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目的    探讨Vita In-Ceram Zirconia渗透陶瓷全瓷修复体的修复效果 ,为临床应用提供参考。方法    对2008年3—5月广东省深圳牙科医疗中心门诊收治的59例接受全瓷修复的患者,共使用Vita In-Ceram Zirconia渗透陶瓷全瓷修复体81件 ,其中上颌61件 ,下颌20件;前牙全冠44个 ,后牙全冠27个 ,前牙固定桥4个, 后牙固定桥6个。通过3～24个月的观察 , 采用美国加利福尼亚牙科学会的质量评价体系对Vita In-Ceram Zirconia渗透陶瓷前、 后牙全冠与前、后牙固定桥修复进行临床效果评价。结果    观察期间失访2例患者4件修复体,对剩余57例患者77件修复体的临床观察结果表明 , Vita In-Ceram Zirconia 渗透陶瓷全冠具有良好的边缘密合性 ,色泽稳定 ,强度高 ,其失败率为0.030 %。结论    在严格选择适应证的前提下,Vita In-Ceram Zirconia渗透陶瓷修复是一种效果良好的全瓷修复方式。     

氧化铝渗透陶瓷底瓷全瓷冠2年临床观察

目的 探讨氧化铝渗透陶瓷作为全瓷修复体底瓷的修复效果,为临床推广应用提供参考。方法 61例门诊患者,修复体159件,其中上颌98件,下颌61件。前牙全冠132个,后牙全冠27个。通过12～24个月的观察,采用美国加利福尼亚牙科学会的质量评价体系对氧化铝渗透陶瓷作为底瓷所做的前、后牙全冠修复进行临床效果评价。结果 对61例患者159颗全冠的临床观察结果 表明,氧化铝渗透陶瓷作为底瓷所制作的全瓷修复体具有良好的的边缘密合性,色泽稳定,强度高,其失败率为1.25%,效果满意。结论 氧化铝渗透陶瓷作为底瓷的全瓷冠修复是一种效果良好的全瓷修复方式。     

In—Ceram体系进展

陶瓷具有很好的性能,它能满足牙科修复的要求,如生物相容性好、美观、色泽稳定、不导电、低导热和在口腔环境内的抗降解能力。但其低强度和脆性一直影响着全瓷修复材料在牙科修复中的应用,尤其是固定桥和后牙冠修复。由法国Sadoun研制的德国Vita公司的In-Ceram技术,是第一个成功用于全瓷冠桥的临床修复技术,从固定桥修复的意义上说,也是目前唯一成功的全瓷修复技术。In-Ceram的核心是其高强度的玻璃渗透氧化铝陶瓷底层材料。后来Vita公司又相继推出In-Ceram Spinell,In-Ceram Zirconia及Celay/In-Ceram技术(将原来的In-Ceram产品命名为In-Ceram Alumina),使In-Ceram发展成为完整的体系,适用于嵌体、高嵌体、前后牙冠、前后牙桥的制作修复,不仅强度高,而且美观,边缘适合性好。现以In-Ceram Alumina为主介绍In-Ceram体系。     

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目的 探讨氧化锆全瓷冠桥修复体的修复效果,为临床应用提供参考.方法 对2008年1月至2009年6月佛山市禅城区口腔医院修复科收治的40例接受全瓷修复的患者,采用计算机辅助设计与计算机辅助制作(CAD/CAM)技术制作氧化锆全瓷冠桥修复体60件,其中上颌32件,下颌28件;前牙单冠24个,后牙单冠21个,前牙固定桥2个,后牙固定桥3个(均为3单位固定桥).分别在修复体黏结后1、3、6、12个月对患者进行随访观察,采用美国加利弗尼亚牙科学会的全瓷修复临床标准对修复体的临床效果进行评价,同时也对牙周健康状况进行评价,记录全瓷修复体牙冠的牙龈出血指数(BI)、牙周袋深度(PD)以及附着丧失(AL).结果 观察期间失访3例患者5件修复体,对剩余的37例患者55件修复体的临床观察结果显示,在黏结1个月后有2件修复体的边缘卡探针,有2颗氧化锆全瓷冠修复的牙齿出现牙龈炎.在黏结3个月后,有1个单冠出现裂纹,1例固定桥断裂,2颗牙齿出现牙龈红肿.在黏结6个月后,有1例桩核冠脱落,2颗牙齿出现牙髓炎或根尖周炎.所有复诊患者在12个月的临床观察中均未见边缘着色和继发龋,有5件修复体的颜色匹配稍差.在各时间点BI、PD和AL等指标与治疗前比较差异均无统计学意义(P＞0.05),各项指标比较差异亦无统计学意义(P＞0.05).结论 氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意.     

