模拟四环素牙瓷贴面修复体的色彩学实验研究
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摘要
对于前牙的美容修复来说，美观是关键，而色彩是美观的前提。瓷贴面由于具有与天然牙相似的色泽、逼真的美学效果及不易着色等优点而被广泛用于前牙美容修复。尽管全瓷贴面对于非四环素牙具有良好的遮色效果及颜色匹配性；但其对四环素牙只有一定的遮色能力且其颜色与比色板不能完全匹配，修复后明度值显著降低，从而限制了其对四环素牙的临床修复效果。有关瓷贴面对四环素变色牙的颜色改善效果的研究也成为全瓷美容修复领域的热点之一，目前该方面的研究主要集中于瓷贴面修复后整体效果的临床观察，而对于瓷贴面修复系统各组成部分对四环素变色牙整体颜色改善的系统研究相对较少。因此，本研究在建立四环素基牙模型（后称模拟四环素牙）的基础上，综合考虑树脂粘结剂（A1、A3色RelyX veneer光固化树脂水门汀，浅色、白色Panavia F双重固化复合树脂水门汀）、基牙颜色（偏黄、偏浅灰、偏亮红、偏深灰、偏暗红色）、瓷贴面自身结构（核瓷厚度）三方面因素，利用CM700d/600d分光测色仪研究IPS e.max铸瓷贴面对模拟四环素牙修复体颜色的影响，从中找出变化规律，从而为临床工作提供帮助。
实验结果显示：
1.使用不同颜色树脂水门汀粘接瓷贴面修复模拟四环素基牙，粘接后模拟四环素基牙颜色改善显著，L*值升高；Dunnett-t检验结果显示使用Panavia F白色树脂水门汀时，粘接前后瓷贴面试件表面的L*、a*、b*值之间的差异无统计学意义；其余各实验组粘接前后瓷贴面试件表面的L*、a*、b*值之间有统计学差异（P﹤0.05）；各实验组修复后的L*值均减小，可能是由于瓷贴面良好的半透性导致了模拟基牙颜色的透出造成的。使用Panavia F白色树脂水门汀粘接前后瓷贴面试件表面颜色的色差△E﹤1.5，不易为肉眼识别；使用其余各树脂水门汀时，瓷贴面试件表面颜色的色差均大于1.5，肉眼可以分辨，造成比色与最终修复效果的差异。采用RelyXveneer光固化树脂水门汀粘接前后瓷贴面试件表面的色差值较大，其中A3色RelyX veneer树脂水门汀粘接前后瓷贴面试件表面的平均色差可达6.26±0.37NBS、A1色RelyX veneer树脂水门汀粘接前后瓷贴面试件表面的平均色差可达6.24±0.19NBS，RelyX veneer树脂水门汀两种颜色之间的色差较小为0.15±0.02NBS。
2.在不同的模拟四环素基牙背景颜色（偏黄、偏浅灰、偏亮红、偏深灰、偏暗红色）基础上进行瓷贴面修复，粘接前后瓷贴面试件表面的L*、a*、b*值之间有统计学差异（P﹤0.05），与标准A2色瓷贴面相比，粘接后的瓷贴面试件表面的L*值减小。随着背景明度值减小，粘接后的瓷贴面试件表面的明度值L*降低程度增加。模拟四环素基牙背景颜色偏黄色时，粘接后瓷贴面试件表面的的a*值减小，b*值增大；模拟四环素基牙背景颜色偏浅灰色及深灰色时，粘接后瓷贴面试件表面的的a*、b*值均减小；模拟四环素基牙背景颜色偏亮红色时，粘接后瓷贴面试件表面的a*、b*值均增大；模拟四环素基牙背景颜色偏暗红色时，粘接后瓷贴面试件表面的a*值增大，b*值减小。模拟四环素基牙背景颜色偏黄色组瓷贴面试件粘接前后的色差值最小为1.25±0.09NBS，背景颜色偏深灰色时瓷贴面试件粘接前后的色差值最大，可达5.28±0.16NBS。
3.瓷贴面核瓷厚度改变时，透明色Choice光固化树脂水门汀粘接后的瓷贴面试件表面的L*a*b*值与模拟基牙试件表面的L*a*b*值之间的差异有统计学意义（P﹤0.05），粘接后的试件表面的L*值增大而且随核瓷厚度的减小，各实验组明度值增加程度变大。粘接前后的色差值最大可达10.46±1.37NBS，此时瓷贴面核瓷厚度为0.3mm；瓷贴面核瓷厚度为0.4mm时粘接前后的色差值最小为9.33±0.75NBS。
使用透明色Choice及白色Panavia F树脂水门汀粘接后，瓷贴面试件表面的L*值与原瓷贴面试件表面的L*值比较均有所下降，白色PanaviaF树脂水门汀粘接后试件表面的L*值下降程度低于使用透明色Choice树脂水门汀粘接后瓷贴面试件表面的L*值的下降程度。透明色Choice树脂水门汀粘接组中瓷贴面核瓷厚度为0.5mm时，对瓷贴面试件表面的L*值进行的配对样本t检验表明差异无统计学意义，瓷贴面核瓷厚度为0.5mm粘接前后的色差值最小为3.98±0.52NBS，瓷贴面核瓷厚度为0.3mm粘接前后的色差值最大为6.13±1.16NBS。白色Panavia F树脂水门汀粘接组，配对样本t检验结果显示：核瓷厚度为0.5mm及0.4mm时，粘接前后瓷贴面试件表面的L*值之间的差异无统计学意义；瓷贴面核瓷厚度为0.4mm粘接前后的色差值最小为1.76±0.83NBS，瓷贴面核瓷厚度为0.5mm粘接前后的色差值最大为3.43±0.29NBS。
由此可见，树脂水门汀、基牙颜色、瓷贴面核瓷厚度均对四环素牙瓷贴面修复体的色彩有着一定的影响。其中使用不同树脂水门汀时，白色Panavia F双重固化复合树脂水门汀对四环素基牙有较好的遮色能力；背景（基牙）颜色为黄色对于修复体的整体颜色影响较小，修复体的整体色彩效果较理想；背景（基牙）颜色偏深灰色时对修复体整体颜色有显著影响，此种情况下应选择遮色效果较好的树脂水门汀粘接瓷贴面或是使用核瓷进行遮色；瓷贴面核瓷厚度越厚其遮色效果越好，然而过厚的核瓷会影响整个瓷贴面的光泽度和半透性。临床医生可根据患者的具体情况和要求选择合适的粘结剂，制作适合的瓷贴面。
Aesthetics is essential to the anterior teeth restoration and the color is oneof the most important aspect of the aesthetics. Porcelain laminate veneer isfavored because of its color-rendering properties and optical properties thatsimulate natural teeth. Porcelain laminate veneer possesses a favorable opaqueeffect and color matching on non-tetracycline teeth, but for tetracycline teeth,the masking capability of the veneer is limited and the lightness of therestoration decreases significantly, which may lead to poor aesthetic effects.As yet, the researches in this field mainly focused on the clinicalobservation of one certain method or comparison of several repair methods.
