磨牙不同桩核系统切削氧化锆全瓷冠修复的边缘和内部适合性研究

doi:10.13591/j.cnki.kqyx.2023.07.006

摘要/Abstract

摘要：

目的研究磨牙CAD/CAM纤维桩核、铸造纯钛桩核、预成纤维桩树脂核3种桩核系统对全冠密合性的影响。方法选择32颗离体上颌第一磨牙,随机分为4组(n=8),分别为A组铸造纯钛桩核组、B组预成纤维桩树脂核组、C组CAD/CAM纤维桩核组、D组无桩核基牙组。A、B、C组均在釉牙骨质界冠方2 mm处截冠,经过完善的根管治疗、桩道及牙体预备后进行桩核制作,桩核粘接后,4组试件按照相同标准进行全冠预备,光学扫描,数字化设计、切削制作氧化锆全瓷冠。使用硅橡胶法和三维偏差分析软件Geomagic Wrap 2021测量其冠边缘及内部的适合性,并对结果进行统计分析。结果无桩核基牙组的切削氧化锆全瓷冠的边缘适合性及内部适合性最佳,桩核的出现会导致切削氧化锆全瓷冠适合性下降:铸造纯钛桩核的影响最大,其边缘适合性及内部适合性最差;预成纤维桩树脂核与CAD/CAM纤维桩核次之,两者间边缘适合性及内部适合性差异无统计学意义(P>0.05)。结论 4组切削氧化锆全瓷冠的边缘及内部适合性均满足临床要求,桩核的出现会影响切削氧化锆全瓷冠的适合性。

关键词: 桩核, 氧化锆全瓷冠, 边缘适合性, 内部适合性

Abstract:

Objective To study the differences in the marginal and internal adaptation of milled monolithic zirconia crowns with CAD/CAM fiber post-core, cast Ti post-core, prefabricated fiber post/resin core and dentin abutment group. Methods Thirty-two maxillary first molars in vitro were randomly divided into four groups(n=8):A-cast Ti post-core, B-prefabricated fiber post/resin core, C-CAD/CAM fiber post-core, D-dentin abutment. The crowns of Group A,B,C were cut 2 mm coronal to the cemento-enamel junction, and the post-and-core production was performed after complete root canal treatment, post canal and tooth preparation. The abutments of the four groups were in the same shape, and all of them were restored by milled monolithic zirconia crowns. Marginal adaptation and internal adaptation were examined using a light-body silicone and a 3D inspection software, Geomagic Wrap 2021 Qualify. The data were statistically analyzed with two-way analyses of variance. Results The milled monolithic zirconia crown in dentin abutment group had the best marginal and internal adaptation. The appearance of post-core would lead to the decrease of monolithic zirconia crown fitness. Cast Ti post-core had the greatest influence, and its marginal and internal fitness was the worst, followed by prefabricated fiber post-core and CAD/CAM, and there was no significant difference in marginal and internal adaptation between the two groups. Conclusion The marginal and internal adaptation of the four groups of monolithic zirconia crowns meet clinical requirements, and the appearance of post-core will affect the adaptation of monolithic zirconia crowns.

Key words: post-core, monolithic zirconia crown, marginal adaptation, internal adaptation

中图分类号:

R783.3

明先庆, 张紫薇, 王子添, 陈心蕾, 罗颐辰, 张玮. 磨牙不同桩核系统切削氧化锆全瓷冠修复的边缘和内部适合性研究[J]. 口腔医学, 2023, 43(7): 614-618.

MING Xianqing, ZHANG Ziwei, WANG Zitian, CHEN Xinlei, LUO Yichen, ZHANG Wei. Study on the marginal and internal adaptation of different post-core systems for milled monolithic zirconia crowns of molars[J]. Stomatology, 2023, 43(7): 614-618.

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组别	根长	近远中径	颊舌径
A	11.40±0.69	7.86±0.52	10.73±0.49
B	11.58±0.76	7.78±0.51	10.93±0.53
C	11.56±0.85	7.77±0.51	11.05±0.65
D	11.38±0.72	7.60±0.40	10.80±0.57
F	0.060	0.557	0.491
P	0.980	0.648	0.691

组别	冠内部适合性	冠边缘适合性	t	P
A	111.06±5.78^a	99.43±4.69^d	0.49	<0.05
B	105.76±7.30^a	89.83±4.35^c	4.80	<0.05
C	103.60±7.09^a	91.75±8.26^cd	3.57	<0.05
D	88.83±9.47^b	87.21±4.14^c	3.50	>0.05
F	12.80	7.00
P	0.000	0.001