Lava CAD/CAM二氧化锆全瓷冠前牙美容修复的临床评价
摘要
目的：通过观察和评价Lava全瓷CAD/CAM系统在前牙修复中的临床效果,探讨Lava全瓷冠在前牙修复中的临床应用。
材料与方法：选择口腔门诊患者15人,共47颗前牙,用金钢砂车针进行二氧化锆全瓷冠牙体预备,取印模,灌制模型,自然光线下用Vitapan 3D-Master比色板进行比色。使用Lava CAD/CAM二氧化锆全瓷冠系统制作修复体,并采用3MRelyXTM U100树脂粘接剂粘接,分别于粘接后1、3、6个月对患者进行复查,根据美国公共健康协会的修正标准对修复体进行边缘着色、龈缘密合度、修复体颜色、修复体周围龋、修复体有无折裂及基牙松动方面的评价。
结果：经过6个月的短期临床观察,全部共47个Lava CAD/CAM二氧化锆全瓷冠修复体当中仅有3例因车祸外力重击导致修复体折裂,其余并无发现龋齿和修复体相关的病损。
结论：适应症的合理选择和规范的牙体预备和粘接操作,Lava CAD/CAM二氧化锆全瓷系统在边缘适合性和美学性能上可达到令患者满意的临床效果。
Objective:This study is to investigate clinical application of the Lava CAD/CAM zirconia all ceramic crown to restore anterior teeth by evaluating the use of the Lava CAD/CAM all ceramic crown for anterior teeth.
Materials and methods:Fifteen patients with 47 anterior teeth from dental clinic were chosen. A regular preparation of anterior teeth related for Lava CAD/CAM zirconia all ceramic crown. Impression taken, model poured, and the color of teeth being chosen under natural light using Vitapan 3D-Master shade guide. The Lava CAD/CAM zirconia system had been manufactured for clinical use and using 3M RelyXTM U100 resin to cementation. Dental clinical examnation including restoration margin chromatosis、gingival close、color of restoration、caries of restoration restoration rrhexis and abutment loosening according to the adjustment standard of American public health association.
Results:There were only 3 crowns were broken by striking in an car accident after six months during the examenation. None was debonded and discolored. No caries were detected.
Conclusion:The use of Lava CAD/CAM zirconia all ceramic crown in restoration can achieve satisfied result both in esthetics appearance and the health of gingival through selecting cases appropriately and a regular preparation and cementation.
材料与方法：选择口腔门诊患者15人,共47颗前牙,用金钢砂车针进行二氧化锆全瓷冠牙体预备,取印模,灌制模型,自然光线下用Vitapan 3D-Master比色板进行比色。使用Lava CAD/CAM二氧化锆全瓷冠系统制作修复体,并采用3MRelyXTM U100树脂粘接剂粘接,分别于粘接后1、3、6个月对患者进行复查,根据美国公共健康协会的修正标准对修复体进行边缘着色、龈缘密合度、修复体颜色、修复体周围龋、修复体有无折裂及基牙松动方面的评价。
结果：经过6个月的短期临床观察,全部共47个Lava CAD/CAM二氧化锆全瓷冠修复体当中仅有3例因车祸外力重击导致修复体折裂,其余并无发现龋齿和修复体相关的病损。
结论：适应症的合理选择和规范的牙体预备和粘接操作,Lava CAD/CAM二氧化锆全瓷系统在边缘适合性和美学性能上可达到令患者满意的临床效果。
Objective:This study is to investigate clinical application of the Lava CAD/CAM zirconia all ceramic crown to restore anterior teeth by evaluating the use of the Lava CAD/CAM all ceramic crown for anterior teeth.
