目的:观察计算机辅助设计与制作一体化氧化锆全瓷桩核修复牙体缺损的临床效果。方法:选取47例患者,72颗牙体缺损的患牙接受了计算机辅助设计与制作的一体化氧化锆全瓷桩核及全瓷冠的修复。临床分为2组,A组: 3壁或4壁牙体缺损患牙39颗,B组: 2壁或1壁牙体缺损患牙33颗。临床观察修复后桩核的稳定性、有无桩核脱落、牙体组织折裂和桩核的折断,同时采用美国公共健康协会(United States Public Health Service,USPHS)的修订标准,观察修复体的颜色匹配性和边缘密合性。结果:47例患者,平均观察约(65.0±4.8)月。在观察期间,通过临床和X线检查,两组均未发现有桩核的脱落、折断和牙体组织的折裂,修复体完整。配对t检验,P>0.05,A、B两组修复效果差异无统计学意义。修复体与邻牙颜色匹配性:A级67颗,B级5颗,颜色匹配率为93.06%;边缘密合性检查:A级64颗,B级8颗,边缘密合度率为88.89%。结论:计算机辅助设计与制作的一体化氧化锆全瓷桩核修复牙体缺损有良好临床效果,可以作为牙体缺损患牙桩核冠修复的一种较好的临床选择。
Objective: To evaluate the effect of computer aided design and computer aided manufacture (CAD/CAM) one-piece zirconia posts and cores for the restoration of defective teeth. Methods: In the study,72 defective teeth of 47 patients who had proper root canal therapy were restored with CAD/CAM onepiece zirconia posts and cores. All the ceramic crowns were finally used to restore contour and function of the teeth. The defective teeth were divided into two groups on the basis of the teeth defect degree. Group A: 39 defective teeth presented with three or four coronal residual walls, and group B: 33 defective teeth presented with less than two coronal residual walls. During the clinical observation period, the stability, dislocation of posts and the occurrence of fractures in either teeth or posts and cores were assessed and analyzed with a paired t test(α=0.05). Meanwhile shade matching was conducted between the restored teeth and normal reference teeth, the marginal fitness of the restored teeth were recorded according to the standard of United States Public Health Service (USPHS) and analyzed with descriptive statistics. Results: The average follow up was (65.0±4.8) months. During the observation period, the restorations were examined both clinically and with periapical radiograph. No incidence of teeth fracture or posts and cores complications were observed in both groups, and all CAD/CAM onepiece zirconia posts and cores remained intact with restored teeth. There were no post and core dislodgement or fracture. There was no difference between group A and group B (P>0.05). The restorative effect of CAD/CAM onepiece zirconia posts and cores with all the ceramic crowns were assessed according to the standard of USPHS, and the number of the restored tooth shade matching with level A was 67, and 5 with level B. The rate of shade matching was 93.06%. As the marginal fitness, 64 restored teeth were level A, and 8 with level B. The rate of restorative teeth marginal fitness was 88.89%.Conclusion: CAD/CAM one-piece zirconia posts and cores were successfully used to restore defective teeth and received excellent clinical effect. So, it can be a good choice for defective teeth which need postcores and crowns restoration.