基于直接法和间接法数字印模制作的高嵌体适合性评价的体外研究

doi:10.19723/j.issn.1671-167X.2025.03.027

摘要/Abstract

摘要：

目的: 探索体外环境下，基于直接法及间接法数字印模技术制作的氧化锆及二硅酸锂增强玻璃陶瓷高嵌体的适合性。方法: 36牙位树脂人工牙48颗，随机分成A、B、C、D 4组，每组12颗，体外完成人工牙标准近中牙合远中高嵌体牙体预备，显微镜下检查预备质量。仿头模固定于牙科治疗椅，将标准人工牙列模型固定于仿头模内。将A、B组树脂人工牙依次置于人工牙列内相应位置，口内扫描仪获取36牙位数字印模。成品托盘，聚醚硅橡胶制取C、D组树脂牙列印模，灌注石膏模型，使用模型扫描仪扫描C、D组石膏模型。4组均使用数字化设计软件完成高嵌体设计，送加工部门完成高嵌体制作(A、C组使用氧化锆材料，B、D组使用二硅酸锂增强玻璃陶瓷材料)，使用三维配准方法评价高嵌体边缘间隙及内部间隙。结果: 基于间接法数字印模技术制作的高嵌体的边缘间隙及内部间隙均小于直接法数字印模组(P < 0.05)，各处理组远中边缘间隙值最大(P < 0.05)，不同制作材料对高嵌体边缘及内部适合性均无显著影响(P>0.05)。结论: 基于间接法数字印模技术制作的高嵌体的边缘适合性及内部适合性均优于直接法，氧化锆及二硅酸锂增强玻璃陶瓷两种修复材料对高嵌体适合性没有影响。

关键词: 牙科印模技术, 牙瓷料, 氧化锆, 二硅酸锂, 高嵌体

Abstract:

Objective: To analyze the fitness of zirconia and lithium disilicate glass-ceramic onlays fabricated with direct and indirect computer-aided design and computer-aided manufacturing (CAD/CAM) technology in vitro. Methods: In the study, 48 standardised typodont left mandibular first molars received standardised onlay preparation. Then, all the specimens were randomly divided into 4 groups. There were 12 specimens in each group. The preparation quality was checked under the stereomicroscope. All the specimens were fixed in typodonts. Subsequently, the typodonts were fixed in the dental simulators to simulate the oral conditions. In groups A and B, the digital impressions were obtained by using the intraoral scanner. In groups C and D, conventional impressions of polyether impression material were obtained according to the instructions of the manufacturer using individual trays. The stone casts were made with type Ⅳ gypsum later. Then, all casts were digitized with the model scanner. Based on the data obtained from the scan, onlay restorations of all the groups were designed using the corresponding software, the simulated cement thickness was set to 50 μm. Then, the final onlays restorations of all the groups were machined with the milling machines in lab. The fabrication materials were different in groups. The specimens of groups A and C were fabricated with zirconia. While, the specimens of groups B and D were fabricated with lithium disilicate glass-ceramic. The marginal gap and internal gap of all restorations were analyzed by 3D replica technique, for each measurement, the specimen was digitised using the model scanner. Results: The marginal gap of the onlays fabricated with indirect digital impressions were smaller than that with direct digital impressions (P < 0.05). At the same time, the internal gap of the onlays fabricated with indirect digital impressions were smaller than that with direct digi-tal impressions (P < 0.05). The marginal gap was larger in distal gingival than that in the other regions in all the groups (P < 0.05). Different fabrication materials, zirconia or lithium disilicate reinforced glass-ceramic, had no effect on onlay marginal and internal fit (P>0.05). Conclusion: The marginal and internal adaptation of the onlays fabricated with indirect digital impressions was better than with direct digital impressions. Zirconia and lithium disilicate reinforced glass-ceramic had no effect on the onlay adaptation.

Key words: Dental impression technique, Dental porcelain, Zirconia, Lithium disilicate, Onlay

中图分类号:

R783.3

钱锟, 刘亦洪. 基于直接法和间接法数字印模制作的高嵌体适合性评价的体外研究[J]. 北京大学学报（医学版）, 2025, 57(3): 604-609.

Kun QIAN, Yihong LIU. Fitness of onlays fabricated with direct and indirect CAD/CAM technology in vitro[J]. Journal of Peking University (Health Sciences), 2025, 57(3): 604-609.

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Group	Method	Material	Internal gap values/μm	Marginal gap values/μm
A (n=12)	Direct	Zirconia	135.54±14.69	144.30±20.44
B (n=12)	Direct	Ceramic	124.16±22.04	135.53±23.44
C (n=12)	Indirect	Zirconia	103.77±13.61	104.55±19.02
D (n=12)	Indirect	Ceramic	108.49±17.83	122.78±23.36

Source	Type Ⅲ sum of squares	df	Mean square	F	P
Corrected model	5 251.241^a	2	2 625.621	8.717	0.001
Intercept	515 841.350	1	515 841.350	1 712.556	< 0.001
Method	5 211.009	1	5 211.009	17.300	< 0.001
Material	40.232	1	40.232	0.134	0.717

Source	Type Ⅲ sum of squares	df	Mean square	F	P
Corrected model	150 406.021^a	15	10 027.068	9.374	< 0.001
Intercept	2 532 324.909	1	2 532 324.909	2 367.339	< 0.001
Method	13 937.982	1	13 937.982	13.030	< 0.001
Position	84 163.215	3	28 054.405	26.227	< 0.001
Material	3 819.499	1	3 819.499	3.571	0.061
Method×Position	12 588.477	3	4 196.159	3.923	0.010
Method×Material	3 140.300	1	3 140.300	2.936	0.089
Position×Material	14 902.929	3	4 967.643	4.644	0.004
Method×Position×Material	9 945.476	3	3 315.159	3.099	0.029

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