红、白美学评价CAD／CAM个性化基台与全瓷冠在前牙区的应用

摘要]目的：研究计算机辅助设计及计算机辅助制作（CAD／CAM）个性化基台及全瓷冠的临床应用，应用红色美学（pinkestheticscore，PES）及白色美学（whiteestheticscore，WES）评价其在前牙区修复的美学效果。方法：运用CAD／CAM个性化基台与全瓷冠修复前牙区种植病例共51例73件，戴用后按红色美学及白色美学评分标准评价其美学修复效果。结果：51例患者共73件CAD／CAM个性化基台及全瓷冠3个月后复查结果：PES10分占9．59％，8～9分占71．23％，6～7分占17．81％，5分及以下占1．37％；WES10分占39．73％，8～9分占60．27％，6～7分占0％，5分及以下占0％。6个月后复查结果：PES10分占8．22％，8～9分占69．86％，6～7分占17．81％，5分及以下占4．11％；WES10分占36．99％，8～9分占61．64％，6～7分占1．37％，5分及以下占O％。一年后复查结果：PES10分占5．48％，8～9分占68．49％，6—7分占20．55％，5分及以下占5．48％；WES10分占31．51％，8～9分占64．38％，6～7分占4．11％，5分及以下占O％。经过1～3年的随访，1例基台在扭矩控制时发生崩瓷，在观察期内1例螺丝松动。所有病例牙龈均较健康，牙龈未见明显退缩，无种植体周围炎的发生。结论：PES及WES评分标准客观、全面，计分方式可比性佳。CAD／CAM个性化基台及全瓷冠生物相容性佳，化学性能稳定，在种植美学前牙区适用范围更广，但仍需进一步跟踪观察其长期应用效果。

PES and WES evaluation of CAD/CAM custom abutments and all ceramic crowns in the anterior teeth area

Objective ： To investigate the clinic application of computer aided design ＆ computer aided manufacturing （ CAD/CAM ） custom abutments and all ceramic crowns and evaluate their esthetic effect in the anterior teeth area according to the assessment criteria Pink Esthetic Score （PES） and White Esthetic Score （WES）. Methods：Totally 73 CAD/CAM custom abutments and all ceramic crowns were used in 51 implant-supported prosthesis cases. The esthetic prosthetic effect was evaluated according to the assessment cri- teria PES and WES. Results：The 3-month-follow-up results of totally 73 CAD/CAM custom abutments and all ceramic crowns of 51 pa- tients： the percentage of the PES scores of 10,8-9,6-7 and ~〈5 was 9.59% ,71.23% ,17.81% ,and 1.37% ,respectively; the percent- age of the VIES scores of 10,8-9,6-7 and≤ 5 was 39.73% ,60.27% ,0% , and 0% , respectively. The 6-month-follow-up results： the percentage of the PES scores of 10,8-9,6-7 and≤5 was 8.22% ,69.86% , 17.81% , and 4.11% , respectively; the percentage of the VIES scores of 10,8-9,6-7 and ≤ 5 was 36.99% ,61.64% , 1.37% , and 0% , respectively. The 1-year-follow-up results： the percentage of the PES scores of 10,8-9,6-7 and≤ 5 was 5.48 % ,68.49 % ,20.55 % , and 5.48 % , respectively ; the percentage of the VIES scores of 10,8-9,6-7 and ≤ 5 was 31.51% ,64.38 % ,4.11% , and 0% , respectively. During the follow-up of 1 to 3 years, there was only one abutment got fractured when the torque control was installed, and one loosened during observation. In all cases, the gingivae were in healthy condition, and no further obvious gingival retreat or periimplantitis occurred. Conclusions ： PES and VIES are objective,integrat- ed and comparable. CAD/CAM custom abutments and all ceramic crowns have good biocompatibility and chemical stability,and can be more widely used in the anterior teeth area. However, their long term effects need to be confirmed by further follow-up.