氧化锆全瓷冠修复体40例临床效果评价

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (3): 364-367.

氧化锆全瓷冠修复体40例临床效果评价

祁兵¹, 何艳²

1.上海市静安区牙病防治所,上海 200041;
2.上海交通大学医学院附属第九人民医院·口腔医学院口腔综合科,上海市口腔医学重点实验室,上海 200011

收稿日期:2015-12-07 修回日期:2016-01-27 出版日期:2016-06-25 发布日期:2016-07-22
通讯作者: 何艳,E-mail：jsjjhy@sina.com E-mail:qijunhao18@163.com
作者简介:祁兵（1967-）,男, 学士,副主任医师

Clinical evaluation of the zirconia all ceramic crowns in 40 consecutive patients

QI Bing¹, HE Yan²

1.Shanghai Jinan Dental Clinic. Shanghai 200041;
2. Department of General Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2015-12-07 Revised:2016-01-27 Online:2016-06-25 Published:2016-07-22

摘要/Abstract

摘要： 目的探讨锆面氧化锆全瓷冠修复体的临床应用效果及边缘适合度。方法选取2014年1月—2015年8月到静安区牙病防治所口腔修复科接受全瓷修复的患者40例,采用计算机辅助设计和计算机辅助制作（CAD/CAM）技术制作氧化锆全瓷冠修复体46件,其中上颌22件,下颌24件;前牙单冠21个,后牙单冠25个。参照美国加利福尼亚牙科医师协会全瓷修复体的临床标准进行效果评价,并以牙龈出血指数、牙周袋深度以及附着丧失3项指标对修复体的牙周状况进行评价。采用SPSS 13.0软件包对结果进行统计学分析。结果全瓷冠患者初戴3个月后,2例出现牙龈炎,其余均未出现边缘着色和继发龋。初戴后6个月,2例出现轻微牙龈炎症;初戴后12个月,未出现牙冠裂纹和断裂、边缘着色和继发龋,3个冠修复体出现颜色不匹配。所有患者在3、6、12个月时间点的龈沟出血指数、牙周袋深度以及附着丧失指标与治疗前的相比无显著差异（P>0.05）。结论氧化锆全瓷冠具有优良的生物相容性、良好的美学效果和良好的稳定性,是理想的临床美学修复体。

关键词: 氧化锆, 全瓷冠, 临床效果

Abstract: PURPOSE: To investigate clinical application, aesthetics, stability and bio-compatibility of zirconia all-ceramic crowns in prosthodontic patients. METHODS: Computer aided design and manufacturing techniques were used to make zirconia all ceramic crowns in 40 patients. They were divided into 2 groups according to the thickness of the gingival thickness. After 12 months of clinical observation, the aesthetics, stability, and bio-compatibility were evaluated by the crown color, crown edge fitness, losing ratio and gingival health. The data were analyzed using SPSS 13.0 software package. RESULTS: Slight marginal discrepancy was observed in 2 zirconia all ceramic crowns, no evidence of decay was observed at 1 year. CONCLUSIONS: Zirconia all ceramic crowns have a low fracture rate, good biological properties and excellent esthetic properties. It is ideal esthetic prosthesis.

中图分类号:

R783.6

祁兵, 何艳. 氧化锆全瓷冠修复体40例临床效果评价[J]. 上海口腔医学, 2016, 25(3): 364-367.

QI Bing, HE Yan. Clinical evaluation of the zirconia all ceramic crowns in 40 consecutive patients[J]. Shanghai Journal of Stomatology, 2016, 25(3): 364-367.

参考文献

[1] Tinschert J, Natt G, Mautsch W, et al. Fracture resistance of lithium disilicate, alumina-, and zirconia-based three-unit fixed partial dentures: a laboratory study [J]. Int J Prosthodont, 2001, 14(3): 231-238.
[2] Guazzato M, Proos K, Quach L, et al. Strength, reliability and mode of fracture of bilayered porcelain/zirconia(Y-TZP) dental ceramics [J]. Biomaterials, 2004, 25(20): 5045-5052.
[3] 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(4): 371-376.
[4] Piconi C, Maccauro G. Zirconia as a ceramic biomaterial [J]. Biomaterials, 1999, 20(1): 1-25.
[5] 赵铱民. 口腔修复学[M].北京: 人民卫生出版社,2008: 541-542.
[6] Triwantana P, Nagaviroj N, Tulapornchai C. Clincical performance and failures of zirconia-based fixed partial dentures: a review literature [J]. J Adv Prosthodont, 2012, 4(2): 76-83.
[7] Sailer I, Fehér A, Filser F, et al. Five-year clinical results of zirconia frameworks for posterior fixed partial dentures [J]. Int J Prosthodont, 2007, 20(4): 383-388.
[8] Lawn B, Bhowmick S, Bush MB, et al. Failure mode in ceramic-based laye structures: a basis for materials design of dental crowns [J]. J Am Ceram Soc, 2007, 90(6):1672-1681.
[9] Kwon TK, Pak HS, Yang JH, et al. Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns [J]. J Adv Prosthodont, 2013, 5(2): 92-97.
[10] Ng J, Ruse D, Wyatt C. A comparison of the marginal fit of crown farbricated with digital conventional methods [J]. J Prosthet Dent, 2014, 112(3): 555-560.
[11] Stewart GP, Jain P, Hodges J. Shear bond strength of resin cements to both ceramic and dentin[J]. J Prosthet Dent, 2002, 88(3): 277-284.
[12] Lan TH, Liu PH, Chou MM, et al. Fracture resistance of monolithic zirconia crowns with different occlusal thicknesses in implant prothesees [J]. J Prosthet Dent, 2016, 115(1): 76-78.
[13] Nordahl N, Vult von Steyern P, Larsson C. Fracture strength of ceramic monolithic crown systems of different thickness [J]. J Oral Sci, 2015, 57(3): 255-261.
[14] 刘亦洪, 王勇, 张庆辉, 等. 基底冠设计对氧化锆全瓷冠抗力的影响 [J]. 北京大学学报(医学版), 2014, 46(1): 71-75.
[15] Mundhe K, Jain V, Pruthi G, et al. Clinical study to evaluate the wear of natural enamel antagonist to zirconia and metal ceramic crowns [J]. J Prosthet Dent, 2015, 114(3): 358-363.
[16] Stober T, Bermejo JL, Rammelsberg P, et al. Enamel wear caused by monolithic zirconia crowns after 6 months of clinical use [J]. J Oral Rehabil, 2014, 41(4): 314-322.