玻璃渗透氧化铝陶瓷全冠美学再修复的临床观察122例

目的 观察玻璃渗透氧化铝陶瓷全冠修复的美学效果。方法 2009年1月—2011年1月常熟玉蕙口腔医院修复科收治的122例接受全瓷再修复的患者,前牙全冠264个,前磨牙全冠54个。通过24个月的观察,采用美国加利福尼亚牙科学会的标准观察结果。结果 玻璃渗透氧化铝陶瓷作为底瓷的全瓷修复体具有良好的边缘密合性,牙龈健康,色泽自然统一,患者认可度高;其失败率仅为1.25%。结论 玻璃渗透氧化铝陶瓷作为底瓷的全瓷冠修复是一种效果良好的美学修复方式。     

IPS-Empress全瓷冠临床观察

目的 :探讨IPS -Empress可铸玻璃陶瓷的修复效果 ,为临床应用提供参考。 方法 :对 68例 179个全瓷冠修复 3年观察 ,对前牙和后牙全瓷冠单冠修复的临床效果进行评价。结果 :68例 79个修复体具有良好的边缘密合性 ,色泽稳定 ,强度高 ,成功率达 86.0 8%。前牙成功率 97.68% ,后牙成功率 70 .0 0 %。结论 :IPS -Empress是一种修复效果较好的全瓷修复材料     

口腔修复学——冠桥

20052014 全瓷桩核与镍铬合金桩核在前牙修复中的受力比较；20052015 微型固位钉式无冠粘结固定义齿的临床应用研究；20052016 银粉加强型玻璃离子制作桩核的临床作用；20052017 245件金属烤瓷修复体制作及临床应用体会；20052018 不同厚度In-Ceram全瓷修复体的色差分析；20052019 根管固位的铸造高嵌体修复后牙缺损的临床观察……     

GI-Ⅱ型渗透陶瓷修复体的临床制作实验

目的:介绍GI-Ⅱ型渗透陶瓷底层瓷材料用于制作全瓷单冠及桥体的方法和技术.方法:选择四川大学华西口腔医院门诊右上中切牙,右上第一磨牙冠修复病例及左上侧切牙缺失双端固定桥修复病例,用GI-Ⅱ型渗透陶瓷作为底层瓷,Vitadur alpha作为饰面瓷,制作前后牙单冠及前牙桥全瓷修复体,口内试戴、粘固结果:修复体美观性能优越,边缘适合性好.结论:GI-Ⅱ型渗透陶瓷能够满足全瓷修复体对底冠的要求,制作出的全瓷修复体效果良好.     

三种全瓷冠的临床效果观察

目的总结应用3种陶瓷全瓷冠的临床效果,为全瓷冠的材料选择应用提供参考。方法选择门诊患者90例,采用IPS Empress热压铸造陶瓷、In-ceram渗透陶瓷以及Cerec2 CAD/CAM技术制作前牙全瓷冠各30件,临床定期观察。结果修复体咀嚼功能好,美观,适合性好,无食物嵌塞,无继发龋及龈炎。Cerec Vita MarkⅡ全瓷冠有1件冠折裂,2件出现裂纹;IPS EmpressⅡ全瓷冠有2件出现裂纹,未折裂;In-Ceram全瓷冠未出现裂纹、折裂现象。结论In-Ceram全瓷冠临床应用效果好。     

