牙科常用非贵烤瓷合金金—瓷结合强度的研究
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摘要
非贵烤瓷熔附金属修复体以其低廉的价格、良好的美观效果、较高的强度、稳定的化学性能和较好的生物相容性,已广泛应用于临床冠桥修复中,并被广大患者所接受。其中,镍铬合金因其价格低廉,机械性能良好及结合强度高等优点,成为目前国内最常用的烤瓷金属基底材料,但其耐腐蚀性和生物相容性稍差,临床有龈染、黏膜过敏等问题,有待进一步解决。为此,近年来不断有新的烤瓷基底材料研制开发并应用于临床,如纯钛、钛合金、含钛合金等。而烤瓷熔附金属修复体成功的关键是金瓷间有良好的结合力,故本实验对临床常用的五种非贵金属基底材料与不同瓷粉的结合强度进行测试比较,以期为临床工作提供实验依据。
      实验选择临床上常用的纯钛、钛合金、含钛合金、Ni-Cr合金五种非贵金属作为研究对象,制作金属试件108个,随机分成9组、每组12个,按临床制作常规,分别熔附Noritake Ti22瓷粉、HeraCeram瓷粉及Vita瓷粉,共获得烤瓷熔附金属试件9组,即:A1组:Ni-Cr(H)熔附HeraCeram瓷粉,A2组:Ni-Cr(H)熔附Vita瓷粉,B1组:Ni-Cr(西北)熔附HeraCeram瓷粉,B2组:Ni-Cr(西北)熔附Vita瓷粉,C组:纯钛熔附Noritake Ti22瓷粉,D组:Ti6Al4V熔附Noritake Ti22瓷粉,E组:Ti6Al7Nb熔附Noritake Ti22瓷粉,F1组:含钛合金熔附HeraCeram瓷粉、F2组:含钛合金熔附Vita瓷粉。采用三点弯曲实验的方法对烧结好的金瓷试件的金-瓷结合情况进行测试,将得到的每组数据进行统计学分析,比较各组金-瓷结合强度。再随机从各组金瓷试件中选择2个、共18个试件,用自凝树脂包埋,用SiC水砂纸进行打磨直至显露金瓷结合界面后利用扫描电镜分别观察各组金属与相熔附的瓷粉结合界面的形貌特征。
     实验结果显示:
     1.Ni-Cr合金组结合情况:A1组试件的结合强度为46.05±3.16,A2组的结合强度为42.05±3.26,B1组的结合强度为44.04±3.69,B2组的结合强度为47.47±2.92。统计学结果显示: A1﹥B1,B2﹥B1(P>0.05);A1﹥A2(P<0.05)。电镜显示:4组试件的瓷层均与金属基体相互交错.结合紧密.无明显气泡.也无明显中间层出现。
     2.纯钛及钛合金组结合情况:C组纯钛-Noritake Ti22结合强度:36.49±2.98 MPa,D组Ti6Al4V-Noritake Ti22结合强度:39.93±2.96 MPa, E组Ti6Al7Nb-Noritake Ti22结合强度:39.35±2.88 MPa。统计学结果显示:D组、E组结合强度均大于C组(P<0.05),D>E(P>0.05)。电镜显示各组瓷粉均与金属基体相互交错.结合紧密.无明显气泡.也无明显中间层出现。
     3.含钛合金组结合情况:F1组含钛合金-HeraCeram结合强度:41.08±2.98 MPa,F2组含钛合金-Vita结合强度:42.29±3.38 MPa,统计学结果显示:F2大于F1组(P>0.05)。电镜显示:各组瓷粉均与金属基体相互交错.结合紧密.无明显气泡.也无明显中间层出现。
     4.将Ni-Cr组(A1、A2、B1、B2),纯钛组(C),钛合金组(D、E)及含钛合金组(F1、F2)的金-瓷结合强度进行比较,统计学结果显示有显著差异,且Ni-Cr>含钛合金>钛合金(2种)>纯钛。
     结论:
     1.本实验各组金属的金-瓷结合强度均大于1SO所要求的基本值25 MPa,符合临床应用要求。
     2.Ni-Cr(H)- HeraCeram瓷大于Ni-Cr(H)-Vita瓷的结合强度(P<0.05),说明同厂家的金属与瓷粉金-瓷结合强度较好;Ni-Cr(西)-Vita的结合强度大于Ni-Cr(西)- HeraCeram瓷的结合强度但无显著性意义(P>0.05),即Ni-Cr(西)金属与Vita瓷和HeraCeram瓷之间均可以相互匹配使用,为临床工作提供更多的选择。
     3.Ti-6Al-4V及Ti-6Al-7Nb与Noritake Ti22瓷的结合强度均大于钛-Noritake Ti22的结合强度(P<0.05),而两种钛合金与瓷的结合强度无显著性意义(P>0.05),这就提示我们钛合金可能比纯钛有更好的临床应用前景。
     4.含钛合金-Vita瓷的结合强度大于含钛合金-HeraCeram瓷的结合强度但无显著性差异(P>0.05),即含钛合金与Vita瓷和HeraCeram瓷均可以相互匹配使用。
     5.临床常用非贵金属的金-瓷结合强度为Ni-Cr>含钛合金>钛合金(2种)>纯钛,统计学分析它们之间有显著性差异,综合有关研究资料分析说明:Ni-Cr合金与瓷的结合强度最高,适于临床应用,但其耐腐蚀性和生物相容性有待改进和提高;纯钛及钛合金虽然生物相容性和耐腐蚀性相对较好,但其结合强度较Ni-Cr和含钛合金低有待进一步提高;含钛合金具有良好的生物化学性能、较好的结合强度,但由于是新型材料其临床远期效果还有待证实。
