全锆冠桥修复体的临床应用现状及并发症分析  

Clinical applications and complications of monolithic zirconia crowns and bridges

作　　者：刘恒妍 刘昱晨 李康杰 田敏 牛丽娜 白石柱 方明 LIU Heng-yan;LIUYu-chen;LI Kang-jie;TIAN Min;NIU Li-na;BAI Shi-zhu;FANG Ming(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University,Xi’an 710032,China;State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Digital Dentistry Center,School of Stomatology,The Fourth Military Medical University,Xi’an 710032,China)

机构地区：[1]口颌系统重建与再生全国重点实验室·国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室·第四军医大学口腔医院修复科,西安710032 [2]口颌系统重建与再生全国重点实验室·国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室·第四军医大学口腔医院数字化口腔医学中心,西安710032

出　　处：《口腔颌面修复学杂志》2023年第6期444-454,共11页Chinese Journal of Prosthodontics

基　　金：陕西省重点研发计划(项目编号:2022SF-062);陕西省重点科技创新团队(项目编号:2020TD-033)。

摘　　要：全锆冠桥修复体,即单层氧化锆冠桥修复体,因其机械性能优异,不含饰面瓷结构不易发生崩瓷,对对颌牙磨耗相对较小,采用数字化制作边缘适合性好等优点,受到越来越多临床医生的关注和使用。传统氧化锆强度和韧性高,但半透性不理想,制作的全锆修复体美学效果略差,多用于后牙区。近年来新开发的高透氧化锆、超透氧化锆等材料,美学性能得到显著提高,可用于前牙美学区修复,拓宽了全锆冠桥修复体的临床应用范围。本文对全锆修复体的优缺点、修复后的存留率及其常见并发症进行综述,以期为正确把握全锆冠桥修复体的适应证,延长其使用寿命、减少修复并发症提供临床指导。经过文献检索,目前全锆冠桥临床研究多集中于传统氧化锆,随访时间多为1~5年,临床存留率76.9%~100%。牙支持式全锆冠桥修复体的常见并发症包括修复体折裂/破损、脱落和牙髓并发症;种植体支持式全锆冠桥修复体的常见并发症包括近中邻接丧失、修复体脱落和折裂。可以通过在牙体预备、修复体设计、粘接前处理、抛光等环节中注意相关细节,修复后避免啃咬硬物,并佩戴垫等方式减少并发症的发生。今后还需进一步观察全锆冠桥五年以上的长期临床应用效果,并对高透氧化锆、超透氧化锆进行评估。Monolithic zirconia crowns and bridges,have gained growing popularity due to their advantages,such as excellent mechanical properties,less susceptibility to chipping without veneering ceramics,less wear on the antagonist tooth,and good marginal adaptation by using computer-aided design and computer-aided manufacturing(CAD-CAM)technology.Traditional zirconia has high fracture resistance and toughness.However,it is mostly used in the posterior region since its limited translucency and aesthetic properties.Currently,the aesthetic properties of the newly-developed materials,such as high translucent zirconia and super-translucent zirconia,have been significantly improved.With these materials,monolithic zirconia restorations can be used in anterior esthetic region.The clinical application of monolithic zirconia crowns and bridges have been widened.This paper reviewed the advantages and disadvantages of monolithic zirconia restorations,survival rates,as well as common complications of monolithic zirconia crowns and bridges.On this basis,clinical guidance was provided for better control the indications for monolithic zirconia restorations,reducing complications,and prolonging their longevities.According to the literature review,most of the clinical studies on monolithic zirconia crowns and bridges were focused on traditional zirconia,with the follow-up period of 1 to 5 years and the survival rate is 76.9%to 100%.Common complications of tooth-supported monolithic zirconia crowns and bridges include fracture/abrasion of the restorations,loss of retention and endodontic complications.Common complications of implant-supported monolithic zirconia restorations include open proximal contacts,loss of retention and framework fracture.The occurrence of complications can be reduced by precise tooth preparation,proper restoration design,accurate pretreatment,and effective polishing,etc.Patients should be instructed to avoid hard bite into food and wear an occlusal guard during sleep.Further observation of the long-term clinical appl

关 键 词：单层氧化锆冠 单层氧化锆固定桥 存留率 并发症 

分 类 号：R783.4[医药卫生—口腔医学]