Gl—Ⅱ型渗透陶瓷修复体的临床制作实验

目的：介绍Gl－Ⅱ型渗透陶瓷底层资料材料用于制作全瓷单冠及桥体的方法和技术。方法：选择四川大学华西口腔医院门诊右上中切牙，右上第一磨牙冠修复病例及左上侧切牙缺失双端固定桥修复病例，用GI－Ⅱ型渗透陶瓷作为底层瓷，Vitadur alpha作为饰面瓷，制作前后牙单冠有前牙桥全瓷修复体，口内试戴、粘固。结果：修复体美观性能优越，边缘适合性好。结论：GI－Ⅱ型渗透陶瓷能够满足全瓷修复体对底冠的要求，制作出的全瓷修复体效果良好。     

Clinical long-term results of VITA In-Ceram Classic crowns and fixed partial dentures: A systematic literature review

PURPOSE: VITA In-Ceram Classic is a system designed to fabricate all-ceramic crowns and fixed partial dentures (FPDs) with a glass-infiltrated aluminum oxide core material. This systematic literature review gives an overview of the clinical performance of the VITA In-Ceram Classic Alumina, Spinell, and Zirconia restorations. MATERIALS AND METHODS: Based on a systematic literature review, an evidence-based selection and assessment of clinical studies of VITA In-Ceram Classic ceramics was carried out. RESULTS: A total of 299 publications were found, 21 of which met the inclusion criteria. Only a few meaningful studies of In-Ceram Alumina FPDs and In-Ceram Zirconia crowns and FPDs were found. The 5-year survival rate of In-Ceram Alumina crowns and In-Ceram Spinell crowns ranged from 91.7% to 100% and is similar to the survival rate of conventional metal-ceramic crowns. The 5-year survival rate of single-retainer In-Ceram Alumina resin-bonded FPDs (RBFPDs) was 92.3%, which is higher than that of 2-retainer RBFPDs. CONCLUSION: In-Ceram Classic Alumina can be recommended for anterior and posterior crowns as well as for anterior single-retainer RBFPDs. Further studies should be initiated to evaluate in detail the clinical performance of In-Ceram Classic Alumina FPDs. In-Ceram Classic Spinell can be recommended for anterior crowns, especially if highly esthetic results are requested. For In-Ceram Classic Zirconia crowns or FPDs no statement can be made presently because of insufficient data.     

Full-ceramic CAD/CIM anterior crowns and copings

The purpose of the investigation was to examine the marginal and internal fit of Cerec anterior crowns and crown copings. The marginal and internal fit of Cerec anterior crowns (n = 18) and copings was examined on each of six anterior model tooth preparations, with different types of butt-margin crown preparation design on different teeth: 1.) straight flat (tooth 22), 2.) following the CEJ with mid-approximally steep curvature angles of 90 degrees mesial and 40 degrees distal (tooth 21) and 3.) same as 2, but with obtuse angles of 130 degrees and 150 degrees (tooth 41). The anterior crowns were machined on Cerec 2 units using Mark II ceramic (Vita), and the Cerec copings using In-Ceram Spinell (Vita). Laboratory slip-cast In-Ceram spinell anterior crown copings served as controls (n = 18). All reconstructions were seated (with adhesive) on the preparations, and the width of the marginal interface was measured circumferentially using SEM at 150x magnification. After cross-sectioning all samples in the bucco-oral direction, the internal fit was measured using this same technique. The marginal width of computer machined Cerec CAD/CIM anterior crowns (59.9 +/- 5.6 microns) was significantly (p < 0.01) lower than that of machined (73.4 +/- 12 microns) and slip-cast In-Ceram spinell copings (75.5 +/- 17 microns). The internal fit values of the slip-cast copings (94.1 +/- 20 microns) were significantly (p < 0.001) lower than those of the Cerec Mark II anterior crowns (141.3 +/- 21 microns) and copings (146.8 +/- 17 microns). Cerec CAD/CIM machined anterior full-ceramic crowns and copings showed excellent fit in comparison with slip-cast In-Ceram spinell copings. In terms of the marginal and internal fit, there were no significant differences (p > 0.05) between the different butt-margin preparation designs. Selected clinical cases demonstrate the high esthetics of anterior Cerec crowns.     