Since non-precious porcelain-fused-to-metal restoration has such advantages as cheep cost、good qualities in the aspects of good-looking、high bonding strength、good biocompatibility and good mechanical function, they have been widely used for dental prosthesis production, and it has been used more and more commonly in clinic. However, Ni-Cr alloy its low cost and good biocompatibility and good mechanical function, it become domestic Ni-Cr alloy as metal substrates have been widely used in clinic , but the long-time clinical practices and experimental investigations demonstrate that the Ni-Cr alloy have lots of adverse effects like stomatitis, rash or gum coloring, etc, clinic have lots of adverse effects like stomatitis, rash or gum coloring, So they also must be replaced by other materials. Pure Ti and Ti alloys and little-Ti-containing alloy, etc, What’s more, the favorable bonding strength between metal and porcelain ensures the adherence of porcelain to the metal base under the motivation of different direction forces during the usual tooth movement. we have employed the three-point bending test to investigate many materials including Ti, Ti-alloy, little-Ti-containing alloy, Ni-Cr alloy, and used the electron microscope to observe their interfaces.
     We choose Ti, Ti-alloy, little-Ti-containing alloy, Ni-Cr alloy as subjects. 108 sheets were divided into 9 groups, each group included 12 sheets. HeraCeram JC porcelain cement was fused and adhered to the group A1:Ni-Cr(H)、B1:Ni-Cr(northwest)and F1:little-Ti-containing alloy; Vita porcelain cement was fused and adhered to the group A2:Ni-Cr(H)、group B2:Ni-Cr(northwest) and group F2: little-Ti-containing alloy; Noritake Ti22 porcelain cement was fused and adhered to the group C:pure Ti、group D:Ti6Al4V and group E: Ti6Al7Nb. By three-point bending test was employed to detect the metal-ceramic bonding test. To make test specimens by the same method, each group included 2 sheets. There were 18 sheets altogether. Test specimens were invested with selfcuring resin, finished with SiC, cleaned and goldblasted. Than metal-ceramic combinational interface were observed and analyzed by SEM.
     Result:
     1.The bonding of Ni-Cr:A1:46.05±3.16, A2:42.05±3.26, B1:44.04±3.69, B2:47.47±2.92, A1﹥B1, B2﹥B1 (P>0.05); A1﹥ A2 (P<0.05). The electron microscopy revealed the bonding was tight between the cement and the metal base and no obvious air bubble or interlayer was found in each group.
     2.The bonding of pure Ti and titanium alloys:C:36.49±2.98 MPa, D:39.93±2.96 MPa, E:39.35±2.88 MPa, D and E>C(P<0.05), D>E(P>0.05). The electron microscopy revealed the bonding was tight between the cement and the metal base and no obvious air bubble or interlayer was found in each group.
