瓷修补树脂与饰面瓷颜色匹配性的研究
摘要
金属烤瓷由于兼具金属的强度和陶瓷的美观，其颜色外观质感逼真，色泽稳定，表面光滑，耐磨性强，不变形，抗折力强，深受患者的欢迎。但是随其应用的广泛，问题也逐渐暴露。因陶瓷材料剪切强度较差，或者不适当的加工过程以及人为因素的破坏，瓷层容易发生崩裂。对于已粘接的冠桥，目前临床常用的方法是用复合树脂修补。用复合树脂修补有诸多优点：包括即刻修补，花费低，操作简单等等，但复合树脂存在不稳定，不耐磨，美观性不好等缺点。随着材料的改进、设备水平的提高以及金属烤瓷粘接系统的出现，增强了树脂修补方法的实用性。学者们做了大量关于树脂和瓷断面或者金属断面的粘接强度的研究，但关于瓷与树脂颜色匹配性的研究较少。本实验针对此问题选用了Vita VMK 95牙本质瓷A2色，Ceramco 3牙本质瓷A2色和Ceram·X duo D2纳米瓷化树脂三种材料，用PR-650光谱扫描色度仪测量以上材料不同厚度下颜色参数L~*、a~*、b~*和透射率T值，并计算色差值△E~*，探讨不同厚度下树脂和饰面瓷之间颜色的匹配程度。
实验结果表明：
(1)不同厚度下，饰面瓷与树脂的颜色参数L~*、a~*、b~*有显著性差异，并随着厚度的减少而减小。
(2)不同厚度下，两种饰面瓷与树脂之间的色差值△E~*之间无统计学差异，都达到肉眼可辨别范围，当厚度在1.0mm和0.8mm时，ΔE*在临床可接受范围内。
(3)不同厚度下，饰面瓷与树脂之间的透射率有显著性差异。随着厚度的降低，透射率显著增加。
综上所述，本研究分析了瓷修补树脂和饰面瓷颜色的匹配程度。结果表明瓷修补树脂的颜色与饰面瓷的颜色有显著性差异，树脂的颜色有待于进一步改善以达到与饰面瓷颜色匹配的效果。另一方面，本实验提供了瓷修补树脂与饰面瓷光学特性差异的基本信息，为临床瓷修补树脂的应用提供了一定的理论基础。也为进一步研究如多种色标和多种材料在不同背景下、不同粘接剂、不同树脂配色以及直接修补的差异提供了实验基础。
The porcelain-fused-to-metal crown (PFM) have the quality of enough intension like metal and the ideal appearances like porcelain. Because of its stable color,glazed surface, good endurence of abrasion and torsion et al, PFM is popular in dentistry.However there are also many problems.Because of the poor shear strength,faulty process and some man-made factors,which can result in fracture.To the crown which have beening cemented,one of the simple way is to repair it by resin-composite directly. This method has several advantages, including quick application,minimal expense,and simplicity. Nevertheless,these repairs tend to have several shortcomings,such as instable,poor wear resistense and aesthetic appearance problems.With the improvement of materials and techniques, the advent of new systems related to bonding to fractured porcelain make it possible. There have been several studies about the bonding strength between resin composite and porcelain or metal,but few studies about the consistency of color between two of them. In this study,Vita VMK95 dentin porcelain(A2), Ceramco 3 dentin porcelain(A2) and Ceram·X duo nano ceramic restorative resin composite (D2)were chosed. The color parameters L*、a*、b* and translucency(T) values of these materials with different thickness were measured with a spectroradiometer (PR-650),and the color different valuesΔE* were calculated to discuss the consistency of color between porcelain-repairing resin composite and veneering porcelain.
The result showed:
(1) In different thickness, the color parameters L*、a*、b* values had statistic differences between veneering porcelain and porcelain-repairing resin composite,and the values decreased with the thickness decreased.
