Email Alert | RSS

北京大学学报（医学版） ›› 2023, Vol. 55 ›› Issue (6): 1105-1110. doi: 10.19723/j.issn.1671-167X.2023.06.023

• 论著 • 上一篇    下一篇

洞缘设计对CAD/CAM瓷嵌体边缘质量和边缘适应性及微渗漏的影响

赵思铭,王晓燕*()   

  1. 北京大学口腔医学院·口腔医院牙体牙髓科, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 口腔生物材料和数字诊疗装备国家工程研究中心, 口腔数字医学北京市重点实验室, 国家卫生健康委员会口腔医学计算机应用工程技术研究中心, 国家药品监督管理局口腔生物材料重点实验室, 北京 100081
  • 收稿日期:2023-01-04 出版日期:2023-12-18 发布日期:2023-12-11
  • 通讯作者: 王晓燕 E-mail:wangxiaoyan@pkuss.bjmu.edu.cn
  • 基金资助:
    中华口腔医学会青年临床科研基金全瓷材料研究项目(CSA-P2019-04)

Influence of cavity design on quality of margin and marginal adaptation and microleakage of all-ceramic CAD/CAM inlays

Si-ming ZHAO,Xiao-yan WANG*()   

  1. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2023-01-04 Online:2023-12-18 Published:2023-12-11
  • Contact: Xiao-yan WANG E-mail:wangxiaoyan@pkuss.bjmu.edu.cn
  • Supported by:
    Clinical Research Fund of Young Scientists for Ceramic Materials of Chinese Stomatological Association(CSA-P2019-04)

RICH HTML

   

PDF (PC)

摘要：

目的: 研究不同洞缘设计(135°洞缘斜面和90°洞缘)对不同材质计算机辅助设计/计算机辅助制造(computer aided design/computer aided manufacturing，CAD/CAM)瓷嵌体边缘质量、边缘适应性及微渗漏的影响。方法: 100颗人磨牙冠部进行颊面(buccal occlusal, BO)洞嵌体预备，其中颊侧的近中和远中预备体边缘分别采用135°洞缘斜面和90°洞缘设计。均分五组，分别采用VitaBlocs Mark Ⅱ、Upcera UP.CAD、IPS e.max CAD、Upcera Hyramic和Lava Ultimate瓷块，Sirona CEREC AC椅旁CAD/CAM系统制作瓷嵌体，体视镜观察嵌体近、远中边缘的完整性及间隙。就位粘接后冷热循环10 000次，均置于5%(质量分数)碱性品红溶液染色24 h，并垂直牙长轴于嵌体颊侧的1/3、中1/2、颈1/3切开，体视镜下观测微渗漏深度。结果: 135°边缘，Upcera Hyramic和Lava Ultimate组的边缘完整率、平均边缘间隙和平均微渗漏深度均优于VitaBlocs Mark Ⅱ、Upcera UP.CAD和IPS e.max CAD组(P＜0.05)；90°边缘，Upcera Hyramic和Lava Ultimate组的平均边缘间隙、平均微渗漏深度和平均微渗漏深度评分均优于Upcera UP.CAD和IPS e.max CAD组(P＜0.05)，边缘完整率差异无统计学意义(P>0.05))。各组内，90°边缘的边缘完整率优于135°边缘(P＜0.05), 平均微渗漏深度差异无统计学意义(P>0.05), VitaBlocs Mark Ⅱ和IPS e.max CAD组内90°边缘的平均边缘间隙优于135°边缘(P＜0.05)，Upcera UP.CAD、Upcera Hyramic和Lava Ultimate组内差异无统计学意义(P>0.05)；Upcera Hyramic和Lava Ultimate组内135°边缘的平均渗透深度评分优于90°边缘(P＜0.05)，VitaBlocs Mark Ⅱ、Upcera UP.CAD和IPS e.max CAD组内差异无统计学意义(P>0.05)。结论: 嵌体修复时，预备体的近、远中边缘应采用90°边缘设计。

关键词: CAD/CAM, 洞缘设计, 边缘完整, 边缘间隙, 微渗漏

Abstract:

Objective: To investigate the influence of 135° and 90° cavity design on quality of margin and marginal adaptation and microleakage of all-ceramic computer aided design/computer aided manufacturing (CAD/CAM) inlays. Methods: One hundred extracted human molars were prepared by criteria of buccal occlusal (BO) inlay. On the buccal, the mesial margin was prepared as 135° bevel while the distal margin was prepared as butt-joint. All-ceramic restorations were made in the Sirona CEREC AC CAD/CAM system with VitaBlocs Mark Ⅱ, Upcera UP.CAD, IPS e.max CAD, Upcera Hyramic and Lava Ultimate. The gaps between each inlay's mesial margin-abutment and distal margin-abutment were recorded under an optical microscope. Each inlay was adhered to the abutment and aged by thermal cycling for 10 000 times. Each specimen was cut into 3 slices after staining. Dye penetration was evaluated under an optical microscope for mesial and distal margins. Results: Mean marginal integrity rate, mean marginal gap value and mean depth of microleakage of 135° margin of Group Upcera Hyramic and Lava Ultimate were significantly better than those of Group VitaBlocs Mark Ⅱ, Upcera UP.CAD and IPS e.max CAD(P < 0.05). Mean marginal gap value, mean depth of microleakage and scale of mean depth of microleakage of 90° margin of Group Upcera Hyramic and Lava Ultimate were significantly better than those of Group Upcera UP.CAD and IPS e.max CAD (P < 0.05) while mean marginal integrity rate was not significantly different (P>0.05). Mean marginal integrity rate of 90° margin was significantly better than that of 135° margin in each group (P < 0.05) while mean depth of microleakage between different margins was not significantly different in each group (P>0.05). Mean marginal gap value of 90° margin of Group VitaBlocs Mark Ⅱ and IPS e.max CAD was significantly better than that of 135° margin (P < 0.05) while there was not significant difference in other 3 groups between 90° and 135° margin (P>0.05). Scale of mean depth of microleakage of 135° margin of Group Upcera Hyramic and Lava Ultimate was significant better than that of 90° margin (P < 0.05) while there was not significantly different in other 3 groups between 90° and 135° margin (P>0.05). Conclusion: The mesial and distal margins of abutement of all-ceramic inlay should be prepared as butt-joint.

Key words: CAD/CAM, Cavity design, Marginal integrity, Marginal Gap, Microleakage

中图分类号: 

  • R783.1

图1

实验流程图"

图2

嵌体预备示意图"

图3

嵌体就位于预备体的表现"

图4

染料渗入嵌体-预备体粘接界面的表现"

图5

嵌体平均边缘完整率"

图6

嵌体平均边缘间隙"

图7

染料平均微渗漏深度"