     3.The bonding of little-Ti-containing alloy: F1:41.08±2.98 MPa, F2:42.29±3.38 MPa, F2>F1(P>0.05). The electron microscopy revealed the bonding was tight between the cement and the metal base and no obvious air bubble or interlayer was found in each group.
     4.Their bonding strengths stepped up in the order of pure titanium, titanium alloys, little-titanium-containing alloy, Ni-Cr alloy.
     Conclusion:
     1. The experiment drew a conclusion that the bonding strengths of the four kinds of base metal-ceramic alloys was all beyond 25 MPa, the baseline of ISO.
     2. The bonding strength of Ni-Cr(H)- HeraCeram is higher than Ni-Cr(H)-Vita(P<0.05); and the bonding strength of Ni-Cr(northwest)-Vita is higher than Ni-Cr(northwest)- HeraCeram,(P>0.05); Ni-Cr(northwest) alloy can fused with Vita porcelain or HeraCeram porcelain.
     3. The bonding strength of Ti-6Al-4V-Noritake Ti22 or Ti-6Al-7Nb-Noritake Ti22 is higher than Ti-Noritake Ti22 respectively(P<0.05), but there has no significance between Ti-6Al-4V and Ti-6Al-7Nb, may be Ti-alloy is better than Ti in clinical use.
     4. The bonding strength of little-Ti-containing alloy-Vita is higher than little-Ti-containing alloy-HeraCeram(P>0.05), so little-Ti-containing alloy may be fused with Vita porcelain or HeraCeram porcelain.
     5. The bonding strength of Ni-Cr alloy-porcelain is the highest,but the anti-causticity and the biocompatibility should be improved; the anti-causticity and the biocompatibility of pure Ti and Ti-alloy is good, but the bonding strength should be improved; the little-Ti-containing alloy is a type of new material, its long-term effect remains to be confirmed.
引文
[1] Bumgarder JD, lucas LC. Surface analysis of nickel chromium dental alloys[J]. Dent Mater, 1993, 9: 252-259.
    [2] 宋应亮,徐君伍,马轩祥,等.人工唾液中修复材料电偶序测定及腐蚀倾向的研究[J].华西口腔医学杂志,1997,15(3):206-209.
    [3] 邓旭亮,胡晓阳,欧阳翔英,等.五种全冠合金铸造后的腐蚀性研究[J].现代口腔医学杂志,2002,16(1):32-33.
    [4] Molinari A,Straffelini G,Tesi B et a1.Wear[J],1 997,208(12):105-112
    [5] Zhang Yumei(张玉梅),Guo Wentian(郭文天),Li Zuocheng(李佐臣).West China Journal ofStomatology(华西牙科学杂志)[J],1999,4:24
    [6] 刘丽 何富明 牙科的应用现状和存在的问题 口腔材料和器械杂志[J]2002:11(1):10-12.
    [7] Roach M ,Parsell D,Gardner S,et a1.Correlation of corrosion and surface analysises for NI-Cr alloys [J].Crit Rev Biomed Eng,1998,26:391-392
    [8] 胡滨,张富强.镍铬合金在人工唾液中的电化学腐蚀行为[J].中华口腔医学杂志,2003,38(2):140—142.
    [9] Willershausen-B,Gruber-I,Fleischmann-C,et al.Gingival pigmentation inPFM andamalgam restorations.–Zahnarztl-Z,1990,45 (6):360-362 (abstract).
    [10] Ito-H,Okada-T,Ishida-T,et al.Treatment and analysis of a clinical case of gingival pigmentation around the Restored teeth.1990, 34(1):1-6(abstract).
    [11] Craig RG. Cytotoxicity of experimental casting alloys evaluated by cell culture test. J Dent Res, 1990, 6(8):1539-1542.
    [12] 麻丰健,何邕江,黄红园.镍铬铝钛烤瓷合金的润湿性的研究[J].温州医学院学报,2001,31(4):220-222.
    [13] Takemoto S, Hattori M, Yoshinari M, et al. Dent Mater J, 2004, 23(3):379- 386.
    [14] Akagi K,Okamoto Y,Matsuura T,et a1.Properties of test metal ceramic titaniumaloys[J].J Prosthet Dent,1992,68:462-467.
    [15] 汪大林,周中华,陆敦,等 牙科含钛镍基烤瓷合金的细胞毒性试验研究(C).成都:第四届全国口腔修复学学术会议论文摘汇要编,2002:98.
