不同间隙设置对椅旁CAD/CAM IPS e.max全瓷冠边缘适合性的影响

摘要/Abstract

摘要： ［摘要］目的观察椅旁CAD/CAM不同间隙设置对IPS e.max全瓷冠边缘适合性的影响，为临床应用提供实验依据。方法采用Ivoclar vivadent模型上的右上颌第一磨牙全冠标准模型翻制硅橡胶阴模，灌注超硬石膏预备体模型25个。用Sirona Cerec AC扫描采集光学印模，获得25个数字化代型。将代型随机分为5组，运用CEREC version 4.4.4操作软件将间隙值分别设置为30 μm(A组)、60 μm(B组)、90 μm(C组)、120 μm(D组)和150 μm(E组)，通过数控铣床切削得到IPS e.max全瓷冠25个，每组5个。采用Variolink N义获嘉粘结系统粘结。Leica体式显微镜扫描代型颊侧、舌侧、近中和远中4个基准点的垂直边缘缝隙，计算均数和标准差，应用SPSS 20.0进行统计学分析，组间及组内两两比较采用LSD检验。结果 4个基准点的边缘适合性值A组均>120 μm；E组均<30 μm；B、C、D组为30~120 μm。A、E组与B、C、D组分别相比均具有显著统计学差异（P<0.05）；B、C、D组之间相比无统计学差异（P>0.05）。各组内颊侧、舌侧、近中、远中不同测量位置之间无统计学差异（P>0.05）。结论 CEREC version 4.4.4间隙设置值为60、90、120 μm时，IPS e.max全瓷冠可以获得临床可接受的边缘适合性。［关键词］ CAD/CAM；全瓷冠；边缘适合性；间隙设置导板外科应用于下颌骨粉碎性骨折精准复位陆友正,王志勇,席洪,达明杰,李威,王育新［摘要］目的探讨应用数字化导板辅助重建钛板精准复位及固定下颌骨粉碎性骨折的方法及效果。方法选取本院2016年1月—2017年12月收治的10例下颌骨粉碎性骨折患者作为研究对象,所有患者术前应用数字化外科技术设计手术导板并行3D打印，术中手术导板辅助重建钛板精准复位及固定下颌骨粉碎性骨折,术后行图像融合及临床评价。结果所用患者均一期愈合，图像融合显示与术前虚拟设计偏差度＜2 mm，咬合关系恢复及骨折复位愈合情况良好,张口度未见异常。结论数字化导板辅助下颌骨粉碎性骨折复位及固定，缩短了手术时间，能精准复位及固定下颌骨粉碎性骨折，临床应用效果确定。

关键词: CAD/CAM , 全瓷冠, 边缘适合性, 间隙设置

Abstract: Objective To observe the influence of different space settings on the marginal adaptation of chair-side CAD/CAM IPS e.max all ceramic crowns to provide experimental evidence for clinical application. Methods A right maxillary first molar in the ivoclar vivadent standard model was used and subsequently replicated into silicone rubber negative mold. Respectively, twenty-five preparations of die stone were irrigated. Twenty-five digital images were obtained by using optical impression of Sirona Cerec AC system. Twenty-five of them were randomly divided into 5 groups，and luting spaces were set to 30 μm(A group)，60 μm(B group)，90 μm(C group)，120 μm(D group)and 50 μm(E group) by CEREC version 4.4.4 computer software. Twenty-five all-ceramic crowns with five ones in each group were obtained according to space settings by Digital Control Cutting equipment．The Variolink N system was used for bonding. The vertical marginal gaps of four datum points, buccal, lingual, mesio and distal points were measured by Leica microscope. The mans and standard deviations were calculated. And the data were analyzed by LSD -test using SPSS 20.0, and the inter-group and intra-group comparison was examined by LSD．Results The marginal adaptations of bucco-lingual and mesio-distal sides were higher than 120 μm in A group，and the marginal adaptations of bucco-lingual and mesio-distal sides were lower than 30 μm in E group. The marginal adaptations of bucco-lingual and mesio-distal sides in B, C and D groups were between 30 μm ~120 μm. There were statistically significant differences(P<0.05) comparing A group with B, C or D groups in the marginal adaptation of bucco-lingual and mesio-distal sides. There were statistically significant differences(P<0.05) comparing E group with B, C or D groups in the marginal adaptation of bucco-lingual and mesio-distal sides. There were no statistically significant differences(P>0.05) among B, C and D groups in the marginal adaptation of bucco-lingual and mesio-distal sides. There were no statistically significant differences(P>0.05) in the marginal adaptation of bucco-lingual and mesio-distal sides in each group. Conclusion The chair-side CAD/CAM IPS e.max all-ceramic crowns can obtain the clinical acceptable marginal adaptation when the space settings are set at 60,90,120 μm while using CEREC version 4.4.4.