(2) In different thickness, theΔE* between the veneering porcelain and porcelain-repairing resin composite had no statistic differences,and all the values reached the recognizable ranges by naked eyes.TheΔE* values were in the ranges of clinic acceptability in 1.0mm and 0.8mm thickness.
(3) In different thickness,the translucency(T) values had statistic differences between veneering porcelain and porcelain-repairing resin composite,and the values were increased exponentially or logarithmicly with the thickness decreased.
In conclusion,this study analysed the consistency of color between porcelain-repairing resin composite and veneering porcelain and there were obvious differences in color between two of them.The color of resin composite should be improved to match the color of veneering porcelain.On the other hand, the study results showed the basic information on the difference in optical properties between porcelain-repairing resin composite and veneering porcelain,it laid a foundation for clinic application of porcelain-repairing.The results also laid a experimental foundation for further studies including several color tabs and materials in different background,cement agent, color combinations and clinic application.
实验结果表明：
(1)不同厚度下，饰面瓷与树脂的颜色参数L~*、a~*、b~*有显著性差异，并随着厚度的减少而减小。
(2)不同厚度下，两种饰面瓷与树脂之间的色差值△E~*之间无统计学差异，都达到肉眼可辨别范围，当厚度在1.0mm和0.8mm时，ΔE*在临床可接受范围内。
(3)不同厚度下，饰面瓷与树脂之间的透射率有显著性差异。随着厚度的降低，透射率显著增加。
综上所述，本研究分析了瓷修补树脂和饰面瓷颜色的匹配程度。结果表明瓷修补树脂的颜色与饰面瓷的颜色有显著性差异，树脂的颜色有待于进一步改善以达到与饰面瓷颜色匹配的效果。另一方面，本实验提供了瓷修补树脂与饰面瓷光学特性差异的基本信息，为临床瓷修补树脂的应用提供了一定的理论基础。也为进一步研究如多种色标和多种材料在不同背景下、不同粘接剂、不同树脂配色以及直接修补的差异提供了实验基础。
The porcelain-fused-to-metal crown (PFM) have the quality of enough intension like metal and the ideal appearances like porcelain. Because of its stable color,glazed surface, good endurence of abrasion and torsion et al, PFM is popular in dentistry.However there are also many problems.Because of the poor shear strength,faulty process and some man-made factors,which can result in fracture.To the crown which have beening cemented,one of the simple way is to repair it by resin-composite directly. This method has several advantages, including quick application,minimal expense,and simplicity. Nevertheless,these repairs tend to have several shortcomings,such as instable,poor wear resistense and aesthetic appearance problems.With the improvement of materials and techniques, the advent of new systems related to bonding to fractured porcelain make it possible. There have been several studies about the bonding strength between resin composite and porcelain or metal,but few studies about the consistency of color between two of them. In this study,Vita VMK95 dentin porcelain(A2), Ceramco 3 dentin porcelain(A2) and Ceram·X duo nano ceramic restorative resin composite (D2)were chosed. The color parameters L*、a*、b* and translucency(T) values of these materials with different thickness were measured with a spectroradiometer (PR-650),and the color different valuesΔE* were calculated to discuss the consistency of color between porcelain-repairing resin composite and veneering porcelain.
The result showed:
(1) In different thickness, the color parameters L*、a*、b* values had statistic differences between veneering porcelain and porcelain-repairing resin composite,and the values decreased with the thickness decreased.
(2) In different thickness, theΔE* between the veneering porcelain and porcelain-repairing resin composite had no statistic differences,and all the values reached the recognizable ranges by naked eyes.TheΔE* values were in the ranges of clinic acceptability in 1.0mm and 0.8mm thickness.
(3) In different thickness,the translucency(T) values had statistic differences between veneering porcelain and porcelain-repairing resin composite,and the values were increased exponentially or logarithmicly with the thickness decreased.
