二硅酸锂玻璃陶瓷在前牙过小牙修复的临床应用

目的 评价二硅酸锂玻璃陶瓷在前牙过小牙修复中的临床应用。方法 对45例患者的87颗牙使用IPS e.max Press铸瓷贴面修复，于修复完成后1、6、12、24、36个月进行复查，参见改良加利福尼亚牙科协会（CDA）/Ryge标准进行评价，检查包括边缘适合性，瓷表面质地，颜色匹配，牙敏感症状和牙龈健康情况五个方面。结果 1个月复查时，11颗基牙出现牙敏感症状，予脱敏治疗处理后症状明显改善。6个月复查牙龈情况，9颗基牙出现牙龈炎症，经卫生宣教及系统牙周治疗后症状好转。1个月及6个月复查时，所有贴面边缘密合，完整性好，瓷表面质地良好。12个月复查时出现1颗贴面完整脱落，清洁处理后重新粘固未再次发生脱落。24个月复查时，一患者进食过程中前牙误咬硬物发生修复体崩折，牙本质暴露，予重新制作贴面进行修复。观察到36个月时7颗基牙出现不同程度龈退缩。结论 二硅酸锂玻璃陶瓷贴面适用于前牙区过小牙修复，可获得良好的临床效果和远期预后。

Clinical application of using lithium disilicate glass-ceramic to restore small anterior tooth

Objective To evaluate the clinical application of lithium disilicate glass ceramic in the treatment of small anterior teeth restoration. Methods 87 teeth of 45 patients were restored by IPS e.max press ceramic veneers. The teeth underwent a detailed clinical examination according to the modified California Dental Association (CDA)/Ryge standards including marginal fitness, ceramic surface, color match, sensitivity, gingival health after 1 month, 6 months, 12 months, 24 months and 36 months. Results 11 teeth showed the sensitive symptoms at the review after 1 month and the symptoms were significantly improved after treatment. After 6 months, 9 teeth showed the inflammation of gums and the symptoms were improved after health education and periodontal treatment. Review after 1 month and 6 months showed that all the veneers had good marginal fitness, integrity and ceramic surface. Review after 12 months showed that a veneer fell off, and was re attached to the tooth surface after cleansing. Review after 24 months showed that a veneer collapsed during eating, and the dentin was exposed. The veneer was re manufactured and restored. Only 7 teeth showed obvious gingival retraction at the review after 36 months. Conclusion Lithium disilicate glass ceramic veneer is suitable for the treatment of anterior teeth and can achieve good clinical effect and long term prognosis.