北京大学学报(医学版) ›› 2020, Vol. 52 ›› Issue (5): 943-947. doi: 10.19723/j.issn.1671-167X.2020.05.025

• 论著 • 上一篇    下一篇

异色牙瓷贴面修复的遮色效果

薛盛豪,王宇轩,许桐楷(),姜婷()   

  1. 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081
  • 收稿日期:2018-10-11 出版日期:2020-10-18 发布日期:2020-10-15
  • 通讯作者: 许桐楷,姜婷 E-mail:xutongkai@vip.163.com;15011229485@139.com
  • 基金资助:
    首都特色临床应用研究项目(Z171100001017096)

Study of masking ability of laminate veneers for discolored teeth

Sheng-hao XUE,Yu-xuan WANG,Tong-kai XU(),Ting JIANG()   

  1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stornatology, Beijing 100081, China
  • Received:2018-10-11 Online:2020-10-18 Published:2020-10-15
  • Contact: Tong-kai XU,Ting JIANG E-mail:xutongkai@vip.163.com;15011229485@139.com
  • Supported by:
    Capital Charateristic Clinical Application Research Project(Z171100001017096)

摘要:

目的:优选异色牙瓷贴面的遮色修复方法,研究不同厚度、不同透光度瓷贴面及组织面遮色涂层、遮色树脂水门汀粘固等处理方式对瓷贴面颜色的影响。方法:选取完整上颌中切牙4颗进行瓷贴面基牙预备,制作颜色为Vita A2的3种厚度(0.8 mm、1.0 mm、1.2 mm)和两种透明度(高透、低透)的热压铸造二硅酸锂玻璃陶瓷贴面各3个,共计72个瓷贴面。再将其中3颗牙冠表面涂色,模拟重度氟斑牙、重度四环素牙和重度异色死髓牙。用3种不同的试粘固用树脂水门汀糊剂(透明无色、不透明遮色、黄色)将每个贴面分别暂时粘固到相应牙面,用比色板和电子比色仪对每个瓷贴面的表面颜色(明度、饱和度、色相)进行比色和记录。将0.8 mm厚高透瓷贴面的组织面烧结遮色瓷涂层后粘固,再次进行比色并分析各遮色处理后颜色的差距。结果:瓷贴面厚度每增加0.2 mm,平均降低1个明度单位,饱和度变化不明显,与粘接剂种类无关。当瓷贴面厚度减小至0.8 mm时,即便使用低透瓷块,其遮色效果也不明显。透明树脂水门汀和黄色水门汀的遮色效果差,而遮色树脂水门汀可以降低平均2个明度单位,饱和度也有下降。组织面遮色涂层可以达到均匀一致,之后无论用何种颜色的树脂水门汀,其明度和饱和度均下降至2M1~2M1.5水平,对于不同异色牙有稳定的遮色效果。结论:对于变色牙的瓷贴面修复,加厚瓷贴面对于恢复自然透光度和色泽最为有效,也可使用组织面遮色涂层和遮色树脂水门汀来降低灰度和提高亮度。

关键词: 变色牙, 遮色, 比色, 瓷贴面

Abstract:

Objective: To select the most effective method among different masking treatments, such as different thickness and transparence, tissue surface’s opaque coating, and opaque resin cement to restore discolored teeth esthetically by porcelain veneer. Methods: Four extracted intact maxillary central incisors were prepared for porcelain veneer restoration and each three heat pressed porcelain veneers from three thicknesses (0.8 mm, 1.0 mm, 1.2 mm) and two transparency(high transparence,HT and low transparence, LT))in Vita shade A2 were fabricated for each tooth, in total of 72 pieces. The surfaces of three prepared teeth were then painted to mimic situations of severe dental fluorosis, severe tetracycline teeth, and necrotic teeth. Each of the veneers was temporarily cemented to the corresponding tooth surface using try-in cements with three different colors (transparent, opaque, and yellow), then used the shade guide (3D master) and electronic colorimeter (easy shade) to record the shade of each porcelain veneer through hue, lightness, and chroma reading. After that, high-transparence porcelain veneers in thickness of 0.8 mm was fused with a layer of opaque porcelain in tissue surface, and were shade matched again after cementation. Statistic treatments were performed to analyze the difference in each masking method. Results: For each 0.2 mm increase in the veneer thickness of porcelain, the average lightness was reduced by 1 unit, while the chroma was not changed which was independent of the type of the resin cements. When the thickness of the porcelain veneer was decreased to 0.8 mm, the opacity effect was not remarkable even if a low-transparence porcelain veneer was used. Transparent and yellow resin cements had poor opaque performance, while opaque resin cement could reduce the lightness by 2 units and the chroma was also reduced. The opaque layer of the tissue surface could be applied uniformly, and the lightness and chroma could be reduced to Vita 2M1 to 2M1.5 levels regardless of the color of resin cements, which suggested a stable opacity effect for different discolored teeth in this study. Conclusion: For porcelain veneer restoration of discolored teeth, thickened veneers are the most effective means to display a natural transmittance and color. Tissue surface’s opacity coatings and opaque resin cements can also be used to reduce grayscale and increase lightness.

Key words: Discolored teeth, Opaque, Shade matching, Porcelain veneers

中图分类号: 

  • R783

图1

分组流程图"

图2

不同厚度和透光度的正常色及变色牙组瓷贴面"

图3

牙齿比色示意图"

表1

瓷贴面厚度和瓷材料透光度对瓷贴面色调的影响"

Group Low transparence High transparence
0.8 mm 1.0 mm 1.2 mm 0.8 mm 1.0 mm 1.2 mm
Normal 2M2 2M2 2M2 2M2 2M2 2M2
Dental fluorosis 3M2 3M2 2R1.5 3L2.5 3M2 2M3
Necrotic teeth 4L1.5 3R1.5 2R1.5 3R1.5 3L1.5 2R2.5
Tetracycline teeth 3R1.5 2M1.5 2M2 3L1.5 3L1.5 3R1.5

表2

不同色调树脂水门汀和瓷贴面组织面烧结遮色层对瓷贴面色调的影响"

Group LT, 0.8 mm HT, 0.8 mm
Transparent Yellow Opaque Transparent Yellow Opaque
Normal WO 2M2 2M2 2M2 2M2 2M2 2M2
Dental fluorosis WO 3M2 3M2 3M1 3L2.5 3M2 3L1.5
W 2M1 2M1 2M1 2M1 2M1 2M1
Necrotic teeth WO 4L1.5 3R1.5 2R1.5 3R1.5 3L2.5 2R2.5
W 2M1 2M1 2M1 2L1.5 2M2 2M1
Tetracycline teeth WO 3R1.5 3R1.5 2M1 3L1.5 2R1.5 2M1
W 2R1.5 2R1.5 2L1.5 2L1.5 2M2 2M1

表3

四环素牙组和正常牙组间不同干预措施所得统计学结果"

Shade/group Thickness Transparency Cements Opacity coating
0.8 mm 1.0 mm 1.2 mm High Low Transparent Yellow Opaque Yes No
Lightness P=0.012 P=0.630 P=0.001 P=0.001
Chroma P=0.132 P=0.067 P=0.022 P=0.001

图4

瓷贴面厚度和瓷材料透光度对瓷贴面明度、饱和度的影响"

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