    [16] Huang HH. Effect of chemical composition on the corrosion behavior of Ni-C-Mo dental casting aloys[J].J Biomed Mater Res,2002,60:458-465.
    [17] Vannoor R J.Materials Sci[J],1987,22(11):3 801~3 811
    [18] Prasad.Arun,Chesire C T.Titanium Alloy Dental Restorations[P].USA,5091l48,l992
    [19] 张新平等.钛及钛合金在牙科领域中的研究现状.稀有金属材料与工程[J],2002,31(4):246-251.
    [20] 张 新 平 , 于 思 荣 等 . 牙 科 用 钛 合 金 研 究 现 状 . 稀 有 金 属 材 料 与 工 程[J],2004,33(12):1243-1247.
    [21] 白天玺主编.现代口腔烤瓷铸造支架修复学.第一版,北京:人民军医出版社,2000:74
    [22] Mohammadi S,Wictorin L,Ericsonetal L E.J Material Sci:Material in Med[J],1 995,6(8):435-444
    [23] Kononen M,Kivilahti J.Bonding of low—fusing dental porcelain to commercially puretitanium [J].J Biomed Mater Res,1994,28:1027-1035.
    [24] 王晓洁,郭天文.钛铸件与三种钛瓷粉结合强度的对比研究. 临床口腔医学杂志.[J].2004, 20(7):401-403.
    [25] King AW, Chai J, Lautenschlager E, Gilbert J. A comparison of the hardness of different types of titanium and conventional metal ceramic. J Prosther Dent, 1994, 72: 314-319.
    [26] King AW,Gilbert JL. Hardness test of two titanium ceramomentals . Northwest Dent Res, 1994, 4:11-412.
    [27] Wirz J, Jaeger K, Schmidlif. modeme galvanotechnologie. Schweiz monztsschr Zahnmed, 1996 , 106 :643-648
    [28] Shell JS, Nielsen JP. Study of the bond between gold alloys and porcelain. J Dent Res [J].1962,(6):14-24.
    [29] Root NS, Findley JA. The bond between porcelain and gold alloys:characteristics and practical considerations. Quintessence Dent Technol, 1976,28: 93.
    [30] 徐君伍主编.口腔修复学.第四版. 人民卫生出版社.2001.101
    [31] 薛淼.口腔应用材料学[M].天津:科技翻译出版公司, 1997, 392-293.
    [32] 徐君伍主编. 口腔修复理论与临床. 北京:人民卫生出版社, 1999.279-298
    [33] 立石哲也.金属系生体材料金属学会会报.1992,31:520.
    [34] Denry IL.Mackert JR.Holloway JA,et alEffect of cubic leucite stabilization on the flexural strength of feldsparhic dental porcelain.J Dent Res 1996,75:1938.
    [35] Asooka K . Tesk JA. Visco-elastic deformation of dental porcelain and porcelain-metal comqt0ati-bility.Dent Mater 1991,7:30.
    [36] DeHoff PH, Anusavice KJ. Thermal incompatibility analysis of a metal-ceramic systems based on flexural displacement data. J Biomed Mater Res, 1998, 41: 614-623
    [37] Walton TR, O’Brien WJ. Thermal stress failure of porcelain bonded to a palladium-silver alloy. J Dent Res, 1985, 64:476-480
    [38] Anusavice KJ, Twiggs SW, Dehoff PH. Correlation of thermal shock resistance with thermal compatibility data for porcelain-metal systems. J Dent Res, 1982, 61: 419-422
    [39] AsookaK.Tesk JA.Transient and residual stress in a porcelain metal strip.J Dent Res 1990,69:463.
    [40] Rimmer A . The flare-up index : a quantitative method to describe the phenomenon[J].J Endodo.1993,19(5):255-256.
    [41] Anusavice KJ.Recent development in restorative dental porcelain[J].J Am Dent Assoc.1993,124(2):72-84.
    [42] 文志红,杜传诗,杜莉.金-瓷修复体瓷折裂及剥脱原因分析.华西口腔医学杂志[J].1998,16(1):62-64.
    [43] Pask JA, Fulrath RM. Fundamentals of Glass-to-Metal Bonding: VIII,Nature of Wetting and Adherence. J Am Ceram Soc,1962,45:592-596.
