CAD/CAM全瓷高嵌体微创修复根管治疗后牙体缺损的效果评价

目的：探讨CEREC计算机辅助设计与制作（computer aided design and computer aided manufacturing ， CAD/CAM）全瓷高嵌体微创修复根管治疗后的后牙牙体缺损的临床疗效。方法选择126例大面积缺损的后牙，经过完善的根管治疗后，采用CEREC CAD/CAM全瓷高嵌体修复缺损牙冠，修复后即刻对患者进行满意度调查，术后即刻及1年后随访，均按照改良的美国公共卫生部（United States Public Health Service ，USPHS）标准对修复体进行临床评价。结果患者满意度在91%以上。根据改良USPHS标准，术后即刻及1年后复查时修复体边缘适合性达到A级分别为92.1％和91.3%（c2=0.052，P=0.820），外形达A级前后两次均为97.6%，表面质地达到A级分别为95.2%和93.7%（c2=0.303，P=0.582），颜色匹配达到A级分别为80.2%和81.7%（c2=0.103，P=0.748）。仅出现1例瓷破裂。结论 CEREC CAD/CAM全瓷高嵌体修复后牙牙体缺损效果良好，远期效果有待观察。

Clinical evaluation of CAD/CAM ceramic onlay restoration of endodontically treated posterior teeth

Objective To evaluate clinical effects of of computer aided design and computer aided manufacturing (CAD/CAM) on the ceramic onlay restoration of endodontically treated posterior tooth. Methods 126 endodontically treated posterior teeth were restored with chair?side CAD/CAM ceramic onlays. The patient satisfaction surveys were carried out immediately after restoration. Clinical evaluations, including marginal adaptation, contour apearance, surface texture, color match were made according to the modified United States Public Health Service (USPHS) criteria immedi?ately after the restoration and 1 year follow?up. Results More than 91% patients were satisfied with the restorations. According to USPHS criteria, 92.1%and 91.3%(c2=0.052,P=0.820)restorations reached A level inmarginal adapta?tion immediately and in 1 year follow?up, and that was 97.6% for the contour appearance, 95.2% and 93.7%(c2 =0.303,P=0.582)for the surface texture, 80.2%and 81.7%(c2=0.103,P=0.748)for the color match. Only one ce?ramic restoration fractured during follow?up. Conclusion CAD/CAM ceramic onlays have good clinical effect in resto?ration of endodontically treated posterior teeth .