CAD/CAM数字化瓷贴面在前牙美学修复中的临床应用  

Clinical application of computer aided design and computer aided manufacture(CAD/CAM)porcelain veneer in all ceramic esthetic restorations for anterior teeth

作　　者：黄罡[1] 陶进京 景建龙[1] 高洋 俞青[2] 魏煦[2] HUANG Gang;TAO Jinjing;JING Jianlong;GAO Yang;YU Qing;WEI Xu(Department of Dental Laboratory,Medical School of Nanjing University,Nanjing Stomatological Hospital,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院,南京市口腔医院口腔修复工艺科,江苏南京210008 [2]南京大学医学院附属口腔医院,南京市口腔医院口腔修复科,江苏南京210008

出　　处：《口腔医学》2020年第4期319-323,共5页Stomatology

基　　金：南京市医学科技发展专项资金资助项目(YKK16159)。

摘　　要：目的探讨CAD/CAM数字化瓷贴面在前牙美学修复中应用的短期临床效果。方法对12例患者的52颗前牙采用CAD/CAM数字化瓷贴面进行美学修复,适应证包括前牙散在间隙、切端缺损、氟斑牙与轻中度四环素牙。所有患者经同一医生牙体预备后,采用3Shape Trios口内扫描仪获取光学印模,3Shape CAD软件设计贴面,日本Roland公司DWX-4W齿科切削系统切削德国VITA公司VITABLOCSRTriLuxe三层色瓷块,椅旁即刻完成数字化瓷贴面的制作。根据改良美国公共健康协会USPHS修复体评价标准,分别于修复后完成当日和1、3、6、12个月对CAD/CAM数字化瓷贴面进行随访复查,结果采用χ2检验分析。结果CAD/CAM数字化瓷贴面的修复体外形、边缘适合性、牙龈状况、继发龋和邻面接触点在观察期间表现良好。有2例数字化瓷贴面在粘结1个月后出现牙龈炎症,经检查为龈下残留粘结剂所致,去净粘结剂后长期随访无不适,χ^2检验分析修复体牙龈状况的A级成功率在4个时间节点间差异无统计学意义。12个月内各项评估A级成功率在90%以上。结论CAD/CAM数字化瓷贴面用于前牙美学修复短期临床效果良好,具有快速、微创、美观、适合性好的优点,为前牙美学微创修复提供了一种治疗方式,但其远期效果仍有待进一步观察。Objective To investigate the short-term clinical effects of CAD/CAM digital porcelain veneer on the esthetic restoration of anterior teeth.Methods Fifty-two cases of anterior teeth esthetic restorations in 12 patients were performed by CAD/CAM digital porcelain veneer.The indications included anterior teeth scattered in space,incisor defect,dental fluorosis and mild to moderate tetracycline teeth.After teeth preparation by the same doctor,all patients used 3-shape scanner to obtain optical impression,CAD(3Shape software)to design veneers,Roland Dental Cutting System of Japan to cut VITABLOCSRTriLuxe three-layer ceramic blocks(VITA Company,Germany),and instantly completed the production of digital porcelain veneer in one day.According to the modified USPHS prosthesis evaluation criteria,the digital porcelain veneers were followed up on the baseline and 1,3,6,12 months after restorations.The results were analyzed by the chi-square test.Results The anatomical form,marginal fitness,gingival condition,secondary caries and proximal contact points of digital porcelain veneer were good during the observation period.There were 2 cases of gingival inflammation in digital porcelain veneer after 1 month of bonding,which was caused by residual bonding agent.There was no discomfort in the follow-up after removing the residual bonding agent.But chi-square test showed there was no significant difference in the success rate of grade A of restoration gingival condition at different time points.Within 12 months,the success rate of grade A was more than 90%.Conclusion Digital porcelain veneer has good short-term effect on esthetic restorations for anterior teeth,which has the advantages of being fast,minimally invasive,beautiful looking and good adaptability.It is a new esthetic and minimally invasive dentistry method for anterior teeth,but its long-term effect remains to be further observed.

关 键 词：CAD/CAM 瓷贴面 微创美容牙科 

分 类 号：R783.3[医药卫生—口腔医学]