In conclusion,this study analysed the consistency of color between porcelain-repairing resin composite and veneering porcelain and there were obvious differences in color between two of them.The color of resin composite should be improved to match the color of veneering porcelain.On the other hand, the study results showed the basic information on the difference in optical properties between porcelain-repairing resin composite and veneering porcelain,it laid a foundation for clinic application of porcelain-repairing.The results also laid a experimental foundation for further studies including several color tabs and materials in different background,cement agent, color combinations and clinic application.
引文
[1] Yanikoglu N. The repair methods for fractured metal-porcelain restorations: a review of the literature[J]. Eur J Prosthodont Restor Dent, 2004, 12(4):161-165.
[2] Jnliana GS, Renata GF, Gelson LA, et al. Shear bond strength of metal-ceramic repair systems[J]. J Prosthet Dent, 2006, 93(3): 165-173.
[3] Walton JN, Gardner FM, Agar JR. A survery of crown and fixed partial denture failures: length of service and reasons for replacement[J]. J Prosthet Dent, 1986, 56(4):416-421.
[4] Hasegawa A, Ikeda I, Kawaguchi S. Color and translucency of in vivo natural central incisors[J]. J Prosthet Dent, 2000, 83(4):418-423.
[5] Paul S, Peter A, Pietrobon N, et al. Visual and spectrophotometric shade analysis of human teeth[J]. J Dent Res, 2002, 81 (8):578-582.
[6] 熊芳．天然牙和牙科陶瓷半透性的研究[J]．四川大学口腔医学博士专业学位论文，2006．
[7] 桑田正博，著，史书俊，译：金属烤瓷修复体的理论和实践[M]．天津科学技术出版社，1984：P219．
[8] Seghi RR, Johnston WM, O'Brien WJ. Spectrophotometric analysis of color differences between porcelain systems[J]. J Prosthet Dent, 1986, 56(1):35-40.
[9] Crispin BJ, Okanoto SK, Globe H. Effect of porcelain crown substructures on visually perceivable value[J]. J prosthet Dent, 1991, 66(2):209-210.
[10] 耀江武．现代口腔色彩学[M]．厦门，厦门大学出版社，2000：P 20-26．
[11] 杨宏军，孙剑，王忠义．金瓷修复体与Vita成品比色板色度差[J]．华西口腔医学杂志，1999，17(2)：147-149．
[12] Seghi RR, Hewlett ER, Kim J. Visual assessment of colorimetric analysis on translucent dental porcelain[J]. J Dent Res, 1988, 67(IADR Abstracts):119-120.
[13] Douglas RD, Brewer JD. Acceptability of shade differences in metal ceramic crowns[J]. J Prosthet Dent, 1998, 79(3):254—260.
[14] Analoui M, Papkosta E, Cochran M, et al. Designing visually optimal shade guides[J]. J Prosthet Dent, 2004, 92(4):371-376.
[15] Winter R. Visualizing the natural dentition[J]. J Esthet Dent, 1993, 5(3): 102-117.
[16] Brodbelt RH, O'Brien WJ, Fan PL. Translucency of dental porcelains [J]. J Dent Res, 1980, 59(1):70-75.
[17] Heffernan MJ, Aquilino SA, Diaz-Arnold AM, et al. Relative translucency of six all-ceramic systems. Part I: Core materials[J]. J Prosthet Dent, 2002, 88(1):4-9.
[18] Breeding LC, Dixon DL, Caughman WF. The curing potential of light-activated composite resin luting agents. J Prosthet Dent, 1991, 65(4):512-518.
[19] Arikawa H, Fujii K, Kanie T, et al. Light transmittance characteristics of light-cured composite resins[J]. Dent Mater, 1998,14(6):405-411.
[20] Kim JJ, Moon HJ, Lim BS, et al. The effect of nanofiller on the opacity of experimental composites[J]. J Biomed Mater Res Part B: Appl Biomater, 2007, 80(2): 332-338.
[21] YT. Koo JB, Hong KJ, et al. Effect of grain size on transmittance and mechanical strength of sintered alumina[J]. Mater. Sci. Eng. A , 2004, 37 (4):191-195.