Materials and methods:Fifteen patients with 47 anterior teeth from dental clinic were chosen. A regular preparation of anterior teeth related for Lava CAD/CAM zirconia all ceramic crown. Impression taken, model poured, and the color of teeth being chosen under natural light using Vitapan 3D-Master shade guide. The Lava CAD/CAM zirconia system had been manufactured for clinical use and using 3M RelyXTM U100 resin to cementation. Dental clinical examnation including restoration margin chromatosis、gingival close、color of restoration、caries of restoration restoration rrhexis and abutment loosening according to the adjustment standard of American public health association.
Results:There were only 3 crowns were broken by striking in an car accident after six months during the examenation. None was debonded and discolored. No caries were detected.
Conclusion:The use of Lava CAD/CAM zirconia all ceramic crown in restoration can achieve satisfied result both in esthetics appearance and the health of gingival through selecting cases appropriately and a regular preparation and cementation.
引文
1. Relly JR, Nishimura 1 Campbell SD. Ceramic in dentistry:Historical roots and current perspectives. J Prosthet Dent,1996,75:18-32.
2. Weinstein M, Katz S, Weinstein AB. Fused porcelain-to-metal teeth. US Patent, No. 3052982.1962.
3. McLean JW, Hughes TH. The reinforcement of dental porcelain with the ceramic oxides [J]. Brit Dent,1965,119 (6):251-267.
4. Mclean JW. Alumina reinforced ceramics special applications:Br idge design and laboratory procedures in dental ceramics[J]. The science and ar t of dental ceramics. Chicago: Quintessence,1982,2:474-479.
5. 李智勇,程祥荣,王贻宁.IPS Empress全瓷贴面颜色效果的初步研究[J].中华口腔医学杂志2004,39(5)：395-398.
6. 张富强.口腔修复基础与临床[M].上海：上海科学技术文献出版社,2004：249-254.
7. Holand W, Schweiger M, Frank M, et al. A comparison of the microstructure and properties of the IPS Empress 2 and the IPS Empress glass-ceramics[J]. J Biomed Mater Res,2000,53 (4):297-303.
8. Holand W, Vogel W, Naumann K, et al. Interface reactions between machinable bioactive glass-ceramics and bone [J]. J Biomed Mater Res,1985,19 (3):303-312.
9. Oh SC, Dong JK, Luthy H, et al. Strength and microstructure of IPS Empress 2 glass-ceramic after different treatments [J]. Int J Prosthodont,2000,13 (6):468-472.
10. Krejci I, Albert P, Lutz F. The influence of antagonist standardization on wear[J]. J Dent Res,1999,78 (2):713-719.
11. Yeo IS, Yang JH, Lee JB. In vitro marginal fit of three all-ceramic crown systems[J]. J Prosthet Dent,2003,90 (5):459-464.
12.陈东.IPS-Empress Ⅱ全瓷嵌体的疗效评价[J].广东牙病防治,2003,11(3)：220-221.
13.胡柏.全瓷冠桥抗折性能研究进展[J].临床口腔医学杂志,2005,21(1)：58-59.
14.周丽晶.In-ceram全瓷修复临床研究概况[J].现代口腔医学杂志,2002,16(5)：447-449.
15.李东方.In-ceram后牙全瓷固定局部义齿的研究进展[J].广东牙病防治2005,13(1)：74-76.
16. Giordanno RA, Pelletier LB, Campbell SD, et al. Flexural strength of alimina and glass components of In-ceram[J]. J Dent Res,1995,73(5):411-418.
17.万干炳,游伦,杜传诗,等.In2Ceram全瓷修复系统的临床应用[J].口腔医学1997,17(2)：77-79.
18. Probster L. Compressive strength of two modern all2ceramic crowns [J]. Int J Pros Dent, 1992,5(5):409-414.
19. Sven Rinke. Marginal accuracy and fracture strength of conventional and opy-milled all-ceramic crowns [J]. Int J Pros Dent,1995,8 (4):303-310.
20. Heffernan MJ, Aquilino SA, Diaz2Arnold AM, et al. Relative translucency of six all-ceramic systems. Part I:core materials[J]. J Prosthet Dent,2002,88 (1):4-9.
