorations were cemented with resin cement. In group 3, provisional restorations were not fabricated to serve as control. After specimens were stored in distilled water for 2 weeks, provisional restorations were removed and final IPS Empress 2 ceramic veneers were bonded with a dual-curing resin. Two microtensile samples from each tooth measuring 1.2 x 1.2 x 5 mm were prepared. These sections were subjected to microtensile testing and failure values were recorded. The data were analysed by one-way anova and Tukey HSD tests. The PLVs, placed on the tooth surface that had received a dentine desensitizer and provisional restorations luted with resin cement (group 2), showed the lowest bond strength in all test groups. But no statistically significant differences were found between the bond strength of PLVs in control group (no provisional restorations) and group 1 (provisional restorations cemented with eugenol-free cement before final cementations). Scanning electron microscopic (SEM) examination of this study also showed that the bonding to enamel surface was better in control group and group 1 than group 2.     

超薄贴面与常规贴面临床对比研究

目的：比较超薄贴面与常规贴面的临床效果,为超薄贴面的临床应用提供依据。方法选取超薄贴面20例与常规贴面修复患者45例,基牙分别为72、120颗,3、6、12、24、36个月后随访,依据改良美国公共卫生署贴面评价分类标准进行临床效果对比研究,统计留存率和成功率。结果经过3年观察,超薄贴面和常规贴面在继发龋、边缘适合性、边缘变色、颜色适合性和结构形态方面均有较好的临床表现,留存率及成功率均大于90%,经连续性校正卡方检验差异均无统计学意义（P>0.05）。结论超薄贴面可以获得与常规贴面相近的临床效果。     

The effect of porcelain laminate veneers on gingival health and bacterial plaque characteristics

Abstract. The aim of this study was to evaluate the response of microbial plaque and gingival inflammation to the placement of porcelain laminate veneers on anterior teeth. 9 patients, 7 female and 2 male (mean age of 30 years), with a total of 35 veneers were examined. The volume of gingival crevicular fluid (GCF), level of neutral proteolytic enzyme activity, gingival index (GI), plaque index (PII) and plaque bacteria vitality were measured at baseline and after the placement of veneers. The volume of GCF increased after the placement of veneers ( p =0.03). No statistically significant differences were found in proteolytic enzyme activity or GI ( p >0.05). There were statistically significant reductions in PII ( p =0.000) and plaque bacteria vitality ( p =0.018). Further research is required to assess the long-term influence of porcelain laminate veneers on gingival health and microbial plaque characteristics.