In vitro marginal fit of three all-ceramic crown systems

STATEMENT OF PROBLEM: Studies on marginal discrepancies of single restorations using various systems and materials have resulted in statistical inferences that are ambiguous because of small sample sizes and limited numbers of measurements per specimen. PURPOSE: The purpose of this study was to compare the marginal adaptation of single anterior restorations made using different systems. MATERIAL AND METHODS: The in vitro marginal discrepancies of 3 different all-ceramic crown systems (Celay In-Ceram, conventional In-Ceram, and IPS Empress 2 layering technique), and a control group of metal ceramic restorations were evaluated and compared by measuring the gap dimension between the crowns and the prepared tooth at the marginal opening. The crowns were made for 1 extracted maxillary central incisor prepared with a 1-mm shoulder margin and 6-degree tapered walls by milling. Thirty crowns per system were fabricated. Crown measurements were recorded with an optical microscope, with an accuracy of +/-0.1 microm, at 50 points spaced approximately 400 microm along the circumferential margin. The criterion of 120 microm was used as the maximum clinically acceptable marginal gap. Mean gap dimensions and standard deviations were calculated for marginal opening. The data were analyzed with a 1-way analysis of variance (alpha=.05). RESULTS: Mean gap dimensions and standard deviations at the marginal opening for the incisor crowns were 87 +/- 34 microm for control, 83 +/- 33 microm for Celay In-Ceram, 112 +/- 55 microm for conventional In-Ceram, and 46 +/- 16 microm for the IPS Empress 2 layering technique. Significant differences were found among the crown groups (P<.05). Compared with the control group, the IPS Empress 2 group had significantly smaller marginal discrepancies (P<.05), and the conventional In-Ceram group exhibited significantly greater marginal discrepancies (P<.05). There was no significant difference between the Celay In-Ceram and the control group. CONCLUSION: Within the limitations of this study, the marginal discrepancies were all within the clinically acceptable standard set at 120 microm. However, the IPS Empress 2 system showed the smallest and most homogeneous gap dimension, whereas the conventional In-Ceram system presented the largest and more variable gap dimension compared with the metal ceramic (control) restoration.     

CAD/CAM氧化锆全瓷冠修复临床疗效评价

目的：探讨CAD／CAM氧化锆全瓷冠的修复效果。方法：选择82例（192颗患牙）,分别在CAD／CAM氧化锆全瓷冠粘接后1、3、6、12个月进行随访观察。采用美国公共健康协会的修订标准对修复体的临床效果进行评价。结果：观察期间失访4例,随访78例共181件修复体,结果显示CAD／CAM全瓷冠颜色达到好以上91．2％,CAD／CAM氧化锆全瓷冠的崩瓷率2．76％,与修复体部位有明显相关性（P〈0．01）,在粘接12个月后有1个修复体的边缘密合度欠佳,所有复诊患者在12个月的临床观察中均未见边缘着色,继发龋和基牙松动。结论：氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意。     

CAD/CAM氧化锆全瓷冠桥随访4年的临床分析

目的:回顾分析评价CAD/CAM氧化锆全瓷冠桥的修复效果.方法:为267位患者制做CAD/CAM氧化锆全瓷冠或桥681件,随访了205例患者的562件全瓷冠桥,随访时间2-6年.对修复体的崩瓷、全瓷冠的颜色与修复体的边缘密合度进行评价.结果:CAD/CAM氧化锆全瓷冠的崩瓷率3.31%,与修复体部位有明显相关性(P＜0.01),不同技术员完成的CAD/C氧化锆全瓷冠的颜色效果有明显不同(P＜0.001),不同颜色预备体的修复体后颜色效果没有明显差异(P＞0.05),CAD/CAM全瓷冠颜色达到好以上90.8%,CAD/CAM全瓷修复体的边缘密合度达到好的99.2%,长桥边缘密合度欠佳,修复体松动脱落0.35%,随访期间没有发现CAD/CAM全瓷修复体基底冠或桥支架折断.结论:CAD/CAM全瓷冠颜色接近天然牙,特别是预备体变色时是115床旨选的美学修复体,CAD/CAM全瓷冠边缘密合度好,整体崩瓷率可接受,但长桥边缘密合度需进一步提高,且磨牙的崩瓷率须进一步研究降低.     