    [44] Anusavice KJ Jr. Hojjatie B, Dehoff PH.Influence of mental thicknesson stress distributionin metal -cerami ccrowns. J Dent Res [J].1986,65(9):1173-1178.
    [45] White SN,Dent B,Caputo A.Strength of porcelain fused to titanium beams.J Prosthet Dent[J].1996,75:640-648.
    [46] Oshida Y, Munoa CA, Winkler MM. Fractal dimension analysis of aluminum oxide particle for sandblasting dental use. Biomed Mater Eng, 1993,3:117-126.
    [47] Gilbert JL, Covey DA, Lautenschlager EP. Bond characteristics of porcelain fused to milled titanium. Dent Mater, 1994,10:134-140.
    [48] Oshida Y, Fung LW, Isikbay SC. Titanium-porcelain system.Part 2:Bond strength of fired porcelain on nitrided pure titanium. Biomed Mater Eng, 1997,7: 13-34.
    [49] 文志红,杜传红,郑弟泽等.不同喷砂粒度对金-瓷结合强度的影响.中华口腔医学杂志[J].1994,29(4):229-231.
    [50] Horng CJ, Okazaki M, Takahahsshi J, Kimura H. Thermal Oxidation effects on porcelain-titaniun restoration. Gaoxiong Yi Xue Ke Xue Za Zhi, 1989,5: 522-528.
    [51] Lubovich RP, Goodkind RJ. Bond strength studies of precious, semiprecious and nonprecious ceramic-metal alloys with two porcelain. J Porsthet Dent [J].1997,37 :288.
    [52] 何惠明,艾绳前,王宝成,施长溪,郭天文。钛表面烤瓷的预氧化处理工艺研究 实用口腔医学杂志,1998,14:14-16.
    [53] Liu J, Atsuta M,,Watanabe I. Bond strength of porcelain to degassed cast titanium. Int Chin J Dent, 2002, 2: 67-74.
    [54] 陈吉华,森修一,永野清司编著.现代临床金属烤瓷修复学.西安:跌西科技出版社,1998:17-60.
    [55] ISO 9693.Metal-ceramic dental restorative systems.Geneva: International Organization for Standarization,1999.
    [56] 孙颖,王忠义.遮色瓷双层涂法对金瓷结合强度的研究.实用口腔医学杂志[J]1999,15(3):189-191.
    [57] Shll JS,Nielsen JP.Study of the bond between gold alloys and porcelain .J Dent Res[J].1962,41(6):14-24.
    [58] Anthony DH,Bureett AP, Smith DL et al.Shear test for measuring bonding in cast gold alloy-porcelain composites.J Dent Rest[J].1973,49:27-33.
    [59] Hammad IA, Talic YF. Designs of bond strength tests for mental-ceramiccomplexes Review of the literature .J Prosthet Dent[J]. 1996,75:602-608.
    [60] Givijan S, Hwget EF ,De Simon LB et al. Determination of apparent bond strength ofalloy-porcelain systems (Abstract).J Dent Rest [J].1974,53:240.
    [61] Papazoglou E ,Brantly WA .Porcelain adherence vs force to failure for Palladium-gallium alloys: A critique if mental-ceramic bond testing .Dent Mater[J].1998,14:112-119.
    [62] Persson M,Bergman M.Metal- ceramic bond strength. Acta Odontol Scand [J].1996,5:160-165.
    [63] Machert JR,Ringle RD,Parry EE,et al. The relationship betweet oxide adherence and porcelain-metal bonding.J Dent Res,1988,67:474-478.
    [64] Ringle PD,Machert JR, Fairhurst CW.An X-ray spectrometric technique for measuring porcelain-metal adherence.J Dent Res, 1983,62:933-936.
    [65] Papazoglou E, Brantly WA .Carr AB et al. Porcelain adherence to high-palladium alloys. J Procelain Dent,1993,70:386-394.
    [66] Lavine MH,Custre RF.Variables affecting the strength of bond between porcelain and gold.J Dent Res[J].1966,45;32-36.
    [67] Lenz J,Schwarz S,Schwickerath H et al.Bond strength of mental-ceramic systems in three-point flexure bond test.J Appl Biomater[J].1995,6:55-64.
    [68] Lenz L,Kessel S.Thermal stresses in metal-ceramic specimens for the ISO ceack initiation test(three-point flexure bond test)Dent Mater[J].1998,14:227-280.