[22] Lee YK Lim BS Rhee SH , et al. Color and translucency of A2 shade resin composites after curing, polishing and thermocycling[J]. Oper Dent, 2005, 30(4):436-442.
[23] Kim DS, Lee JH, Sang RJ, et al. Improvement of translucency in Al_2O_3 ceramics by two-step sintering technique[J]. J Eur Ceram Soc. 2007, (Article in Press).
[24] Hisama K. Effects of the firing temperature on the color and strength of metal bonded porcelain[J]. Fukuoka Shika Daigaku Gakkai Zasshi, 1989,16(3): 369-390.
[25] Kamishima N, Ikeda T, Sano H. Color and translucency of resin composites for layering techniques[J]. Dent Mater, 2005, 24(3): 428-432.
[26] Rada RE. Intraoral repair of metal ceramic restorations[J]. J Prosthet Dent, 1991, 65(3):348-350.
[27] Latta MA, Barkmeier WW. Approaches for intraoral repair of ceramic restorations[J]. Compend Contin Educ Dent, 2000, 21(8):635-639, 642-644 quiz 646.
[28] Chung KH, Hwang YC. Bonding strengths of porcelain repair systems with various surface treatment[J]. J Prosthet Dent, 1997, 78(3):267-274.
[29] Kim BK, Bae HE, Shim JS, et al. The influence of ceramic surface treatments on the tensile bond strength of composite resin to all-ceramic coping materials[J]. J Prosthet Dent, 2005, 94(4):357-362.
[30] 赵煜，巢永烈．金属烤瓷冠崩瓷的临床修补[J]．北京口腔医学，2005，13(4)：262-264．
[31] 佟岱，孙志辉．烤瓷冠桥崩瓷后专用树脂修补的研究[J]．现代口腔医学杂志，2006，20(1)：11-13．
[32] Ozcan M, Niedermeier W. Clinical study on the reasons for and location of failures of metal-ceramic restorations and survival of repairs[J]. Int J Prosthodont, 2002, 15(3):299-302.
[1] Joiner A. Tooth colour: a review of the literature[J]. J Dent, 2004, (Suppl1):3-12.
[2] Vaarkamp J, Tenbosch JJ, Verdonschot EH. Propagation of light through human dental enamel and dentin[J]. Caries Res, 1995, 29(1): 8-13.
[3] Monsenego G, Burdairon G. Fluorescence of dental porcelain[J]. J Prosthet Dent, 1993, 69(1):106-113.
[4] Watts A, Addy M. Tooth discolouration and staining: a review of the literature [J]. Br Dent J, 2001, 190(6):309-316.
[5] Mayekar SM. Shade of a color illusion or reality?: new technique in esthetic and restorative dentistry [J]. Dent Clin North Am, 2001, 45 (1): 155-172.
[6] O'Brien WJ, Hemmendinger H, Boenke KM, et al. Color distribution of three regions of extracted human teeth[J]. Dent Mater, 1997, 13(3): 179-185.
[7] Hasegawa A, Ikeda I, Kawaguchi S. Color and translucency of in vivo natural central incisors[J]. J Prosthet Dent, 2000, 83(4):418-423.
[8] Jahangiri L, Reinhardt SB, Mehra RV, et al. Relationship between tooth shade value and skin color: an observational study[J]. J Prosthet Dent, 2002, 87(2): 149-152.
[9] 熊芳．天然牙和牙科陶瓷半透性的研究[J]．四川大学口腔医学博士专业学位论文，2006．
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[16] Analoui M, Papkosta E, Cochran M. Designing visually optimal shade guides[J]. J Prosthet Dent, 2004, 92(4):371-373.
[17] Cal E, Sonugelen M, Guneri P. Application of a digital technique in evaluating the reliability of shade guides[J]. J Oral Rehabil, 2004, 31(9):483-491.
