北京大学学报(医学版) ›› 2021, Vol. 53 ›› Issue (1): 88-94. doi: 10.19723/j.issn.1671-167X.2021.01.014

• 论著 • 上一篇    下一篇

应用超声器械改善预备体肩台的效果

李思雨1,段雪飞2,曹烨2,Δ()   

  1. 1.北京大学口腔医学院·口腔医院,综合科, 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
    2.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:2020-09-09 出版日期:2021-02-18 发布日期:2021-02-07
  • 通讯作者: 曹烨 E-mail:ye.cao@bjmu.edu.cn
  • 基金资助:
    北京大学口腔医院新技术新疗法项目(PKUSSNCT-14B04)

Evaluation of the effect of using ultrasonic instruments to improve the shoulder of the preparations

LI Si-yu1,DUAN Xue-fei2,CAO Ye2,Δ()   

  1. 1. Department of General Dentistry, 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 Stomatology, Beijing 100081, China
    2. 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 Stomatology, Beijing 100081, China
  • Received:2020-09-09 Online:2021-02-18 Published:2021-02-07
  • Contact: Ye CAO E-mail:ye.cao@bjmu.edu.cn
  • Supported by:
    New Technology and New Therapy Project of Peking University School and Hospital of Stomatology(PKUSSNCT-14B04)

摘要:

目的: 比较超声器械与金刚砂车针预备所形成的肩台表面粗糙度的差异,为超声肩台预备的临床开展提供依据。方法: (1)6颗离体前磨牙颊舌侧的不同区域分别使用不同粗糙度的金刚砂车针进行预备,聚醚橡胶制取肩台区印模,三维形貌测量激光显微镜(three-dimensional topography measurement laser microscope, 3-D TMLM)扫描印模并比较表面粗糙度。(2)6颗离体前磨牙颊侧的近、远中分别使用金刚砂车针和超声器械进行预备,聚醚橡胶制取肩台区印模,3-D TMLM扫描印模并比较表面粗糙度,牙科显微镜(×25)观察肩台表面形态。(3)上颌对称同名离体前牙20颗,灌注标准模型后随机分为超声器械组和金刚砂车针组,于仿头模上牙体预备后聚醚橡胶制取肩台印模;扫描并对比肩台印模近中、中央、远中区域表面粗糙度。用SPSS 25.0软件进行统计学分析。结果: (1)不同区域内预备体肩台和印模肩台的Ra和Rz差异均无统计学意义。(2)超声器械预备后肩台印模表面粗糙度[Ra:(6.59±2.33) μm,Rz:(34.69±7.29) μm]明显小于金刚砂车针[Ra:(21.79±4.89) μm,Rz:(91.69±14.82) μm](P<0.05);牙科显微镜下可见超声预备的肩台形态清晰连续。(3)超声器械预备后肩台印模各区域的表面粗糙度Ra均小于金刚砂车针,其差异有统计学意义(P<0.001);超声器械预备后肩台印模各区域表面粗糙度Ra的差异无统计学意义,而金刚砂车针预备后肩台印模在近中及远中区域的表面粗糙度Ra均大于中央区域,其差异有统计学意义(P<0.001)。结论: 超声器械可获得更光滑的肩台表面,尤其可以显著改善肩台近邻面处的预备效果。

关键词: 超声器械, 肩台预备, 粗糙度, 三维形貌, 印模

Abstract:

Objective: To provide the basis for the clinical development of ultrasonic shoulder preparation by comparing the roughness and three-dimensional topography of shoulder surface between ultrasonic instruments and conventional rotary instruments, to make preliminary suggestions for clinical use of ultrasonic instruments.Methods: (1) Four areas of buccal and palatal surfaces of six extracted human premolars were prepared with different grit size of rotary instruments. Polyether was used to take impression of the shoulder area, 3-D topography measurement laser microscope (3-D TMLM) was used to scan the impressions and compare the shoulder surface roughness of the four areas. (2) Six extracted human premolars were prepared, mesial half of the shoulder was finished with traditional rotary instruments and distal half with ultrasonic instruments. Polyether was used to take impression of the shoulder area, 3-D TMLM was used to scan the impressions and compare the shoulder surface roughness and 3-D topography, and the shoulder surface morphology was observed by surgical microscope (×25 magnification). (3) Twenty extracted human maxillary symmetrical homonymous anterior teeth were poured into die stone using artificial gingiva, ultrasonic instruments group and rotary instruments group were divided randomly. After preparing the teeth and taking the shoulder impression with polyether in dental simulate on the training system, the surface roughness of the shoulder impression in mesial, middle and distal areas was scanned and compared. The data were analyzed using SPSS 25.0 software package.Results: (1) There was no significant difference in Ra and Rz values between the abutment shoulder and impression shoulder in different areas. (2) The surface roughness of the shoulder impression prepared by ultrasonic instruments [Ra:(6.59±2.33) μm, Rz:(34.69±7.29) μm] was significantly smaller than that of the rotary instruments [Ra:(21.79±4.89) μm, Rz:(91.69±14.82) μm] (P<0.05). The morphology of the shoulder prepared by ultrasonic instruments was clear and continuous under microscope observation. (3) The surface roughness of each area of the shoulder prepared by ultrasonic instruments was significantly lower than that of the rotary instruments (P<0.001); there was no significant difference of the surface roughness (Ra) in each area of the shoulder impression after ultrasonic instrument preparation, while the shoulder impression roughness in the mesial and distal areas was significantly higher than that in the middle area (P<0.001) after rotary instrument preparation.Conclusion: Compared with the rotary instruments, the ultrasonic instruments can obtain a smoother shoulder surface, especially can significantly improve the shoulder preparation effect near the proximal surface.

Key words: Ultrasonic Instruments, Margin Preparation, Roughness, 3-D surface topography, Impression

中图分类号: 

  • R783.4

图1

不同区域的车针预备顺序"

图2

离体前磨牙按不同区域分别使用金刚砂车针和超声预备肩台"

图3

口内超声器械套装牙体预备顺序"

图4

不同粗糙度金刚砂车针预备后的预备体和印模肩台表面扫描照片"

表1

不同粗糙度金刚砂车针预备后的预备体和印模肩台表面的粗糙度"

Items Area 1 Area 2 Area 3 Area 4
Ra/μm Abutment 37.31±6.37 22.94±6.83 17.96±8.11 13.53±5.62
Impression 30.20±5.82 21.73±5.40 19.32±3.90 11.46±2.22
Rz/μm Abutment 196.19±34.83 145.10±28.40 114.28±21.99 87.93±14.79
Impression 185.61±32.46 136.76±27.87 126.10±19.69 79.68±16.12

表2

超声器械和金刚砂车针预备后的肩台表面粗糙度"

Items Ultrasonic instruments Rotary instruments t value P value
Ra/μm Abutment 5.92±2.28 18.13±3.77 4.80 <0.001
Impression 6.59±2.33 21.79±4.89 5.10 <0.001
Rz/μm Abutment 29.01±5.91 80.99±12.02 7.10 <0.001
Impression 34.69±7.29 91.69±14.82 8.09 <0.001

图5

超声器械和金刚砂车针预备后的预备体和印模肩台表面显微形貌三维重建图"

图6

超声器械和金刚砂器械预备肩台的牙科显微镜下成像(×25)"

图7

超声器械和金刚砂车针预备后肩台印模不同区域的表面粗糙度比较"

图8

超声预备后和金刚砂车针预备后印模肩台表面不同区域的显微形貌三维重建图"

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