洞缘设计对CAD/CAM瓷嵌体边缘质量和边缘适应性及微渗漏的影响  

Influence of cavity design on quality of margin and marginal adaptation and microleakage of all-ceramic CAD/CAM inlays

作　　者：赵思铭 王晓燕[1] ZHAO Si-ming;WANG Xiao-yan(Department of Cariology and Endodontology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry&NMPA Key Laboratory for Dental Materials,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院牙体牙髓科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京100081

出　　处：《北京大学学报（医学版）》2023年第6期1105-1110,共6页Journal of Peking University:Health Sciences

基　　金：中华口腔医学会青年临床科研基金全瓷材料研究项目(CSA-P2019-04)。

摘　　要：目的:研究不同洞缘设计(135°洞缘斜面和90°洞缘)对不同材质计算机辅助设计/计算机辅助制造(computer aided design/computer aided manufacturing,CAD/CAM)瓷嵌体边缘质量、边缘适应性及微渗漏的影响。方法:100颗人磨牙冠部进行颊牙合面(buccal occlusal,BO)洞嵌体预备,其中颊侧的近中和远中预备体边缘分别采用135°洞缘斜面和90°洞缘设计。均分五组,分别采用VitaBlocs MarkⅡ、Upcera UP.CAD、IPS e.max CAD、Upcera Hyramic和Lava Ultimate瓷块,Sirona CEREC AC椅旁CAD/CAM系统制作瓷嵌体,体视镜观察嵌体近、远中边缘的完整性及间隙。就位粘接后冷热循环10000次,均置于5%(质量分数)碱性品红溶液染色24 h,并垂直牙长轴于嵌体颊侧的牙合1/3、中1/2、颈1/3切开,体视镜下观测微渗漏深度。结果:135°边缘,Upcera Hyramic和Lava Ultimate组的边缘完整率、平均边缘间隙和平均微渗漏深度均优于VitaBlocs MarkⅡ、Upcera UP.CAD和IPS e.max CAD组(P<0.05);90°边缘,Upcera Hyramic和Lava Ultimate组的平均边缘间隙、平均微渗漏深度和平均微渗漏深度评分均优于Upcera UP.CAD和IPS e.max CAD组(P<0.05),边缘完整率差异无统计学意义(P>0.05))。各组内,90°边缘的边缘完整率优于135°边缘(P<0.05),平均微渗漏深度差异无统计学意义(P>0.05),VitaBlocs MarkⅡ和IPS e.max CAD组内90°边缘的平均边缘间隙优于135°边缘(P<0.05),Upcera UP.CAD、Upcera Hyramic和Lava Ultimate组内差异无统计学意义(P>0.05);Upcera Hyramic和Lava Ultimate组内135°边缘的平均渗透深度评分优于90°边缘(P<0.05),VitaBlocs MarkⅡ、Upcera UP.CAD和IPS e.max CAD组内差异无统计学意义(P>0.05)。结论:嵌体修复时,预备体的近、远中边缘应采用90°边缘设计。Objective:To investigate the influence of 135°and 90°cavity design on quality of margin and marginal adaptation and microleakage of all-ceramic computer aided design/computer aided manufacturing(CAD/CAM)inlays.Methods:One hundred extracted human molars were prepared by criteria of buccal occlusal(BO)inlay.On the buccal,the mesial margin was prepared as 135°bevel while the distal margin was prepared as butt-joint.All-ceramic restorations were made in the Sirona CEREC AC CAD/CAM system with VitaBlocs MarkⅡ,Upcera UP.CAD,IPS e.max CAD,Upcera Hyramic and Lava Ultimate.The gaps between each inlay’s mesial margin-abutment and distal margin-abutment were recorded under an optical microscope.Each inlay was adhered to the abutment and aged by thermal cycling for 10000 times.Each specimen was cut into 3 slices after staining.Dye penetration was evaluated under an optical microscope for mesial and distal margins.Results:Mean marginal integrity rate,mean marginal gap value and mean depth of microleakage of 135°margin of Group Upcera Hyramic and Lava Ultimate were significantly better than those of Group VitaBlocs MarkⅡ,Upcera UP.CAD and IPS e.max CAD(P<0.05).Mean marginal gap value,mean depth of microleakage and scale of mean depth of microleakage of 90°margin of Group Upcera Hyramic and Lava Ultimate were significantly better than those of Group Upcera UP.CAD and IPS e.max CAD(P<0.05)while mean marginal integrity rate was not significantly different(P>0.05).Mean marginal integrity rate of 90°margin was significantly better than that of 135°margin in each group(P<0.05)while mean depth of microleakage between different margins was not significantly different in each group(P>0.05).Mean marginal gap value of 90°margin of Group VitaBlocs MarkⅡand IPS e.max CAD was significantly better than that of 135°margin(P<0.05)while there was not significant difference in other 3 groups between 90°and 135°margin(P>0.05).Scale of mean depth of microleakage of 135°margin of Group Upcera Hyramic and Lava Ultimate was signif

关 键 词：CAD/CAM 洞缘设计 边缘完整 边缘间隙 微渗漏 

分 类 号：R783.1[医药卫生—口腔医学]