[18] Dagg H, O'connell B, Claffey N, et al. The influence of some different factors on the accuracy of shade selection[J]. J Oral Rehabil, 2004, 31(9):900-904.
[19] Paul S, Peter A, Pietrobon N. Visual and spectrophotometic shade analysis of human teeth[J]. J Dent Res, 2002, 81(8):578-582.
[20] Brewer JD, Wee A, Seghi R. Advances in color matching[J]. Dent Clin North Am, 2004, 48(2):341-358.
[21] Tung FF, Goldstein GR, Jang S. The repeatability of an intraoral dental colorimeter[J]. J Prosthet Dent, 2002, 88(6):585-590.
[22] 吕新广．对光谱三刺激值概念的理解．包装工程[J]．2002，23(5)：40-41．
[23] Guan YH, Lath DI, Lilley TH. The measurement of tooth whiteness by image analysis and spectrophotometry: a comparison[J]. J Oral Rehabil, 2005, 32(1):7-15.
[24] Shimada K, Kakehashi Y, Matsumura HE, et al. In vivo quantitative evaluation of tooth color with hand-held colormeter and custom templete[J]. J Prosthet Dent, 2004, 91 (4):389-391.
[25] Bellamy P, Puri G, Bowtell P, et al. Clelab tooth color Measurements comparing contact and non-contact clinical methods. In: 2005 IADR/AADR CADR 83rd General Session & Exhibition,Baltimore Convention Center, 2005.
[2] Jnliana GS, Renata GF, Gelson LA, et al. Shear bond strength of metal-ceramic repair systems[J]. J Prosthet Dent, 2006, 93(3): 165-173.
[3] Walton JN, Gardner FM, Agar JR. A survery of crown and fixed partial denture failures: length of service and reasons for replacement[J]. J Prosthet Dent, 1986, 56(4):416-421.
[4] Hasegawa A, Ikeda I, Kawaguchi S. Color and translucency of in vivo natural central incisors[J]. J Prosthet Dent, 2000, 83(4):418-423.
[5] Paul S, Peter A, Pietrobon N, et al. Visual and spectrophotometric shade analysis of human teeth[J]. J Dent Res, 2002, 81 (8):578-582.
[6] 熊芳．天然牙和牙科陶瓷半透性的研究[J]．四川大学口腔医学博士专业学位论文，2006．
[7] 桑田正博，著，史书俊，译：金属烤瓷修复体的理论和实践[M]．天津科学技术出版社，1984：P219．
[8] Seghi RR, Johnston WM, O'Brien WJ. Spectrophotometric analysis of color differences between porcelain systems[J]. J Prosthet Dent, 1986, 56(1):35-40.
[9] Crispin BJ, Okanoto SK, Globe H. Effect of porcelain crown substructures on visually perceivable value[J]. J prosthet Dent, 1991, 66(2):209-210.
[10] 耀江武．现代口腔色彩学[M]．厦门，厦门大学出版社，2000：P 20-26．
[11] 杨宏军，孙剑，王忠义．金瓷修复体与Vita成品比色板色度差[J]．华西口腔医学杂志，1999，17(2)：147-149．
[12] Seghi RR, Hewlett ER, Kim J. Visual assessment of colorimetric analysis on translucent dental porcelain[J]. J Dent Res, 1988, 67(IADR Abstracts):119-120.
[13] Douglas RD, Brewer JD. Acceptability of shade differences in metal ceramic crowns[J]. J Prosthet Dent, 1998, 79(3):254—260.
[14] Analoui M, Papkosta E, Cochran M, et al. Designing visually optimal shade guides[J]. J Prosthet Dent, 2004, 92(4):371-376.
[15] Winter R. Visualizing the natural dentition[J]. J Esthet Dent, 1993, 5(3): 102-117.
[16] Brodbelt RH, O'Brien WJ, Fan PL. Translucency of dental porcelains [J]. J Dent Res, 1980, 59(1):70-75.