There are no systemic research about the effects of the resin cement, abutmentteeth color and the thickness of core porcelain on the final color of tetracyclinediscolored teeth after porcelain laminate veneer restoration. Therefore, in thisstudy we established a tetracycline-based dental model and systemicallyassessed the effects of resin cement (including A1- and A3-shade of the RelyXveneer light-curing system, and light- and opaque-shade of Panavia F doublecuringsystem), abutment teeth color (including yellow, light gray, bright red, dark gray, dull red), and the core porcelain thickness of the veneer on the colorof IPS e.max porcelain veneer restorations for mimic-tetracyclinepigmentation teeth. In our investigation, the L*a*b* values were measured byspectrophotometers CM-700d/600d and the color differences(△E) werecalculated
The results are listed as follows:
1. The difference of the L*a*b* values among different resin cementgroups were significant(P<0.005). There was no significant difference betweenthe L*a*b* values of the control group and the opaqueshade of Panavia Fgroup. The color difference (△E) was lower than 1.5 only between the controlgroup and the opaqueshade of Panavia F group, but not among others.
2. The L*a*b* values were significantly different(P<0.005) amongdifferent simulated background (abutment teeth). With the backgroundbrightness value decreased, compared with the control group, the L* valuedecreased greatly and the color difference(△E) value increased obviously. Itshowed that the color of the abutment teeth influenced the color of therestoration seriously, and the influence was the least when the abutment teethcolor was yellow.
3. L*a*b* values were significantly different(P<0.005) among differentcore porcelain thickness. With the nuclear porcelain thickness thinning,△L*value and color difference(△E) value increased of experimental group. Thatindicate porcelain veneers masking ability trail off.
In summary, resin cements, abutment teeth color and core porcelainthickness of veneers all have significant effects on the color aesthetics of theporcelain veneer restoration. Compared with other resin cements used in thisstudy, the Opaqueshade of Panavia F resin cement has better masking ability. The restorations possesses favorable as abutment teeth color is yellowmeanwhile it should choose preferable masking cements when abutment teethcolor is dark grey. As the thickness of the core porcelain increased, the maskingability increased greatly, but the thickness also affected the glossiness andtranslucency of the veneers. Therefore, the dentists should choose appropriateresin cements and porcelain veneers according to the patient’s requirementsand the specific circumstances.
