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.     

Bone rehabilitation to achieve optimal aesthetics.

Treatment involving oral implants has established a high success rate, including implant survival on a long-term basis. The challenge facing the clinicians today is to achieve an optimal long-term aesthetic result. To address this challenge, the volume of the underlying hard and soft tissue must be restored either prior to or simultaneously with the implant placement. The learning objective of this article is to review the critical biologic and clinical criteria essential in achieving a predictable success in aesthetic enhancement of the implant site.     

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。     

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.     

Techniques used to fabricate all-ceramic restorations in the dental practice

Porcelain is an increasingly popular material to use for restorations. This article will discuss the 3 main ways to fabricate porcelain restorations. The first method involves waxing up the restoration to the proper form and casting it in molten porcelain similar to the lost wax technique for gold. The second technique requires the use of porcelain in a powder form to be stacked on top of a refractory die or a platinum foil and then fired in the oven. The third main technique is the use of a CAD/CAM system to mill the porcelain restoration from a solid block of porcelain. All 3 techniques are valid and the clinician should have a thorough understanding of which techniques are appropriate in various clinical situations.     

Clinically relevant approach to failure testing of all-ceramic restorations

STATEMENT OF PROBLEM. One common test of single-unit restorations involves applying loads to clinically realistic specimens through spherical indenters, or equivalently, loading curved incisal edges against flat compression platens. As knowledge has become available regarding clinical failure mechanisms and the behavior of in vitro tests, it is possible to constructively question the clinical validity of such failure testing and to move toward developing more relevant test methods. PURPOSE: This article reviewed characteristics of the traditional load-to-failure test, contrasted these with characteristics of clinical failure for all-ceramic restorations, and sought to explain the discrepancies. Literature regarding intraoral conditions was reviewed to develop an understanding of how laboratory testing could be revised. Variables considered to be important in simulating clinical conditions were described, along with their recent laboratory evaluation. CONCLUSIONS: Traditional fracture tests of single unit all-ceramic prostheses are inappropriate, because they do not create failure mechanisms seen in retrieved clinical specimens. Validated tests are needed to elucidate the role(s) that cement systems, bonding, occlusion, and even metal copings play in the success of fixed prostheses and to make meaningful comparisons possible among novel ceramic and metal substructures. Research over the past 6 years has shown that crack systems mimicking clinical failure can be produced in all-ceramic restorations under appropriate conditions.     

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。     

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.     

Copy-milled all-ceramic restorations: case reports.

When all-ceramic systems are used, a respect for biocompatibility, an understanding of the patient's esthetic demands, and a justifiable reliance on the strength of the selected system are integral to success. Severely damaged molar teeth in two patients were restored with all-ceramic onlays that were prepared with a copy-milling system for ceramics. The onlay patterns were fabricated directly in the mouth with autopolymerizing resin. For these patients, the use of biologic, all-ceramic, copy-milled restorations resulted in clinical success as well as recovered function and esthetics.     

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。     

Dental technicians' experiences with all-ceramic extra-coronal restorations

The aim of this study was to identify the dental technicians' experiences with extra-coronal all-ceramic restorations. A questionnaire was mailed to all laboratories registered in The Norwegian Association of Dental Laboratory Owners (n=186). The response was 149 (80%). All-ceramic restorations were produced by 93 (62%) of the responding laboratories. A few of these (1 7%) produced the majority (67%) of the restorations. The dental technicians reported low rates of remakes (median 2%) for all-ceramic restorations. The low production and the limited number of laboratories that perform this work show that there is room for extended training and more expertise in this field.     

Avoiding failures during insertion of all-ceramic restorations

The seating, cementing, and finishing of all-ceramic restorations can be a very demanding operation. All steps must be accomplished well in order to produce a clinically acceptable result. Successful placement of all-ceramic restorations can result in an immediate reward for both the patient and the operator; however, only with very careful consideration of occlusion, laboratory work, and chairside seating and finishing can a successful long-term result be realized.     

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...