[17] Heffernan MJ, Aquilino SA, Diaz-Arnold AM, et al. Relative translucency of six all-ceramic systems. Part I: Core materials[J]. J Prosthet Dent, 2002, 88(1):4-9.
[18] Breeding LC, Dixon DL, Caughman WF. The curing potential of light-activated composite resin luting agents. J Prosthet Dent, 1991, 65(4):512-518.
[19] Arikawa H, Fujii K, Kanie T, et al. Light transmittance characteristics of light-cured composite resins[J]. Dent Mater, 1998,14(6):405-411.
[20] Kim JJ, Moon HJ, Lim BS, et al. The effect of nanofiller on the opacity of experimental composites[J]. J Biomed Mater Res Part B: Appl Biomater, 2007, 80(2): 332-338.
[21] YT. Koo JB, Hong KJ, et al. Effect of grain size on transmittance and mechanical strength of sintered alumina[J]. Mater. Sci. Eng. A , 2004, 37 (4):191-195.
[22] Lee YK Lim BS Rhee SH , et al. Color and translucency of A2 shade resin composites after curing, polishing and thermocycling[J]. Oper Dent, 2005, 30(4):436-442.
[23] Kim DS, Lee JH, Sang RJ, et al. Improvement of translucency in Al_2O_3 ceramics by two-step sintering technique[J]. J Eur Ceram Soc. 2007, (Article in Press).
[24] Hisama K. Effects of the firing temperature on the color and strength of metal bonded porcelain[J]. Fukuoka Shika Daigaku Gakkai Zasshi, 1989,16(3): 369-390.
[25] Kamishima N, Ikeda T, Sano H. Color and translucency of resin composites for layering techniques[J]. Dent Mater, 2005, 24(3): 428-432.
[26] Rada RE. Intraoral repair of metal ceramic restorations[J]. J Prosthet Dent, 1991, 65(3):348-350.
[27] Latta MA, Barkmeier WW. Approaches for intraoral repair of ceramic restorations[J]. Compend Contin Educ Dent, 2000, 21(8):635-639, 642-644 quiz 646.
[28] Chung KH, Hwang YC. Bonding strengths of porcelain repair systems with various surface treatment[J]. J Prosthet Dent, 1997, 78(3):267-274.
[29] Kim BK, Bae HE, Shim JS, et al. The influence of ceramic surface treatments on the tensile bond strength of composite resin to all-ceramic coping materials[J]. J Prosthet Dent, 2005, 94(4):357-362.
[30] 赵煜，巢永烈．金属烤瓷冠崩瓷的临床修补[J]．北京口腔医学，2005，13(4)：262-264．
[31] 佟岱，孙志辉．烤瓷冠桥崩瓷后专用树脂修补的研究[J]．现代口腔医学杂志，2006，20(1)：11-13．
[32] Ozcan M, Niedermeier W. Clinical study on the reasons for and location of failures of metal-ceramic restorations and survival of repairs[J]. Int J Prosthodont, 2002, 15(3):299-302.
[1] Joiner A. Tooth colour: a review of the literature[J]. J Dent, 2004, (Suppl1):3-12.
[2] Vaarkamp J, Tenbosch JJ, Verdonschot EH. Propagation of light through human dental enamel and dentin[J]. Caries Res, 1995, 29(1): 8-13.
[3] Monsenego G, Burdairon G. Fluorescence of dental porcelain[J]. J Prosthet Dent, 1993, 69(1):106-113.
[4] Watts A, Addy M. Tooth discolouration and staining: a review of the literature [J]. Br Dent J, 2001, 190(6):309-316.
[5] Mayekar SM. Shade of a color illusion or reality?: new technique in esthetic and restorative dentistry [J]. Dent Clin North Am, 2001, 45 (1): 155-172.
[6] O'Brien WJ, Hemmendinger H, Boenke KM, et al. Color distribution of three regions of extracted human teeth[J]. Dent Mater, 1997, 13(3): 179-185.
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