实验结果显示：
1.使用不同颜色树脂水门汀粘接瓷贴面修复模拟四环素基牙，粘接后模拟四环素基牙颜色改善显著，L*值升高；Dunnett-t检验结果显示使用Panavia F白色树脂水门汀时，粘接前后瓷贴面试件表面的L*、a*、b*值之间的差异无统计学意义；其余各实验组粘接前后瓷贴面试件表面的L*、a*、b*值之间有统计学差异（P﹤0.05）；各实验组修复后的L*值均减小，可能是由于瓷贴面良好的半透性导致了模拟基牙颜色的透出造成的。使用Panavia F白色树脂水门汀粘接前后瓷贴面试件表面颜色的色差△E﹤1.5，不易为肉眼识别；使用其余各树脂水门汀时，瓷贴面试件表面颜色的色差均大于1.5，肉眼可以分辨，造成比色与最终修复效果的差异。采用RelyXveneer光固化树脂水门汀粘接前后瓷贴面试件表面的色差值较大，其中A3色RelyX veneer树脂水门汀粘接前后瓷贴面试件表面的平均色差可达6.26±0.37NBS、A1色RelyX veneer树脂水门汀粘接前后瓷贴面试件表面的平均色差可达6.24±0.19NBS，RelyX veneer树脂水门汀两种颜色之间的色差较小为0.15±0.02NBS。
2.在不同的模拟四环素基牙背景颜色（偏黄、偏浅灰、偏亮红、偏深灰、偏暗红色）基础上进行瓷贴面修复，粘接前后瓷贴面试件表面的L*、a*、b*值之间有统计学差异（P﹤0.05），与标准A2色瓷贴面相比，粘接后的瓷贴面试件表面的L*值减小。随着背景明度值减小，粘接后的瓷贴面试件表面的明度值L*降低程度增加。模拟四环素基牙背景颜色偏黄色时，粘接后瓷贴面试件表面的的a*值减小，b*值增大；模拟四环素基牙背景颜色偏浅灰色及深灰色时，粘接后瓷贴面试件表面的的a*、b*值均减小；模拟四环素基牙背景颜色偏亮红色时，粘接后瓷贴面试件表面的a*、b*值均增大；模拟四环素基牙背景颜色偏暗红色时，粘接后瓷贴面试件表面的a*值增大，b*值减小。模拟四环素基牙背景颜色偏黄色组瓷贴面试件粘接前后的色差值最小为1.25±0.09NBS，背景颜色偏深灰色时瓷贴面试件粘接前后的色差值最大，可达5.28±0.16NBS。
3.瓷贴面核瓷厚度改变时，透明色Choice光固化树脂水门汀粘接后的瓷贴面试件表面的L*a*b*值与模拟基牙试件表面的L*a*b*值之间的差异有统计学意义（P﹤0.05），粘接后的试件表面的L*值增大而且随核瓷厚度的减小，各实验组明度值增加程度变大。粘接前后的色差值最大可达10.46±1.37NBS，此时瓷贴面核瓷厚度为0.3mm；瓷贴面核瓷厚度为0.4mm时粘接前后的色差值最小为9.33±0.75NBS。
使用透明色Choice及白色Panavia F树脂水门汀粘接后，瓷贴面试件表面的L*值与原瓷贴面试件表面的L*值比较均有所下降，白色PanaviaF树脂水门汀粘接后试件表面的L*值下降程度低于使用透明色Choice树脂水门汀粘接后瓷贴面试件表面的L*值的下降程度。透明色Choice树脂水门汀粘接组中瓷贴面核瓷厚度为0.5mm时，对瓷贴面试件表面的L*值进行的配对样本t检验表明差异无统计学意义，瓷贴面核瓷厚度为0.5mm粘接前后的色差值最小为3.98±0.52NBS，瓷贴面核瓷厚度为0.3mm粘接前后的色差值最大为6.13±1.16NBS。白色Panavia F树脂水门汀粘接组，配对样本t检验结果显示：核瓷厚度为0.5mm及0.4mm时，粘接前后瓷贴面试件表面的L*值之间的差异无统计学意义；瓷贴面核瓷厚度为0.4mm粘接前后的色差值最小为1.76±0.83NBS，瓷贴面核瓷厚度为0.5mm粘接前后的色差值最大为3.43±0.29NBS。
由此可见，树脂水门汀、基牙颜色、瓷贴面核瓷厚度均对四环素牙瓷贴面修复体的色彩有着一定的影响。其中使用不同树脂水门汀时，白色Panavia F双重固化复合树脂水门汀对四环素基牙有较好的遮色能力；背景（基牙）颜色为黄色对于修复体的整体颜色影响较小，修复体的整体色彩效果较理想；背景（基牙）颜色偏深灰色时对修复体整体颜色有显著影响，此种情况下应选择遮色效果较好的树脂水门汀粘接瓷贴面或是使用核瓷进行遮色；瓷贴面核瓷厚度越厚其遮色效果越好，然而过厚的核瓷会影响整个瓷贴面的光泽度和半透性。临床医生可根据患者的具体情况和要求选择合适的粘结剂，制作适合的瓷贴面。
Aesthetics is essential to the anterior teeth restoration and the color is oneof the most important aspect of the aesthetics. Porcelain laminate veneer isfavored because of its color-rendering properties and optical properties thatsimulate natural teeth. Porcelain laminate veneer possesses a favorable opaqueeffect and color matching on non-tetracycline teeth, but for tetracycline teeth,the masking capability of the veneer is limited and the lightness of therestoration decreases significantly, which may lead to poor aesthetic effects.As yet, the researches in this field mainly focused on the clinicalobservation of one certain method or comparison of several repair methods.