Key words: CAD/CAM , all-ceramic crown, marginal adaptation, space setting

中图分类号:

R783.2

刘琳洁严媛媛王章涵丁伟山. 不同间隙设置对椅旁CAD/CAM IPS e.max全瓷冠边缘适合性的影响[J]. , 2019, 39(8): 710-713.

参考文献 16

[1]	Francesco Riccitiello,Massimo Amato, Renato Leone, et al. In vitro Evaluation of the Marginal Fit and Internal Adaptation of Zirconia and Lithium Disilicate Single Crowns: Micro-CT Comparison Between Different Manufacturing Procedures[J]. Open Dent J, 2018,12(2): 160–172.
[2]	Fawaz Alqahtani. Marginal fit of all-ceramic crowns fabricated using two extraoral CAD/CAM systems in comparison with the conventional technique[J]. Clin Cosmet Investig Dent,2017,9(3): 13–18.
[3]	Ji Suk SHIM, Jin Sook LEE,Jeong Yol LEE,et al. Effect of software version and parameter settings on the marginal and internal adaptation of crowns fabricated with the CAD/CAM system[J]. J Appl Oral Sci, 2015,23(5):515-522.
[4]	邵金龙,王兵,丁伟山,等.不同制作工艺对金属基底边缘适合性影响的实验分析[J].口腔颌面修复学杂志,2013,14(3):155-158.
[5]	Oliver Schaefera,David C Wattsb,Bernd W Siguschc,et a1. Marginal and Internal fit of pressed lithium disilicate partial crowns in vitro:A three-dimensional analysis of accuracy and reproducibility[J]．Dental Materials,2012,28(3):320-326.
[6]	Baroudi K, Ibraheem SN. Assessment of chair-side computer aided design and computer aided manufacturing restorations: a review of the literature[J]. J Int Oral Health, 2015, 7(4): 96-104.
[7]	Nejatidanesh F, Amjadi M, Akouchekian M, et al. Clinical performance of CEREC AC Bluecam conservative ceramic restorationsafter five years-a retrospective study[J]. J Dent, 2015, 43(9): 1076-1082.
[8]	Dureja I, Yadav B, Malhotra P, et al. A comparative evaluation of vertical marginal fit of provisional crowns fabricated by computer-aided design/computer-aided manufacturing technique and direct (intraoral technique) and flexural strength of the materials: An in vitro study[J]. J Indian Prosthodont Soc, 2018,18(4):314-320.
[9]	Ji Suk SHIM,Jin Sook LEE,Jeong Yol LEE,et al. Effect of software version and parameter settings on the marginal and internal adaptation of crowns fabricated with the CAD/CAM system[J]. J Appl Oral Sci,2015,23(5):515-522.
[10]	Arena A, Baldissara P, Ciocca L,et al. Influence of reparation design and spacing parameters on the risk of chipping of crowns made with Cerec Bluecam before cementation[J]. J Prosthodont Res, 2018,29(18) :30354-30362.
[11]	Park SH ,Yoo YJ,Cho BH ,et a1.Marginal and interal fit of CAD /CAM restorations[J].Restor Dent Endod ,2016 ,41(1 ):37-43.
[12]	?z?elik TB, Yilmaz B, ?eker E, et al. Marginal adaptation of provisional CAD/CAM restorations fabricated using various simulated digital cement space settings[J].Int J Oral Maxillofac Implants,2018,33(5):1064-1069.
[13]	丁伟山,黄爱玲,胡以俊,等. CAD/CAM氧化锆底层冠适合性的实验研究[J].口腔颌面修复学杂志,2010,11(3):144-146.
[14]	曾欣,宋宇,于艳玲,等.全瓷嵌体修复儿童第一恒磨牙严重缺损的效果[J]. 口腔疾病防治, 2018,26(9):578-583.
[15]	Otto T,De Nisco S．Computer-aided direct ceramic restorations 10-year prospective clinical study of Cerec CAD/CAM inlays and onlays [J].Int J Prosthodont,2002,15(2 ):122-128.
[16]	Reich S,Brnngsberg B,Teschner H,et a1.The occlusal precision of laboratory versus CAD/CAM processed all-ceramic crowns[J].A m J Dent,2010,23(1):53-56.