椅旁CAD-CAM二硅酸锂玻璃陶瓷全冠的修复效果评价  

Clinical performance of chairside monolithic lithium disilicate glass-ceramic CAD-CAM crowns

作　　者：陈月靖 姚瑶[1] 罗傲翔 CHEN Yuejing;YAO Yao;LUO Ao-xiang(Stomatological Center,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China)

机构地区：[1]北京大学深圳医院口腔医学中心,广东深圳518036

出　　处：《上海口腔医学》2021年第2期191-195,共5页Shanghai Journal of Stomatology

基　　金：广东省自然科学基金(S2012010010382)。

摘　　要：目的:探讨椅旁计算机辅助设计与计算机辅助制作(CAD-CAM)二硅酸锂玻璃陶瓷全冠的修复效果,并分析累积生存率的影响因素。方法:将2015年3月-2017年3月于北京大学深圳医院完成椅旁Cerec系统制作的二硅酸锂玻璃陶瓷修复体修复的214例牙体缺损患者作为研究对象。备牙后,进行光学印模,采用椅旁Cerec系统设计和制作修复体,最后完成试戴与粘接。评价修复体3、6、12、24和36个月的临床效果和美学效果,计算修复体累积生存率,分析性别、年龄、牙髓状况、修复牙位置和粘接剂种类对累积生存率的影响。采用SPSS 20.0软件包对数据进行统计学分析。结果:经36个月的随访,修复体失败的原因主要体现在边缘密合性、修复体崩瓷和修复体脱落;3、6、12、24和36个月时,患者对修复体牙冠色彩渐变反应、牙冠形状、近端接触质量及咀嚼能力均大于9分;修复体累积生存率分别为100.00%、96.17%、94.89%、92.77%和91.06%;不同性别、年龄、牙髓状况间修复体累积生存率无显著差异(P>0.05)。结论:椅旁CAD-CAM二硅酸锂玻璃陶瓷全冠修复体3年累积生存率较高且可获得较满意的美学效果,性别、年龄、牙髓状况对累积生存率影响不大。PURPOSE: To investigate the clinical performance of chairside monolithic lithium disilicate glass-ceramics computer-aided design(CAD)-computer aided manufacturing(CAM) crowns, and to analyze the influencing factors of cumulative survival rate. METHODS: Two hundred and fourteen patients who had chairside posterior lithium disilicate glass-ceramic CAD-CAM crowns in Peking University Shenzhen Hospital from March 2015 to March 2017 were enrolled. The crown preparations were milled using Cerec Omnicam system. The clinical and esthetic effects of the crowns were analyzed at 3, 6, 12, 24, and 36 months. The cumulative survival rate of crowns was calculated, and the effects of gender, age, pulp condition, tooth position and adhesive type on the cumulative survival rate were analyzed. SPSS 20.0 software package was used for statistical analysis. RESULTS: After a 36-month follow-up, the failed crowns were mainly caused by marginal integrity, crown fracture and loss of retention. During the observation period of 3, 6, 12, 24 and 36 months, the scores of color, shape, quality of proximal contact, and chewing ability were greater than 9. The cumulative survival rates were 100.00%, 96.17%, 94.89%, 92.77% and 91.06% at 3, 6, 12, 24 and 36 months, respectively. The cumulative survival rate had no significant difference among different gender, age, and dental pulp sta-tus(P >0.05). CONCLUSIONS: Chairside monolithic lithium disilicate glass-ceramic CAD-CAM crowns have a high3-year cumulative survival rate and good esthetic outcome, which is not affected by gender, age, and pulp status with high clinical value.

关 键 词：椅旁CAD-CAM 二硅酸锂玻璃陶瓷 牙体缺损 全冠 累积生存率 美学效果 

分 类 号：R783.3[医药卫生—口腔医学]