There are no systemic research about the effects of the resin cement, abutmentteeth color and the thickness of core porcelain on the final color of tetracyclinediscolored teeth after porcelain laminate veneer restoration. Therefore, in thisstudy we established a tetracycline-based dental model and systemicallyassessed the effects of resin cement (including A1- and A3-shade of the RelyXveneer light-curing system, and light- and opaque-shade of Panavia F doublecuringsystem), abutment teeth color (including yellow, light gray, bright red, dark gray, dull red), and the core porcelain thickness of the veneer on the colorof IPS e.max porcelain veneer restorations for mimic-tetracyclinepigmentation teeth. In our investigation, the L*a*b* values were measured byspectrophotometers CM-700d/600d and the color differences(△E) werecalculated
The results are listed as follows:
1. The difference of the L*a*b* values among different resin cementgroups were significant(P<0.005). There was no significant difference betweenthe L*a*b* values of the control group and the opaqueshade of Panavia Fgroup. The color difference (△E) was lower than 1.5 only between the controlgroup and the opaqueshade of Panavia F group, but not among others.
2. The L*a*b* values were significantly different(P<0.005) amongdifferent simulated background (abutment teeth). With the backgroundbrightness value decreased, compared with the control group, the L* valuedecreased greatly and the color difference(△E) value increased obviously. Itshowed that the color of the abutment teeth influenced the color of therestoration seriously, and the influence was the least when the abutment teethcolor was yellow.
3. L*a*b* values were significantly different(P<0.005) among differentcore porcelain thickness. With the nuclear porcelain thickness thinning,△L*value and color difference(△E) value increased of experimental group. Thatindicate porcelain veneers masking ability trail off.
In summary, resin cements, abutment teeth color and core porcelainthickness of veneers all have significant effects on the color aesthetics of theporcelain veneer restoration. Compared with other resin cements used in thisstudy, the Opaqueshade of Panavia F resin cement has better masking ability. The restorations possesses favorable as abutment teeth color is yellowmeanwhile it should choose preferable masking cements when abutment teethcolor is dark grey. As the thickness of the core porcelain increased, the maskingability increased greatly, but the thickness also affected the glossiness andtranslucency of the veneers. Therefore, the dentists should choose appropriateresin cements and porcelain veneers according to the patient’s requirementsand the specific circumstances.
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28. Peumans M,Van Meerbeek B,Lambrechts P,et al. .Five year clinicalperformance of porcelain veneers.Quintessence Int.1998.29(4): 211–21.
29. Dumfahrt H,Schaffer H.Porcelain laminate veneers.A retrospectiveevaluation after 1 to 10 years of service:part II–clinical results.Int JProsthodont.2000.13(1):9–18.
30. Friedman MJ.A 15year review of porcelain veneer failurea clinician'sobservations. Compend Contin Educ Dent.1998.(19):625-636.
31. Fradeani M,Redemagni M,Corrado M.Porcelain laminate veneers:6 to 12-year clinical evaluation--a retrospective study.Int J Periodontics RestorativeDent.2005.25(1):9-17.
32.陈吉华,施长溪,王玫,等. 546例四环素牙烤瓷贴面修复的临床观察.中华口腔医学杂志.2003.38(3):199-202.
33.巢永烈,周敏,谢德操.上前牙薄型瓷贴面的临床应用研究.中华口腔医学杂志.1993.28(4):216-18.
34.胡晓阳,宋世卿.烤瓷贴面的应用观察.中华口腔医学杂.1993. 28(1):17-19.
35.李彦,魏素毕,米乃元等.三种烤瓷贴面牙体预备的临床修复效果评价.中山医科大学学报.2000.2l(4):293-295.
36. Weinstein M.KataS.Weinstein AB.Fused porcelaintometle teeth.US patentNo.3052982.1962.
37. Castellani D,Blaccettll.T,Giovannoni.A,Bernardini.UD.Resistance tofracture of metal ceramic and all-ceramic crowns. Int J Prosthodont.1994.7(2):149-54.