Two-year clinical evaluation of lithia-disilicate-based all-ceramic crowns and fixed partial dentures.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of crowns and fixed partial dentures (FPDs) made with the Empress 2 system over a 2-year period. METHODS: Twenty anterior or posterior all-ceramic (Empress 2) crowns and 20 anterior or posterior, three-unit fixed partial dentures were fabricated for 15 patients. Evaluations of the restorations were performed at baseline and once a year during the 2-year follow-up period. U.S. Public Health Service criteria were used to examine the marginal adaptation, color match, secondary caries and visible fractures in the restorations. Survival rate of the restorations were determined using Kaplan-Meier statistical analysis. RESULTS: U.S. Public Health Service criteria showed 100% Alpha scores concerning recurrent caries for both crowns and FPDs. No crown fractures were observed during the 2-year follow-up, however, 10 (50%) catastrophic failures of FPDs occurred. Five (25%) failures occurred within the 1-year clinical period and the others (25%) within the second year. SIGNIFICANCE: Single unit Empress 2 all-ceramic crowns exhibited a satisfactory clinical performance over 2-year period. Furthermore, the high fracture rate of Empress 2 FPDs limits the usage of Empress 2 for the fabrication of all-ceramic FPD.     

Survival rates of resin-bonded, glass fiber-reinforced composite fixed partial dentures with a mean follow-up of 42 months: a pilot study

STATEMENT OF PROBLEM: Although short-term clinical data exist for resin-bonded, glass fiber-reinforced composite fixed partial dentures (FPDs), long-term data are needed. PURPOSE: The survival rates of 29 resin-bonded, glass fiber-reinforced composite fixed partial dentures were evaluated in this clinical study for periods of up to 42 months. MATERIAL AND METHODS: FPDs were fabricated to replace 1 to 3 missing maxillary or mandibular teeth of 29 patients not able to be treated with conventional FPDs. Originally, there were 37 patients (the drop-out rate was 22%). The FPDs were retained with wings, inlays, complete coverage crowns, or combinations of these that were bonded to tooth structure. The FPD frameworks were made of continuous unidirectional E-glass fibers with a multiphase polymer matrix and light-polymerized particulate composite veneer. The patients were recalled for examinations, where a general dental examination was performed, 1 to 3 times per year for up to 63 months (minimum 24 months, mean 42 months). Partial or complete total debonding of the FPD or the framework fracture was considered a treatment failure. The data were analyzed with the Kaplan-Meier survival test (alpha=.05). RESULTS: Two resin frameworks fractured, and 3 frameworks were debonded. Kaplan-Meier survival probability at 63 months was 75%. Three of the failed FPDs were rebonded or repaired in situ, producing a functional survival rate of 93% after rebonding or repairing (mean survival time was 55 months). CONCLUSION: The results of this clinical study of 29 prostheses suggest that glass fiber-reinforced FPDs may be a possible alternative to cast metal resin-bonded FPDs. These restorations were successfully used as multiple-unit prostheses that employed a variety of abutment tooth preparation designs.     

Integration of all-ceramic restorations in reconstructive prosthetic dentistry: a case report.

A male patient presented for maxillary and mandibular complete-arch prostheses. A total of eight all-ceramic restorations, eight metal-ceramic crowns, and four metal-ceramic fixed partial dentures were placed. The restorations were examined for marginal integrity, anatomic form, surface, and color for a period of 12 months. All restorations were in function at the end of the evaluation period. There was no adverse event. No substantial difference between the all-ceramic onlays and the metal-ceramic crowns was apparent. The all-ceramic restorations exhibited the least plaque growth. Bleeding on probing was minimal at both restoration types. The marginal integrity of the all-ceramic restorations was considered to be nearly as precise as that of the metal-ceramic crowns.