不同印模方式及肩台形态对全瓷冠边缘密合性的影响-口腔临床医学专业论文.docxVIP

摘要 摘要 万方数据 万方数据 摘 要 目的： 研究 CAD/CAM 技工室系统中不同光学印模方法及肩台形态对氧化锆全锆 冠的边缘密合性的影响，为临床牙体预备及印模方式的选择提供参考。 方法： 设计并制备右下第一磨牙全冠预备体代型 16 个，按肩台形态不同分为 4 组 （n=4），分别为直角肩台组，直角斜面组，凹面肩台组，凹面斜面组；采用 CAD/CAM 技工室系统直接法、硅橡胶阴模法和间接法对各组代型进行光学数据 采集，制作 48 个氧化锆全锆冠。采用硅橡胶复制法和体视显微镜法评价各肩台 组及印模组代型的全冠边缘间隙。平均边缘间隙＜100μm 时，为临床可接受范 围，采用 SPSS17.0 软件对实验数据进行统计分析。 结果： 三组印模方式中，平均边缘间隙直接法扫描组（空白组）＜硅橡胶法扫描 组（硅橡胶组）＜间接法扫描组（超硬石膏组），其中，空白组全冠边缘间隙 明显小于硅橡胶组和超硬石膏组，差异有统计学意义（P＜0.05）。对比印模方 式，肩台形态对全冠边缘间隙的影响更大。平均边缘间隙 凹面斜面组＜直角斜 面组＜凹面肩台组＜直角肩台组。凹面斜面组的全冠边缘间隙与其他三组相比 有显著差异（P＜0.01）。直角肩台组肩台区间隙厚度均一，而凹面肩台组肩台 区间隙厚度从代型轴面转角处到边缘处，间隙呈现逐渐增大的趋势，在边缘处 最大，甚至超过临床可接受的 100μm 的界限。 结论： ①在 CAD/CAM 技工室系统下，硅橡胶组和超硬石膏组模型都有一定程度 “失真”，但精度都在临床可接受范围内。②凹面斜面的边缘密合性最佳，斜 面能显著减小全冠边缘间隙。 关键词：边缘间隙；肩台形态；硅橡胶阴模；超硬石膏模型；CAD/CAM 技工 室系统；氧化锆全瓷冠； III ABSTRACT Objective: To study the effects of different optical impression methods in CAD/CAM inlab system and finish line type on marginal adaption of Zirconium dioxide all-ceramic crown ，and to provide references for clinical tooth preparation and impression pattern. Methods: sixteen right mandibular first molar in the standard model were designed and prepared. Based on finish line, they were divided into 4 groups (n=4): shoulder (Group A), shoulder with bevel (Group B), chamfer (Group C), and chamfer with bevel (Group D); direct method, silicone rubber impression and indirect method for CAD/CAM inlab system were used to carry out optical impression and manufacture 48 zirconia dioxide all-ceramic crown. The marginal fit of the crowns was evaluated with a replica technique and measured with a travelling microscope. The mean full crown marginal discrepancy＜100μm was clinically acceptable. SPSS17.0 was used to conduct statistical analysis of the experimental data. Results: In the three impression groups, direct scanning (control group)＜ silicone rubber scanning (silicone rubber group)＜ indirect scanning (die stone group). The full crown marginal discrepancy of the control group was obviously lower the silicone rubber group a