38. Ring M.E.Dentistry,an illustrated history.New York HN Abrams.1985:16081,193-211.
39. Jones DW.Development of dental Ceramics.Dent Clin North Am.1985.29(4):621-44.
40. Sozio RB,Riley EJ.The shrink-free ceramic crown.J Prosthet Dent.1983.49(2): 182-7.
41. Malament KA.The cast glass-ceramic restoration.J Prosthet Dent.1987.57(6):674-83.
42. Colorimetric Observers ,Publ.CIE No.S 002,Central Bureau of the CIE.Vienna.1986.
43. Colorimetry,Publ.CIE No.15.2,Central Bureau of the CIE.Vienna.1986c.
44.片山伊九右卫门.牙齿颜色的测定与表示方法.中华口腔医学杂志.1999.34(5):307-309.
45. Jorgenson MW,Goodkind RJ.Spectrophotometric study of five porcelainshades relative to the dimensions of colour, porcelain thickness and repeatedfirings. J Prosthet Dent.1979.42(1):96-105.
46. van der Burgt TP,ten Boseh JJ,Borsboom PC,et al. A comparison of newand conventional methods for quantification of tooth color. J Prosthet Dent.1990.63(2):155-62.
47. Culipepper WD.A comparative study of shade-matching proceduces.JProsthet Dent.1970.24:166-173.
48. FondriestJ. Shade matching in restorative dentistry: the science andstrategies. Int J Periodontics Restorative Dent.2003.23(5):467-79.
49. Barna GJ,TaylorJW,King GE,Pellen GB.The influence of selected lightintensities on color perception within the color range of natural teeth.J ProsthetDent.1981.46(4):450-3.
50.S.okubo,A.Kanawati,M.Richards.Evaluation of visual and instrument shadematching.J Prosthet Dent.1998.80(6):642-648.
51. Macentee M.Instrument at Color measurement of vital and extractedhuman teeth.J oral Rehabil.1981.8(3):203.
52. Brewer JD,Wee A,Seghi R,Advances in color matching. Dent Clin NorthAm.2004.48(2):341-58.
53. Ishikawa NS.Using a computer colormatching system in color reproductionof porcelain restorations. Part3:a newly developed spectrophotometer designedfor clinic application. Int J Proshodont. 1994.7(l):50.
54. Goodkind RJ,Schwabacher WB. Use of a fiberoptice olorimeter for invivocolor measurements of 2830 anterior teeth.J Prosthet Dent.1987.58(5):535.
55.朱津蓉.天然牙颜色的测量与匹配的研究进展.国外医学口腔医学分册.1996.23(5):280-283.
56.郭航,刘峰.《口腔美学比色》.北京:人民军医出版社.2005:21-23.
57. Bolt RA，ten Boseh JJ,CooPs JC.Influence of window size in smallwindowcolor measurement,Particularly of teeth.Phys Med Biol1994.39(7):1133-42.
58. Johnston WM,Hesse NS,Davis BK,et al.Analysis of edgelosses inreflectance measurements of pigmented maxillofacial elastomer.J DentRes.1996.75(2):752-60.
59. R.Douglas,M.Przybylska.Predicting porcelain thickness required for dentalshade matches.J Prosthetic Dent.1999.82(2):143-9.
60. Stephen F,Rosenstiel,William M,Johnston.The effects of manipulativevariables on the color of ceramic metal restorations.J Prosthetic Dent.1988.60(3):297-303.
61. J.D Brewer,J.S Glennon,D.A Garlapo.Spectrometric analysis of the metalsubstrates on the color of metalceramic restorations. J Prosthetic Dent.1991.65(5):634-41.
62.郭航.牙冠、复合树脂和陶瓷材料的颜色的相关性能研究.第四军医大学博士学位论文.1991.
63. Seghi RR.Hewlett ER,Kim J.Visual and insutrumental translucent dentalporcelain.J Dent Res.1989.68(12):176.
64. Terada Y. Chromatic studies of porcelain veneered crownhiding effect oncolour of metal base.J Jpn Prosthodont Soc.1985.29:1270-83.
65. O'Brien WJ,Groh CL,Boenke KM.A new,small-colour-difference equationfor dental shades.J Dent Res.1990.69(11):1762-4.
66. Douglas RD,Brewer JD Acceptability of shade difference in metal ceramiccrowns.J Prosthet Dent.1998.79(2):254-260.
67. Johnston WM,Kao EC.Assessment of appearance match by visualobservation and clinical colorimetry.J Dent Res.1989.68(5):819-22.
68.杨宏军,孙剑,王忠义.金瓷修复体与vita成品比色板色度差.华西口腔医学杂志.1999.17(2):147-149.
69. B.K.Davis,S.A.Aquilino,P.S. Lund et al. Subjective evaluation of the effectof porcelain opacity on the resultant color of porcelain veneers. InternationalJournal of Prosthodontics.1990(3):567-72.
70. B.K.Davis,J.O.Scott,W.M.Johnston.Effect of porcelain shades on finalshade of porcelain veneers. Journal of Dental Research.1991(70):475.
71. B.K.Davis,S.A.Aquilino,P.S.Lund et al.Colorimetric evaluation of the effctof porcelain opacity on the resultant color of porcelain vneeers. InternationalJournal of Prosthodontics.1992(5):130-136.