21. Mclaren EA, White SN. Survival of In2ceram crowns in a private practice:a prospectiveclinical trial [J]. J Pros Dent,2000,83 (2):16-22.
22. Fradeani M, Aquilano A, Corrado M. Clinical experience with In-ceram spinell crowns: 52year follow2up [J]. Int J Periodontics Restorative Dent,2002,22 (6):525-533.
23.楼北雁,巢齐宇,王敏,等.Cercon全瓷在口腔固定修复中的应用初探[J].华西口腔医学杂志,2004,22(5)：402—403.
24.孙蕾.氧化锆应用于全瓷修复的研究进展[J].国外医学·口腔医学分册2005,32(2)：145-147.
25. Filser F, Kocher P, Weibel F, et al. Reliability and strength of all-ceramic dentalrestorations fabricated by direct ceramic machining[J].Int J Comput Dent,2001,4 (2):89-106.
26. Reiss B. Clinical results of Cercon inlays in a dental practice over a period of 18 years [J]. Int Journal of Computerized Dentistrty,2006,9(1):11-22.
27.赵云凤,骆小平,田杰模.采用CAD/CAM和玻璃渗透技术制作高强度全瓷冠的研究[J]华西医科大学学报,2001,32(3)：438-440.
28.王航,刘双云.Procera all-ceram-一种高强度全瓷系统的介绍[J].国外医学·口腔医学分册,1998,25(5)：271.
1. Christensen GJ. The state of t he art in esthetic restorative den tistry[J]. J Am Dent Assoc, 1997,128(9):1315-1317.
2. Tinscherf J, Natt G, Spiekemann H, et al. Fracture resistance of lithium disilicat-, alumina-and zirconia-based three unit fixed denture:a laboratory study [J]. Int J Prosthodont,2001,14 (3):231-238.
3. Guszzato M, Proos K, Quach L, et al. Strength, reliability and mode of fracture of bilayeredporcelain/zirconia (Y-TZP) dental ceramics [J]. Biomaterials,2004,25:5040-5052.
4. Peters Mc, de vree J H, Brekelmans wA. Distributed Crack analysis of ceramic inlay [J]Dent Res,1993,72:1537-1540.
5. 张富强.口腔修复材料氧化锆陶瓷的研究与应用.上海交通大学学报(医学版)[J],2006,10：1081-04.
6. Komine F, Gerds T, Witkowski S, et al. Influence of framework configuration on themarginal adap tation of zirconium dioxide ceramic anterior four-unit frameworks[J]. Acta Odontol Scand,2005,63 (6):361-366.
7. SuttorD. Lava zirconia crowns and bridges[J]. Int J ComputDent,2004,7 (1):67-76.
8. 刘洪臣,王燕一.各种瓷修复的特点与临床选择[J].中华口腔医学杂志,2008,43(9)：571-573.
9. Massironi D, Pascetta R, Romeo G. Precision in Dental Esthetics:Clinical and Laboratory-Procedures [M]. Milan, Quintessence,2007:84-107.
10. Steyern V P. All-ceramic fixed partial dentures. Studies on aluminum oxide and zircon-niumdioxide based ceramic systems [J]. Swed Dent J.2005,173:1-69.
11. Komine F, Iwai T, Kobayashi K, Matsumura H. Marginal and internal adaptation ofzirconium dioxide ceramic copings and crowns with different finish line designs [J]. Dent Mater J. 2007,26(5):659-664.
12.马轩祥.口腔修复学[M],5版.北京：人民卫生出版社,2004：96,129,386.
13. Fischer H,Weber M,Marx R. Lifetime prediction of all-ceramic bridges by computational Methods[J].J Dent Res,2003,82(3):238-242.
14. Covacci V,Bruzzese N,Maccauro G,et al.In vitro evaluation of the mutagenic and carcinogenic power of high purity zirconia ceramic[J]. Biomaterials,1999,20:371-376.
