作为后牙固定义齿支架材料的新型氧化铈稳定四方晶相氧化锆／氧化铝纳米复合体——修复后1年前瞻性病例系列的初步结果

目的：检验饰面瓷后．氧化铈稳定四方晶相氧化锆／氧化铝纳米复合体（Ce—TZP／A-纳米复合体）做为后牙三单位固定桥（FDPs）支架的临床效果。材料和方法：将单个前磨牙或磨牙缺失需要单个固定桥修复的8名患者纳入病例研究系列。使用CAD／CAM系统（Hint—Eis）制作8个Ce—TZP／A-纳米复合体FDP支架．在支架表面烧制氧化锆饰面瓷（Vintage ZR．Shofu）,树脂粘结剂粘结FDPs。粘结后2周、3个月、6个月、12个月选择USPHS标准对修复体进行评价。比较基牙（实验组）与对侧未治疗牙（对照组）的菌斑指数、探诊出血、牙周袋深度等生物学评价指标。在粘结后即刻以及6个月、12个月随访时进行X线检查。对数据进行统计分析。结果：8个被检测FDPs的平均观测期为128-4-11个月。FDPs的保存率为100％。此外,未见FDPs在技术或生物学方面的并发症。实验组PCR为0.1±01、BOP 0.2±0.2、PPD 2.6±0.8。对照组PCR为0．2±0．2、BOP 0.1±0.1、PPD2.6±0．6。两组间各项均值无显著性差异。结论：修复治疗一年后的结果显示．Ce—TZP／A复合体是一种可靠的支架材料。确认上述结论还需要纳入更多的患者．并进行长期的临床随机对照观察实验。     

CAD/CAM氧化锆及Empress全瓷冠修复三年临床效果比较

目的:比较CAD/CAM氧化锆及Empress全瓷冠修复3年的临床效果。方法:选择350例患者共838个全冠修复体(其中CAD/CAM氧化锆全冠428颗、Empress铸瓷全冠410颗),平均观察期36.2±5月,随访检查基牙和修复体情况,分别对两组全瓷冠的存留率和修复成功率进行统计学分析。结果:观察期内共有41颗全瓷冠(19颗为氧化锆,22颗为Empress铸瓷)完全失败,需重新制作。氧化锆全瓷冠和Empress铸瓷全冠的存留率分别为95.1%和95.8%,成功率分别为90.7%和91.2%,其差异均无统计学意义。结论:CAD/CAM氧化锆和Empres铸瓷全冠均能满足临床需要,有较好的修复效果。     

CAD/CAM氧化锆全瓷冠修复前牙的临床观察

目的观察计算机辅助设计/制造（computer-aided design/computer-aided manufacturing,CAD/CAM）技术制作氧化锆全瓷冠修复前牙的临床效果。方法对8例需烤瓷冠修复前牙的患者,进行CAD/CAM氧化锆全瓷冠修复。随访1-2年观察全瓷冠修复体的色泽稳定性、牙龈健康状况和边缘密合性。结果12个全瓷冠修复体均无变色、崩瓷和裂纹,边缘密合,牙龈健康状况良好,无红肿出血、牙龈黑线。结论CAD/CAM氧化锆全瓷冠生物相容性好,美观耐用。     

氧化锆后牙固定局部义齿：5年前瞻性临床试验研究

本研究的目的在于评估后牙3单位和4单位氧化锆固定局部义齿（FPDs）修复5年后的功能情况。最初．30例患者参与试验,复诊检查时只有25例患者参加．共计25例FPDs,平均复诊时间为62．1个月．其余5例患者没有参与复诊。修复治疗后至第60个月复查期间,2例FPDs修复失败,失败原因是经过牙髓治疗后的基牙．其修复体出现氧化锆固定桥断裂或饰面瓷断裂的现象。修复体5年保存率为92％。根据该研究结果可以得出．氧化锆固定桥应用于后牙受力区．具有足够的机械强度。而个别修复体出现饰面瓷大块断裂的现象,这主要与固定桥设计不合理和磨牙症有关。     