72. W.H.M?rmann,C.Link,F.Lutz.Color changes in veneer ceramics caused bybonding composite resins.Acta Med Dent Helv.1996(1): 97-102.
73. Peumans M,Van Meerbeek B,Lambrechts P,Vanherle G.Porcelain veneers:areview of the literature.J Dent.2000.28(3):163-77.
74. Friedman M. Augmenting restorative dentistry with porcelain veneers.J AmDen Assoc.1991.122(6):29-34.
75. Nakamura T, Saito O, Fuyikawa J, et al. Influence of abutment substrateand ceramic thickness on the color of heatpressed ceramic crowns. J OralRehabil.2002.29(9):805-9.
76.周国锋,陈吉华,卫张蕊等.Cerinate瓷贴面临床修复色彩学研究及粘结树脂对其颜色的影响.中国美容医学.2005.14(1):57-59.
77.章非敏,牟雁东,赵云凤等.试色糊剂对牙齿双层烤瓷贴面颜色的影响.南京医科大学学报.2002.22(3):200-202.
78.李智勇,程祥荣,王贻宁.IPS Empress全瓷贴面颜色效果的初步研究.中华口腔医学.2004.39(5):395-398.
79. DA.Garber. Direct composite veneers versus etched porcelain laminateveneers. J Dent Clin Noth Am.1989.33(2):301-304.
80. DJ Pippin,JM Mixson,AP Soldanels.Clinical evaluation of restoredmaxillary incisors:Veneers vs PFM corwns. J Am DentAssoc.1995.126(11):1523-1529.
81. KL O′Keeef,PL Pease,HK Herrin.Variables affecting the spectraltransmittance of light through porcelain veneers samples.J ProsthetDent.1991.66(4):434-438.
82. A Vichi,M Ferrari,CL Davidson,Influence of ceramic and cement thicknesson the masking of various types of opaque posts.J ProsthetDent.2000.83(4):412-417.
83. Kim S,Son H,Cho B,et al.Translucency and masking ability of variousopaqueshade composite resins.Journal of dentistry.2009.37(2):102–107.
84.阮丹平,钱程辉,张修银等.四环素着色前牙色度学分布特征的检测分析.上海口腔医学.2006,15(6):567-570.
85.徐军,石红光,尹明,等.有关四环素牙比色板的初步研究.现代口腔医学杂志.1998.12(4):286-289.
86.许文才.印刷色彩学.北京:中国轻工业出版社.2007.
87. Christensen GJ. The advantages of minimally invasive dentistry. J Am DentAsso.2005.136(11):1563-1565.
88. Christensen GJ. Has tooth structure been replaced. J Am Dent Asso.2002.133(1):103-105.
89. Joiner A. Evaluation of a 6% hydrogen peroxide tooth whitening gel onenamel and dentine microhardness in vitro.J Dent.2004.32(1):27-34.
90. Terry DA, McGuire M.The perio-aesthetic-restorative approach for anteriorreconstruction-PartⅠ:Evaluation and periodontal surgey.Pract Proced AesthetDent.2002.14(5):363-9.
91.曹静.临床常见因素对全瓷冠颜色影响的实验研究.第四军医大学博士论文.2008.
92.Kelly JR,Nishmura I,Campbell SD. Ceramics in dentistry:historical rootsand current perspectives.J Prosthet Dent.1996.75(1):18-32.
93.周国锋,陈吉华,王辉等.瓷贴面透射率的测定及其与牙釉质片透射率的比较.中华口腔医学杂志.2005.11(40):503.
94.段静静.不同预备方式对前牙铸瓷修复体抗折强度的影响.南昌大学硕士学位论文.2008.
95.王彬.三种常见环境因素对瓷贴面粘结剂颜色影响的实验研究.第四军医大学硕士学位论文.2006.
96.张翔.牙科玻璃渗透氧化锆陶瓷颜色再现的相关研究.第四军医大学硕士学位论文.2006.
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18. Calamia JR.Clinical evaluation of etched porcelain veneers.Am JDent.1989.2(1):9-15.
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20. Kelly JR, ,Nishimura I,Campbell SD.Ceramic in dentistry: historical rootsand current persectives.J Prosthet Dent.1996.75 (1):18-32.
21. Peumans M,Van Meerbeek B,Lambrechts P,Vanherle G.Porcelain veneers:areview of literature.J Dent.2000.28(3):163-77.
22. RA Giordano,L Pellerier, S Campbell, R Pober.Flexural strength of aninfused ceramic and feldspathic porcelain.J Prosthet Dent.1995.73(4): 411-418.
23. SA Lang,CB Star.Castale glass ceramics for veneer restorations.1992.67(5):590-594.
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26. Fradeani M.Six-year follow-up with Empress veneers.Int J PeriodonticsRestorative Dent.1998.18(3):216–25.