15. Kim HW,Noh YJ,Koh YH,et al. Effect of CaF2 on densification and properties ofhydrox-yapatite-zirconia composites for biomedical applications[J].Biomaterials,2002,23(2002): 4113-4121.
16. Piconi C, Maccauro G. Zirconia as a ceramic biomaterial [J]. Biomaterials,1999,20:1-25.
2. Weinstein M, Katz S, Weinstein AB. Fused porcelain-to-metal teeth. US Patent, No. 3052982.1962.
3. McLean JW, Hughes TH. The reinforcement of dental porcelain with the ceramic oxides [J]. Brit Dent,1965,119 (6):251-267.
4. Mclean JW. Alumina reinforced ceramics special applications:Br idge design and laboratory procedures in dental ceramics[J]. The science and ar t of dental ceramics. Chicago: Quintessence,1982,2:474-479.
5. 李智勇,程祥荣,王贻宁.IPS Empress全瓷贴面颜色效果的初步研究[J].中华口腔医学杂志2004,39(5)：395-398.
6. 张富强.口腔修复基础与临床[M].上海：上海科学技术文献出版社,2004：249-254.
7. Holand W, Schweiger M, Frank M, et al. A comparison of the microstructure and properties of the IPS Empress 2 and the IPS Empress glass-ceramics[J]. J Biomed Mater Res,2000,53 (4):297-303.
8. Holand W, Vogel W, Naumann K, et al. Interface reactions between machinable bioactive glass-ceramics and bone [J]. J Biomed Mater Res,1985,19 (3):303-312.
9. Oh SC, Dong JK, Luthy H, et al. Strength and microstructure of IPS Empress 2 glass-ceramic after different treatments [J]. Int J Prosthodont,2000,13 (6):468-472.
10. Krejci I, Albert P, Lutz F. The influence of antagonist standardization on wear[J]. J Dent Res,1999,78 (2):713-719.
11. Yeo IS, Yang JH, Lee JB. In vitro marginal fit of three all-ceramic crown systems[J]. J Prosthet Dent,2003,90 (5):459-464.
12.陈东.IPS-Empress Ⅱ全瓷嵌体的疗效评价[J].广东牙病防治,2003,11(3)：220-221.
13.胡柏.全瓷冠桥抗折性能研究进展[J].临床口腔医学杂志,2005,21(1)：58-59.
14.周丽晶.In-ceram全瓷修复临床研究概况[J].现代口腔医学杂志,2002,16(5)：447-449.
15.李东方.In-ceram后牙全瓷固定局部义齿的研究进展[J].广东牙病防治2005,13(1)：74-76.
16. Giordanno RA, Pelletier LB, Campbell SD, et al. Flexural strength of alimina and glass components of In-ceram[J]. J Dent Res,1995,73(5):411-418.
17.万干炳,游伦,杜传诗,等.In2Ceram全瓷修复系统的临床应用[J].口腔医学1997,17(2)：77-79.
18. Probster L. Compressive strength of two modern all2ceramic crowns [J]. Int J Pros Dent, 1992,5(5):409-414.
19. Sven Rinke. Marginal accuracy and fracture strength of conventional and opy-milled all-ceramic crowns [J]. Int J Pros Dent,1995,8 (4):303-310.
20. Heffernan MJ, Aquilino SA, Diaz2Arnold AM, et al. Relative translucency of six all-ceramic systems. Part I:core materials[J]. J Prosthet Dent,2002,88 (1):4-9.
21. Mclaren EA, White SN. Survival of In2ceram crowns in a private practice:a prospectiveclinical trial [J]. J Pros Dent,2000,83 (2):16-22.
22. Fradeani M, Aquilano A, Corrado M. Clinical experience with In-ceram spinell crowns: 52year follow2up [J]. Int J Periodontics Restorative Dent,2002,22 (6):525-533.