饰瓷工艺对氧化锆陶瓷颜色和透光性的影响

目的 测定采用不同饰瓷工艺制作的氧化锆试件的色彩参数和透射比,探讨饰瓷工艺对氧化锆全瓷修复体颜色和透光性的影响.方法 制作15片厚度为(0.50±0.01)mm、直径为10 mm的氧化锆圆盘试件,表面烧结0.10 mm结合层瓷.按随机排列表法将试件分为3组(ZP、ZC和ZPC组),每组5片.ZP组采用直接热压铸技术压铸0.60 mm厚饰瓷层;ZC组采用涂层技术涂塑烧结0.60 mm厚饰瓷层;ZPC组先压铸0.30 mm厚饰瓷层,再涂塑烧结0.30 mm厚饰瓷层.用电脑比色仪和分光光度计测定饰瓷前后试件的色彩参数L*、a*、b*值和可见光积分透射比τ,计算色饱和度C*ab和色差ΔE,进行单因素方差分析(α=0.05)和Turkey's多重检验.测定A2色标准比色片的色彩参数,计算各组与比色片的色差.结果 ZP、ZPC、ZC 3组的a*值分别为-1.35±0.07、-0.64±0.06、-0.36±0.05,差异有统计学意义(P＜0.05);b*值分别为27.01±0.07、25.48±0.11、23.28±0.25,差异有统计学意义(P＜0.05);C*ab值分别为27.04±0.08、25.49±0.11、23.28±0.25,差异有统计学意义(P＜0.05).3组中ZP组的L*值和τ值最大,分别为87.53±0.48和1.64±0.03;ZPC组的L*值和τ值最小,分别为82.14±0.18和1.47±0.01(P＜0.05).ZC组与比色片的色差最小ΔE=1.04,ZP组与比色片的色差最大AE=4.86.结论 热压铸技术饰瓷的氧化锆陶瓷明度较高、透光性较好;热压铸后涂层技术饰瓷的氧化锆陶瓷明度较低、透光性较差;涂层技术饰瓷的氧化锆陶瓷与比色片的色差最小,能准确再现比色结果.     

氧化锆陶瓷悬臂树脂粘结固定义齿的远期疗效及对缺牙的影响

目的 探讨氧化锆陶瓷悬臂树脂粘结固定义齿(RBFDPs)的远期疗效及对缺牙的影响.方法 选择牙缺失患者91例进行氧化锆陶瓷悬臂RBFDPs修复,按照患者牙缺失因素分为3组,并对修复后即刻、3个月、3年后、5年后的修复体的固位、边缘密合性、美观、口腔卫生状况、牙体牙周健康等进行评价.采用SPSS 22.0软件包对数据进行...     

评价氧化锆瓷内冠-金沉积外冠套筒冠义齿的修复效果

目的:评价氧化锆瓷内冠-金沉积外冠套筒冠固位体义齿的临床修复效果。方法:选择16例对原义齿修复不满意,要求重新修复的KennedyⅠ、Ⅱ牙列缺损患者,设计氧化锆瓷内冠-金沉积外冠套筒冠固位体义齿修复,评价修复前和修复后6个月、12个月、24个月、36个月的修复效果及基牙松动度。结果:观察期内,16例患者对修复效果满意,基牙松动度较修复前明显改善(P<0.05)。结论:氧化锆瓷内冠-金沉积套筒冠义齿材料生物相容性好,患者对修复效果满意,可在不接受或不具备种植义齿修复条件且经济状况良好的患者中应用。     

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。     

隐形固定义齿的临床应用观察

隐形义齿,又称弹性仿生义齿,自1954年应于临床以来,常用于做活动义齿修复,作者根据患者的要求及固定义齿的设计原理,自1995年开始应用隐形义齿的材料试做隐型固定义齿,并与设计相同的一般固定义齿进行比较,取得了较为满意的效果,现报告如下:材料和方法1 临床资料为原戴一般活动义齿,隐形活动义齿患者,因基托不适,活动度较大要求重做或首次即要求     