27. Kihn PW,Barnes DM.The clinical longevity of porcelain veneers:a 48-month clinical evaluation.J Am Dent Assoc.1998.129(6):747–52.
28. Peumans M,Van Meerbeek B,Lambrechts P,et al. .Five year clinicalperformance of porcelain veneers.Quintessence Int.1998.29(4): 211–21.
29. Dumfahrt H,Schaffer H.Porcelain laminate veneers.A retrospectiveevaluation after 1 to 10 years of service:part II–clinical results.Int JProsthodont.2000.13(1):9–18.
30. Friedman MJ.A 15year review of porcelain veneer failurea clinician'sobservations. Compend Contin Educ Dent.1998.(19):625-636.
31. Fradeani M,Redemagni M,Corrado M.Porcelain laminate veneers:6 to 12-year clinical evaluation--a retrospective study.Int J Periodontics RestorativeDent.2005.25(1):9-17.
32.陈吉华,施长溪,王玫,等. 546例四环素牙烤瓷贴面修复的临床观察.中华口腔医学杂志.2003.38(3):199-202.
33.巢永烈,周敏,谢德操.上前牙薄型瓷贴面的临床应用研究.中华口腔医学杂志.1993.28(4):216-18.
34.胡晓阳,宋世卿.烤瓷贴面的应用观察.中华口腔医学杂.1993. 28(1):17-19.
35.李彦,魏素毕,米乃元等.三种烤瓷贴面牙体预备的临床修复效果评价.中山医科大学学报.2000.2l(4):293-295.
36. Weinstein M.KataS.Weinstein AB.Fused porcelaintometle teeth.US patentNo.3052982.1962.
37. Castellani D,Blaccettll.T,Giovannoni.A,Bernardini.UD.Resistance tofracture of metal ceramic and all-ceramic crowns. Int J Prosthodont.1994.7(2):149-54.
38. Ring M.E.Dentistry,an illustrated history.New York HN Abrams.1985:16081,193-211.
39. Jones DW.Development of dental Ceramics.Dent Clin North Am.1985.29(4):621-44.
40. Sozio RB,Riley EJ.The shrink-free ceramic crown.J Prosthet Dent.1983.49(2): 182-7.
41. Malament KA.The cast glass-ceramic restoration.J Prosthet Dent.1987.57(6):674-83.
42. Colorimetric Observers ,Publ.CIE No.S 002,Central Bureau of the CIE.Vienna.1986.
43. Colorimetry,Publ.CIE No.15.2,Central Bureau of the CIE.Vienna.1986c.
44.片山伊九右卫门.牙齿颜色的测定与表示方法.中华口腔医学杂志.1999.34(5):307-309.
45. Jorgenson MW,Goodkind RJ.Spectrophotometric study of five porcelainshades relative to the dimensions of colour, porcelain thickness and repeatedfirings. J Prosthet Dent.1979.42(1):96-105.
46. van der Burgt TP,ten Boseh JJ,Borsboom PC,et al. A comparison of newand conventional methods for quantification of tooth color. J Prosthet Dent.1990.63(2):155-62.
47. Culipepper WD.A comparative study of shade-matching proceduces.JProsthet Dent.1970.24:166-173.
48. FondriestJ. Shade matching in restorative dentistry: the science andstrategies. Int J Periodontics Restorative Dent.2003.23(5):467-79.
49. Barna GJ,TaylorJW,King GE,Pellen GB.The influence of selected lightintensities on color perception within the color range of natural teeth.J ProsthetDent.1981.46(4):450-3.
50.S.okubo,A.Kanawati,M.Richards.Evaluation of visual and instrument shadematching.J Prosthet Dent.1998.80(6):642-648.
51. Macentee M.Instrument at Color measurement of vital and extractedhuman teeth.J oral Rehabil.1981.8(3):203.
52. Brewer JD,Wee A,Seghi R,Advances in color matching. Dent Clin NorthAm.2004.48(2):341-58.
53. Ishikawa NS.Using a computer colormatching system in color reproductionof porcelain restorations. Part3:a newly developed spectrophotometer designedfor clinic application. Int J Proshodont. 1994.7(l):50.
54. Goodkind RJ,Schwabacher WB. Use of a fiberoptice olorimeter for invivocolor measurements of 2830 anterior teeth.J Prosthet Dent.1987.58(5):535.
55.朱津蓉.天然牙颜色的测量与匹配的研究进展.国外医学口腔医学分册.1996.23(5):280-283.
56.郭航,刘峰.《口腔美学比色》.北京:人民军医出版社.2005:21-23.
57. Bolt RA，ten Boseh JJ,CooPs JC.Influence of window size in smallwindowcolor measurement,Particularly of teeth.Phys Med Biol1994.39(7):1133-42.
58. Johnston WM,Hesse NS,Davis BK,et al.Analysis of edgelosses inreflectance measurements of pigmented maxillofacial elastomer.J DentRes.1996.75(2):752-60.
