超薄瓷贴面和传统瓷贴面临床效果的比较与评价

发布时间：2018-05-08 11:17

本文选题：超薄不备牙贴面 + 传统备牙贴面　；参考：《安徽医科大学》2017年硕士论文

【摘要】：人类的牙齿不仅是直接行使咀嚼的器官,而且对发音、言语及保持面部协调美观均具有重要作用[1]。根据牙齿在牙列中的位置和功能可分为前牙和后牙,前牙发挥美学的功能相对后牙来说作用较大。患者前牙过小牙、畸形牙、四环素牙、氟斑牙、着色牙、切端少量缺损等异常牙齿会严重影响患者美观及患者自信心,甚至可能会影响患者心理健康。伴随着生活质量和审美观念的提高,患者对于前牙区牙齿所展现的美学要求越来越高;但是对于患者前牙区的美学修复治疗,一直都是口腔医师的挑战。Buonocore[2]发明的酸蚀粘结技术和Bowen[3]发明的树脂粘结剂的临床应用,增加了医师临床上对于前牙区美学修复治疗方案的选择,这些早期研究的发明发现,使得现代瓷贴面的临床应用变为可能。相对于全冠、部分冠等其他修复方式,瓷贴面具有少量备牙甚至不用备牙、创伤最小、强度高、生物相容性优及美观性能好等优势,目前已被临床医师和患者广泛接受。现代瓷贴面根据备牙量的有无可分为传统备牙瓷贴面和不备牙超薄瓷贴面。传统贴面应用于临床时间较长些,其临床效果已得到学者一致公认;随着陶瓷材料和计算机技术的发展,贴面最薄处可达0.2毫米(mm),临床上可无需备牙或仅去除牙体组织倒凹即可,此即超薄不备牙瓷贴面。超薄贴面应用于临床时间相对传统贴面时间较短,但因其创伤最小、美观效果好、生物相容性优等,加之2009年Koirala学者提出“口腔微创美容观念”的理念和治疗方案受到临床医师和专家的高度评价和重视,目前超薄贴面也备受大部分临床医师和患者的亲睐。目的本课题通过观察比较超薄不备牙瓷贴面和传统瓷贴面的临床效果,从而分析评估超薄不备牙瓷贴面的短期临床应用效果。方法1、医师电话预约一年前制作超薄瓷贴面和传统贴面的34位患者,其中包括实验组54颗前牙进行的超薄不备牙贴面修复和对照组57颗前牙进行的传统备牙贴面修复。所有修复体均属于对接型,均是同一家义齿加工厂采用Ivoclar Vivadent公司推出的IPS e.max HT瓷块加工而成,因位于前牙美学区,修复体边缘均采用龈下边缘设计;2、复诊时,由同一位医师对患者基牙的敏感性、继发龋、牙龈情况及修复体颜色的匹配性、边缘密合性、边际着色情况进行检查并记录,评价的标准采用Kihn介绍的改良Ryge标准及Silness和Joe介绍的牙龈检查方法,对其检查结果采用卡方检验进行统计分析。结果患者修复一年后复诊检查时,实验组超薄瓷贴面和对照组传统瓷贴面均无继发龋、术后敏感和边缘着色情况的发生,两组修复体的边缘密合性、颜色满意度及牙龈反应复查结果均是P0.05,两组差异无统计学意义。结论超薄不备牙贴面短期临床修复的效果不亚于传统贴面短期临床修复效果。
[Abstract]:Human teeth are not only a direct masticatory organ, but also play an important role in pronunciation, speech and facial harmony [1]. According to the position and function of teeth in dentition, the anterior teeth can be divided into anterior teeth and posterior teeth. The aesthetic function of anterior teeth is more important than that of posterior teeth. Abnormal teeth, such as anterior teeth, deformed teeth, tetracycline teeth, fluorosis teeth, stained teeth and a few defects at the incisors, may seriously affect the beauty and confidence of the patients, and may even affect the mental health of the patients. With the improvement of quality of life and aesthetic concept, the aesthetic requirements of the anterior teeth are higher and higher, but the aesthetic restoration of the anterior teeth is more and more important. It has always been a challenge for stomatologists. Buonocore and Bowen [3] invented the acid-etching bonding technique and the clinical application of resin binders, which increased the choice of clinical treatment options for aesthetic restoration of anterior teeth. It makes the clinical application of modern porcelain veneer possible. Compared with other restoration methods, such as full crown, partial crown and so on, porcelain veneer has the advantages of little or no tooth preparation, minimal trauma, high strength, excellent biocompatibility and good aesthetic performance, and has been widely accepted by clinicians and patients. Modern porcelain veneer can be divided into traditional enamel veneer and unprepared ultra-thin porcelain veneer according to the number of teeth. With the development of ceramic materials and computer technology, the clinical effect of traditional veneer has been recognized by scholars as it has been used for a longer period of time. The thinnest part of the veneer can be up to 0.2 mm / mm, and no need to prepare teeth or just remove the inverted concave of tooth tissue can be removed clinically, which is called ultra-thin and unprepared porcelain veneer. The clinical time of ultra-thin veneer is shorter than that of traditional veneer, but because of its minimal trauma, good aesthetic effect, excellent biocompatibility, etc. In addition, in 2009, Koirala scholars put forward the concept and treatment of "oral minimally invasive beauty concept" by clinicians and experts of high praise and attention, the current ultra-thin veneer is also favored by most clinicians and patients. Objective by observing and comparing the clinical effects of ultra-thin porcelain veneer and traditional porcelain veneer, this paper analyzed and evaluated the short-term clinical application effect of ultra-thin and unprepared dental porcelain veneer. Methods 1. 34 patients with ultra-thin porcelain veneer and traditional veneer were made by telephone, including 54 unprepared teeth in the experimental group and 57 in the control group. All the prostheses are of the docking type. They are all made from the same denture factory using the IPS e.max HT porcelain from Ivoclar Vivadent. Because they are located in the aesthetic area of the anterior teeth, the edges of the restoration are all designed by the subgingival edge design. The sensitivity of abutment teeth, secondary caries, gingival conditions and color matching of prostheses, edge compactness, marginal coloring were examined and recorded by the same physician. The evaluation criteria were modified Ryge standard introduced by Kihn and gingival examination method introduced by Silness and Joe. The results were statistically analyzed by chi-square test. Results there were no secondary caries on the ultra-thin porcelain veneer in the experimental group and the traditional porcelain veneer in the control group, the sensitivity and edge coloration of the two groups were observed, and the edge tightness of the two groups was observed. The results of color satisfaction and gingival reaction were P 0.05, there was no significant difference between the two groups. Conclusion the effect of short-term clinical restoration of unprepared tooth veneer is no less than that of traditional veneer.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.9

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