氧化锆基底和饰瓷结合强度的分析

目的分析和比较几种全瓷系统基底和饰瓷的结合强度。方法制作直径为8 mm、厚度为3 mm的Lava、 Cercon、IPS e.max ZirCAD、Procera试件各20个,分别为Lava组、Cercon组、IPS e.max ZirCAD组、Procera组。每组各选10个试件表面烤制厚度为1 mm的相应饰瓷,10个试件表面烤制厚度为2 mm的相应饰瓷。对试件进行剪切强度的测定和断裂模式的观察。结果饰瓷厚度为1 mm时,Lava、Cercon、IPS e.max ZirCAD、Procera组的剪切强度分别为：（13.82±3.71）、（13.24±2.09）、（6.37±4.15）、（5.19±5.31）MPa;饰瓷厚度为2 mm时,各组的剪切强度分别为：（38.77±1.69）、（21.67±3.34）、（12.70±4.24）、（9.94±6.67）MPa。Lava组和Cercon组的剪切强度高于IPS e.max ZirCAD组和Procera组（P<0.05）,饰瓷厚度为2 mm的试件的剪切强度高于饰瓷厚度为1 mm的试件（P<0.05）。各组试件破坏模式均以界面破坏为主。结论氧化锆基底和饰瓷的结合强度因基底材料的不同而不同,饰瓷的厚度对结合强度有明显的影响。     

Marginal fit of Zirconia posterior fixed partial dentures

The aim of this study was to investigate the marginal fit of posterior fixed partial dentures (FPDs) made with 2 computer-aided design/computer-assisted manufacture systems--Procera Bridge Zirconia (Nobel Biocare) and Lava AllCeramic System (3M ESPE)--and to analyze the differences between abutments and between buccal and lingual surfaces. Twenty standardized specimens were prepared to receive posterior 3-unit FPDs. FPDs were fabricated according to the manufacturer's instructions. A scanning microscope (JSM-6400, JEOL) with a magnification of 1,000x was used for measurements. Three-way analysis of variance showed significant differences (P < .001) in marginal adaptation between the ceramic groups. Procera Bridge Zirconia showed the lowest discrepancies (26 +/- 19 microm). No significant differences were observed between abutments and surfaces, and no significant interaction was observed among the ceramic system, abutments, and surfaces. The accuracy of fit achieved by both zirconia systems was within the range of clinical acceptability, with Procera Bridge Zirconia showing the best marginal fit.     

All-ceramic inlay-retained fixed partial dentures: preliminary results from a clinical study

OBJECTIVES: The objective of this study was to evaluate the clinical performance of zirconia-based all-ceramic fixed partial dentures anchored by inlays. METHODS: A total of thirty FPDs, manufactured using a zirconia frame and veneered with press ceramic, were anchored by use of inlay retainers. All FPDs were designed to replace one missing molar and were adhesively luted by use of one of two different resin cements. Documentation included failures and other complications, plaque accumulation, and aesthetic and functional performance. Statistical analysis was performed using a cox-regression model. RESULTS: During the 12 months observation period a total of thirteen clinically relevant complications occurred-four delaminations of the veneer and six decementations. Three FPDs had to be replaced because of a fracture of the framework. The cement chosen, the location, and the design of the retainer had no statistically significant effect on the occurrence of complications. During the observation period, accumulation of plaque on the abutment teeth was not significantly greater than on reference teeth. Postoperative sensitivity did not differ significantly between the different luting cement groups. The aesthetic and functional performance of the FPDs was acceptable. CONCLUSIONS: Improved adhesion between resin cement and inlay retainer is desirable before general recommendation of all-ceramic inlay-retained FPDs. Use of different luting cements seems to have no effect on the occurrence of complications.     