1 Azeem RA , Sureshbabu NM . Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review[J]. J Conserv Dent, 2018, 21 (1): 2- 9.
2 Schroeder M , Reis A , Luque-Martinez I , et al. Effect of enamel bevel on retention of cervical composite resin restorations: A systematic review and meta-analysis[J]. J Dent, 2015, 43 (7): 777- 788.
doi: 10.1016/j.jdent.2015.02.017
3 中华口腔医学会口腔美学专业委员会, 中华口腔医学会口腔材料专业委员会. 全瓷美学修复材料临床应用专家共识[J]. 中华口腔医学杂志, 2019, 54 (12): 825- 828.
doi: 10.3760/cma.j.issn.1002-0098.2019.12.007
4 Taha D , Spintzyk S , Sabet A , et al. Assessment of marginal adaptation and fracture resistance of endocrown restorations utilizing different machinable blocks subjected to thermomechanical aging[J]. J Esthet Restor Dent, 2018, 30 (4): 319- 328.
doi: 10.1111/jerd.12396
5 Contrepois M , Soenen A , Bartala M , et al. Marginal adaptation of ceramic crowns: A systematic review[J]. J Prosthet Dent, 2013, 110 (6): 447- 454.
doi: 10.1016/j.prosdent.2013.08.003
6 Goujat A , Abouelleil H , Colon P , et al. Marginal and internal fit of CAD-CAM inlay/onlay restorations: A systematic review of in vitro studies[J]. J Prosthet Dent, 2019, 121 (4): 590- 597.
doi: 10.1016/j.prosdent.2018.06.006
7 Dioguardi M , Alovisi M , Troiano G , et al. Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: A systematic review and meta-analysis[J]. Clin Oral Investig, 2021, 25 (12): 6597- 6621.
doi: 10.1007/s00784-021-04187-x
8 Oz FD , Bolay S , Canatan S . A clinical evaluation of resin nanoceramic CEREC omnicam restorations associated with several factors[J]. J Esthet Restor Dent, 2021, 33 (4): 583- 589.
doi: 10.1111/jerd.12691
9 Frankenberger R , Hartmann VE , Krech M , et al. Adhesive luting of new CAD/CAM materials[J]. Int J Comput Dent, 2015, 18 (1): 9- 20.
10 Gold SA , Ferracane JL , da Costa J . Effect of crystallization firing on marginal gap of CAD/CAM fabricated lithium disilicate crowns[J]. J Prosthodont, 2018, 27 (1): 63- 66.
doi: 10.1111/jopr.12638
11 Baldi A , Comba A , Michelotto Tempesta R , et al. External marginal gap variation and residual fracture resistance of composite and lithium-silicate CAD/CAM overlays after cyclic fatigue over endodontically-treated molars[J]. Polymers (Basel), 2021, 13 (17): 3002.
doi: 10.3390/polym13173002
12 Lima FF , Neto CF , Rubo JH , et al. Marginal adaptation of CAD-CAM onlays: Influence of preparation design and impression technique[J]. J Prosthet Dent, 2018, 120 (3): 396- 402.
doi: 10.1016/j.prosdent.2017.10.010
13 Oliveira J , Dorado L , Koch D , et al. Marginal microleakage in cavities prepared with CVD tip and 245 bur[J]. Dent Implantol Update, 2009, 20 (3): 17- 23.
14 Simi B , Suprabha B . Evaluation of microleakage in posterior nanocomposite restorations with adhesive liners[J]. J Conserv Dent, 2011, 14 (2): 178- 181.
doi: 10.4103/0972-0707.82631
15 傅柏平, 金光盛, MatthiasH. 自蚀粘接剂对复合树脂微渗漏的影响[J]. 浙江大学学报(医学版), 2002, 31 (5): 53- 56.
16 周宪华, 牛文芝, 王鹏来, 等. 有无洞缘斜面对聚合瓷嵌体微渗漏影响的实验研究[J]. 现代口腔医学杂志, 2012, 26 (6): 392- 393.
[1] 李秋菊,宫玮玉,董艳梅. 生物活性玻璃预处理对牙本质粘接界面耐久性的影响[J]. 北京大学学报（医学版）, 2020, 52(5): 931-937.
[2] 李爽，张清. 玷污层对新型三氧化矿物凝聚体根尖封闭性的影响[J]. 北京大学学报(医学版), 2018, 50(3): 560-563.
[3] 谢窈, 张笋, 葛立宏. 乳牙应用Er:YAG激光备洞充填微渗漏效果的离体研究[J]. 北京大学学报（医学版）, 2014, 46(3): 474-477.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . 书讯[J]. 北京大学学报（医学版）, 2007, 39(3): 225 -328 .
[2] 黄萍, 刘炯, 夏英杰, 仲燕莹, 陈跃国. 两种准分子激光手术治疗超高度近视的对比研究[J]. 北京大学学报（医学版）, 2007, 39(5): 498 -502 .
[3] 范少光. 向王志均院士学习[J]. 北京大学学报（医学版）, 2000, 32(4): 300 .
[4] 马红, 高妍, 杨建梅, 惠岩, 陈澜, 王淑凤. 人血浆瘦素水平与肥胖及血浆胰岛素水平的关系[J]. 北京大学学报（医学版）, 2001, 33(6): 559 -561 .
[5] 樊志荣, 卢义侠, 李长龄. 肾病综合征大鼠肾小球血管紧张素Ⅱ受体结合的变化及机制[J]. 北京大学学报（医学版）, 2001, 33(6): 565 .
[6] 范蓉, 张成飞, 高岩, 李斌斌, 王晶. 核因子-κB受体活化因子配体和骨保护素在慢性根尖周炎病损组织中的表达[J]. 北京大学学报（医学版）, 2008, 40(1): 39 -42 .
[7] 章巍, 王广发, 张红, 牟向东, 金哲. 用内科胸腔镜进行滑石粉胸膜固定术治疗恶性胸腔积液27例临床分析[J]. 北京大学学报（医学版）, 2008, 40(6): 600 -602 .
[8] 田清平, 冯雪茹, 庞永正, 唐朝枢, 刘梅林. 血浆皮质醇激素抑制素水平与冠心病的关系[J]. 北京大学学报（医学版）, 2009, 41(5): 537 -540 .
[9] 陈磊, 张豪, 冯海兰, 张凤军. 正常受试者单侧咀嚼运动中的牙合接触模式[J]. 北京大学学报（医学版）, 2009, 41(1): 90 -94 .
[10] 赵英芳, 田新霞, 杜娟, 张云岗, 刘松年, 林杰, 郑杰. 胃癌中p16INK4a和RB基因甲基化状况及其表达[J]. 北京大学学报（医学版）, 2003, 35(4): 382 -385 .
ISSN 1671-167X
CN 11-4691/R
主管单位：中华人民共和国教育部
主办单位：北京大学
地址： 北京市海淀区学院路38号 北京大学医学部 《北京大学学报（医学版）》
邮编：100191
电话：010-82801551
Email： xbbjb2@bjmu.edu.cn

《北京大学学报（医学版）》
微信公众号
版权所有 © 2018 《北京大学学报（医学版）》编辑部