59. R.Douglas,M.Przybylska.Predicting porcelain thickness required for dentalshade matches.J Prosthetic Dent.1999.82(2):143-9.
60. Stephen F,Rosenstiel,William M,Johnston.The effects of manipulativevariables on the color of ceramic metal restorations.J Prosthetic Dent.1988.60(3):297-303.
61. J.D Brewer,J.S Glennon,D.A Garlapo.Spectrometric analysis of the metalsubstrates on the color of metalceramic restorations. J Prosthetic Dent.1991.65(5):634-41.
62.郭航.牙冠、复合树脂和陶瓷材料的颜色的相关性能研究.第四军医大学博士学位论文.1991.
63. Seghi RR.Hewlett ER,Kim J.Visual and insutrumental translucent dentalporcelain.J Dent Res.1989.68(12):176.
64. Terada Y. Chromatic studies of porcelain veneered crownhiding effect oncolour of metal base.J Jpn Prosthodont Soc.1985.29:1270-83.
65. O'Brien WJ,Groh CL,Boenke KM.A new,small-colour-difference equationfor dental shades.J Dent Res.1990.69(11):1762-4.
66. Douglas RD,Brewer JD Acceptability of shade difference in metal ceramiccrowns.J Prosthet Dent.1998.79(2):254-260.
67. Johnston WM,Kao EC.Assessment of appearance match by visualobservation and clinical colorimetry.J Dent Res.1989.68(5):819-22.
68.杨宏军,孙剑,王忠义.金瓷修复体与vita成品比色板色度差.华西口腔医学杂志.1999.17(2):147-149.
69. B.K.Davis,S.A.Aquilino,P.S. Lund et al. Subjective evaluation of the effectof porcelain opacity on the resultant color of porcelain veneers. InternationalJournal of Prosthodontics.1990(3):567-72.
70. B.K.Davis,J.O.Scott,W.M.Johnston.Effect of porcelain shades on finalshade of porcelain veneers. Journal of Dental Research.1991(70):475.
71. B.K.Davis,S.A.Aquilino,P.S.Lund et al.Colorimetric evaluation of the effctof porcelain opacity on the resultant color of porcelain vneeers. InternationalJournal of Prosthodontics.1992(5):130-136.
72. W.H.M?rmann,C.Link,F.Lutz.Color changes in veneer ceramics caused bybonding composite resins.Acta Med Dent Helv.1996(1): 97-102.
73. Peumans M,Van Meerbeek B,Lambrechts P,Vanherle G.Porcelain veneers:areview of the literature.J Dent.2000.28(3):163-77.
74. Friedman M. Augmenting restorative dentistry with porcelain veneers.J AmDen Assoc.1991.122(6):29-34.
75. Nakamura T, Saito O, Fuyikawa J, et al. Influence of abutment substrateand ceramic thickness on the color of heatpressed ceramic crowns. J OralRehabil.2002.29(9):805-9.
76.周国锋,陈吉华,卫张蕊等.Cerinate瓷贴面临床修复色彩学研究及粘结树脂对其颜色的影响.中国美容医学.2005.14(1):57-59.
77.章非敏,牟雁东,赵云凤等.试色糊剂对牙齿双层烤瓷贴面颜色的影响.南京医科大学学报.2002.22(3):200-202.
78.李智勇,程祥荣,王贻宁.IPS Empress全瓷贴面颜色效果的初步研究.中华口腔医学.2004.39(5):395-398.
79. DA.Garber. Direct composite veneers versus etched porcelain laminateveneers. J Dent Clin Noth Am.1989.33(2):301-304.
80. DJ Pippin,JM Mixson,AP Soldanels.Clinical evaluation of restoredmaxillary incisors:Veneers vs PFM corwns. J Am DentAssoc.1995.126(11):1523-1529.
81. KL O′Keeef,PL Pease,HK Herrin.Variables affecting the spectraltransmittance of light through porcelain veneers samples.J ProsthetDent.1991.66(4):434-438.
82. A Vichi,M Ferrari,CL Davidson,Influence of ceramic and cement thicknesson the masking of various types of opaque posts.J ProsthetDent.2000.83(4):412-417.
83. Kim S,Son H,Cho B,et al.Translucency and masking ability of variousopaqueshade composite resins.Journal of dentistry.2009.37(2):102–107.
84.阮丹平,钱程辉,张修银等.四环素着色前牙色度学分布特征的检测分析.上海口腔医学.2006,15(6):567-570.
85.徐军,石红光,尹明,等.有关四环素牙比色板的初步研究.现代口腔医学杂志.1998.12(4):286-289.
86.许文才.印刷色彩学.北京:中国轻工业出版社.2007.
87. Christensen GJ. The advantages of minimally invasive dentistry. J Am DentAsso.2005.136(11):1563-1565.
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