Full zirconia fixed detachable implant-retained restorations manufactured from monolithic zirconia: clinical report after two years in service

The most frequently encountered problem with fixed detachable dental prostheses is loosening or fracture of the prosthetic screws. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. For this type of prosthesis it is necessary to place the implants in a position that enables occlusal or lingual access so as not to impair the esthetics. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with angled dental implants with buccal access. The prostheses were esthetically pleasing, and no clinical complications have been reported after 2 years.     

前牙氧化锆全瓷粘接桥两年临床应用效果观察

目的 观察前牙氧化锆全瓷粘接桥的修复效果,为氧化锆全瓷粘接桥修复的适应证选择和临床应用提供参考.方法 选择23例单颌缺失1～2颗前牙的患者,进行单翼或双翼氧化锆全瓷粘接桥修复.随访时根据美国公共健康协会标准,观察粘接桥的完整性、边缘着色、继发龋和颜色匹配性.结果 共制作粘接桥29件,其中单翼粘接桥23件,双翼粘接桥6件.观察14～30个月,平均22个月.1件双翼粘接桥修复失败,2件单翼粘接桥修复失败.26件粘接桥无边缘着色,无继发龋,仅2件单翼粘接桥颜色偏白.粘接桥累积生存率为90%(26/29).结论 对单颌缺失1～2颗前牙的患者进行氧化锆全瓷粘接桥修复,可以达到恢复前牙美观和功能的效果.     

A longitudinal clinical study of bonded fixed partial dentures: the first 5 years.

Etched-metal, composite resin-bonded, fixed partial dentures, as described in the early 1980s, gained an immediate application and popularity in restorative dentistry. This initial report presents the results of the first 5 years of a 10-year longitudinal study of these restorations. A total of 71 fixed partial dentures, ranging in use from 13 to 65 months, that were placed at the University of California, Los Angeles, School of Dentistry using consistent design parameters and restorative techniques have been analyzed. The results of this initial report indicate: (1) bonded fixed partial dentures are technique-sensitive; (2) optimal success requires meticulous attention to procedural detail; (3) anterior bonded fixed partial dentures do not appear to need routine 180-degree-plus circumferential retainer preparation for predictable success; (4) posterior bonded fixed partial dentures appear to require 180-degree-plus circumferential preparation for predictable success; (5) for single-tooth posterior replacements or single-to-double tooth anterior replacements, bonded fixed partial dentures are a viable alternative to conventional fixed partial dentures when intact abutments exist; and (6) most failures occurred within the first year.     

Clinical results of lithium-disilicate crowns after up to 9 years of service

Objectives

The purpose of this prospective study was to evaluate the clinical outcome of anterior and posterior crowns made of a lithium-disilicate glass–ceramic framework material (IPS e.max Press, Ivoclar Vivadent).

Materials and methods

A total of 104 single crowns were placed in 41 patients (mean age, 34?±?9.6 years; 15 male, 26 female). Eighty-two anterior and 22 posterior crowns were inserted. All teeth received a 1-mm-wide chamfer or rounded shoulder preparation with an occlusal/incisal reduction of 1.5–2.0 mm. The minimum framework thickness was 0.8 mm. Frameworks were laminated by a prototype of a veneering material combined with an experimental glaze. Considering the individual abutment preconditions, the examined crowns were either adhesively luted (69.2 %) or inserted with glass–ionomer cement (30.8 %). Follow-up appointments were performed 6 months after insertion, then annually. Replacement of a restoration was defined as failure.

Results

Four patients (10 crowns) were defined as dropouts. For the remaining 94 crowns, the mean observation time was 79.5 months (range, 34–109.7 months). The cumulative survival rate according to Kaplan–Meier was 97.4 % after 5 years and 94.8 % after 8 years. Applying log rank test, it was shown that the location of the crown did not significantly have an impact on the survival rate (p?=?0.74) and that the cementation mode did not significantly influence the occurrence of complications (p?=?0.17).

Conclusions

The application of lithium-disilicate framework material for single crowns seems to be a reliable treatment option.

Clinical relevance

Crowns made of a lithium-disilicate framework material can be used clinically in the anterior and posterior region irrespective of an adhesive or conventional cementation when considering abutment preconditions.