    [69] Liu J, Atsuts M, Watanabe I, Bond strength of porcelain to degassded cast titanium. Int Chin J Dent[J].2002,2;67-74.
    [70] ISO 9693.Metal-ceramic dental restorative systems.Geneva:International Organization for Standardization,1999.
    [71] 王晓洁,郭天文,张玉梅等.钛铸件与三种钛瓷粉结合强度的对比研究 [J].临床口腔医学杂志,2004,20(7):401—403.
    [72] Strietzel R. The Nickel Error. J Multidiscipl Colab Prosthedont, 1999, 1(1): 76-81.
    [73] 马轩祥.我国瓷修复的问题与展望[J].中华口腔医学杂志,1999,34(5):361.
    [74] 夏春明,施长溪.烤瓷修复体崩瓷的修复[J].口腔材料器械杂志,2002,1(11):35-44.
    [75] 宋应亮,徐君伍,马轩祥,等.人工唾液中修复材料电偶序测定及腐蚀倾向的研究[J].华西口腔医学杂志,1997,15(3):206-209.
    [76] Adachi M,Maekert JR,Parry EE,et.al.0xide adherep.eace and porcelain bonding to tltanium and Ti- 6AI- 4V alloy.[J] Dent Res,1990.69:12-30.
    [77] Rimmer A . The flare-up index : a quantitative method to describe the phenomenon[J].J Endodo.1993,19(5):255—256.
    [78] Anusavice KJ.Recent development in restorative dental porcelain[J].J Am Dent Assoc.1993,124(2):72—84.
    [79] Kononen M,Kivilahti J.Bonding of low—fusing dental porcelain to commercially puretitanium[J].J Biomed MaterRes,1994,28:1027— 1035.
    [80] 张新平,于思荣,何镇明等.牙科用钛合金研究现状[J],稀有金属材料与工程,2004,33(12)1243-1245.
    [81] Walton R,Fouad A.Endodontic interappointment flare-ups:a prospective study of incidence and related factors[J].J Endodo.1992,18(4):172-177.
    [82] Adachi M,Mackert JR,Parry EE,et al.0xide adherence and porcelain bondung to titanium and Ti-6AI-4V alloy[J].J Dent Res,1990.69 , 1230.
    [83] 刘 肃,周延民等镍铬合金、钛合金及金铂合金在人工唾液中的耐腐蚀性能[J]. 吉林大学学报(医学版). 2005, 31(5):774-777.
    [84] Bumgarder JD,Lucas LC.Cellular response to metallic ions released from nickel-chromium dental aloys[J].J Dent Res,1995,74(8):l 521-l 52.
    [85] 周雅彬.口腔铸造合金离子析出状况及影响因素[J].国外医学口腔医学分册,2003,3o(5):373-4,377.
    [86] 孙佳凝.牙科合金材料的生物相容性及影响合金离子析出的因素[J].国外医学口腔医学分册,2003,30(3):212-4.
    [87] Hayes R B.The careinogenicity ofmetals in humans[J].Cancer Causes Control,1997,8(3):371-85.
    [88] Wataha J C,Craig R G.Hanks C T.The release of elements of dental casting alloys into cell—culture medium[J].J Dent Res,1991.70(6):1014-8.
    [89] Gil F J,Sanchez L A,Espias A,et a1.In vitro corrosion be.haviour and metallic 44ion release of diferent presthodontic alloys[J].Int Dent J,1999,49(6):361-7.
    [90] Bayramoglu G,Alemdaroglu T,Kedici S, et a1.The efect of PH on the corrosion of dental metal alloys[J].J Oral Rehabil.2000,27(7):563-75.
    [91] Ciccarelli R B。Wetterbahn K E.Nickel distribution and DNA lesions induced in rat tissues by the caicinogen nichel carbonate[J].Cancer Res,1982,42(9):3544-9.
    [92] Schmalz G,Langer H,Schweikl H.Cytotoxicity of dental alloyextracts and corresponding metal salt solutions[J].J Dent Res,1998,77(10):1772-8.
    [93] 黄河长一,马莉等钛合金与镍一铬合金底层冠烤瓷冠边缘对牙龈健康的影响[J].中山大学学报(医学科学版)2004,25(3):308-9.

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