23.楼北雁,巢齐宇,王敏,等.Cercon全瓷在口腔固定修复中的应用初探[J].华西口腔医学杂志,2004,22(5)：402—403.
24.孙蕾.氧化锆应用于全瓷修复的研究进展[J].国外医学·口腔医学分册2005,32(2)：145-147.
25. Filser F, Kocher P, Weibel F, et al. Reliability and strength of all-ceramic dentalrestorations fabricated by direct ceramic machining[J].Int J Comput Dent,2001,4 (2):89-106.
26. Reiss B. Clinical results of Cercon inlays in a dental practice over a period of 18 years [J]. Int Journal of Computerized Dentistrty,2006,9(1):11-22.
27.赵云凤,骆小平,田杰模.采用CAD/CAM和玻璃渗透技术制作高强度全瓷冠的研究[J]华西医科大学学报,2001,32(3)：438-440.
28.王航,刘双云.Procera all-ceram-一种高强度全瓷系统的介绍[J].国外医学·口腔医学分册,1998,25(5)：271.
1. Christensen GJ. The state of t he art in esthetic restorative den tistry[J]. J Am Dent Assoc, 1997,128(9):1315-1317.
2. Tinscherf J, Natt G, Spiekemann H, et al. Fracture resistance of lithium disilicat-, alumina-and zirconia-based three unit fixed denture:a laboratory study [J]. Int J Prosthodont,2001,14 (3):231-238.
3. Guszzato M, Proos K, Quach L, et al. Strength, reliability and mode of fracture of bilayeredporcelain/zirconia (Y-TZP) dental ceramics [J]. Biomaterials,2004,25:5040-5052.
4. Peters Mc, de vree J H, Brekelmans wA. Distributed Crack analysis of ceramic inlay [J]Dent Res,1993,72:1537-1540.
5. 张富强.口腔修复材料氧化锆陶瓷的研究与应用.上海交通大学学报(医学版)[J],2006,10：1081-04.
6. Komine F, Gerds T, Witkowski S, et al. Influence of framework configuration on themarginal adap tation of zirconium dioxide ceramic anterior four-unit frameworks[J]. Acta Odontol Scand,2005,63 (6):361-366.
7. SuttorD. Lava zirconia crowns and bridges[J]. Int J ComputDent,2004,7 (1):67-76.
8. 刘洪臣,王燕一.各种瓷修复的特点与临床选择[J].中华口腔医学杂志,2008,43(9)：571-573.
9. Massironi D, Pascetta R, Romeo G. Precision in Dental Esthetics:Clinical and Laboratory-Procedures [M]. Milan, Quintessence,2007:84-107.
10. Steyern V P. All-ceramic fixed partial dentures. Studies on aluminum oxide and zircon-niumdioxide based ceramic systems [J]. Swed Dent J.2005,173:1-69.
11. Komine F, Iwai T, Kobayashi K, Matsumura H. Marginal and internal adaptation ofzirconium dioxide ceramic copings and crowns with different finish line designs [J]. Dent Mater J. 2007,26(5):659-664.
12.马轩祥.口腔修复学[M],5版.北京：人民卫生出版社,2004：96,129,386.
13. Fischer H,Weber M,Marx R. Lifetime prediction of all-ceramic bridges by computational Methods[J].J Dent Res,2003,82(3):238-242.
14. Covacci V,Bruzzese N,Maccauro G,et al.In vitro evaluation of the mutagenic and carcinogenic power of high purity zirconia ceramic[J]. Biomaterials,1999,20:371-376.
15. Kim HW,Noh YJ,Koh YH,et al. Effect of CaF2 on densification and properties ofhydrox-yapatite-zirconia composites for biomedical applications[J].Biomaterials,2002,23(2002): 4113-4121.
16. Piconi C, Maccauro G. Zirconia as a ceramic biomaterial [J]. Biomaterials,1999,20:1-25.