本文選題：牙科全瓷 + 單層結(jié)構(gòu)��； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的 對(duì)四種全瓷材料兩種結(jié)構(gòu)設(shè)計(jì)與制作的片狀試件以及全冠修復(fù)體的顏色再現(xiàn)的差異性進(jìn)行比較，為臨床上合理進(jìn)行全瓷冠修復(fù)設(shè)計(jì)以及全瓷材料的選擇提供參考依據(jù)。 方法 一、實(shí)驗(yàn)室部分： 實(shí)驗(yàn)分組：利用四種全瓷材料，愛爾創(chuàng)ST氧化鋯（Upcera組）、CerconHT氧化鋯（Cercon組）、Vita In-ceram YZ氧化鋯（Vita組）、IPS E.maxPress（IPS組）制作直徑為10mm的方形片狀試件，，每組全瓷材料試件又分為單層結(jié)構(gòu)（M組）和雙層結(jié)構(gòu)（B組）兩組。 單層試件：只用單一全瓷材料通過CAD/CAM切削或熱壓鑄直接形成1.60mm±0.02厚的氧化鋯或鑄瓷試件。 雙層試件：由氧化鋯或鑄瓷基底及燒結(jié)于基底表面的飾瓷兩種全瓷材料制作而成。氧化鋯試件為0.50mm氧化鋯+1.10mm飾瓷；鑄瓷試件為0.80mm鑄瓷+0.80mm飾瓷（厚度誤差控制在±0.02mm）。 對(duì)以上試件進(jìn)行CIE1976L*、a*、b*色度值及透射率的測量并比較分析。 二、臨床部分：在臨床上篩選患者，分別常規(guī)備牙取模比色，在牙科技術(shù)加工中心制作四種不同全瓷材料的單層結(jié)構(gòu)（全鋯冠/全鑄瓷冠）及雙層結(jié)構(gòu)（氧化鋯/鑄瓷內(nèi)冠+飾瓷）的全冠，試戴合適后，對(duì)所有全冠進(jìn)行CIE1976L*、a*、b*色度值的測量，并由10名經(jīng)過比色訓(xùn)練的醫(yī)生及技師進(jìn)行目測評(píng)估，比較修復(fù)體的臨床接受度。 結(jié)果 一、實(shí)驗(yàn)室部分： 色度值同組材料單雙層結(jié)構(gòu)間比較結(jié)果表明Upcera組單雙層試件色差為2.85，色差可接受；Cercon-M組偏紅黃色相；鑄瓷單層試件L*較大，a*、b*較�。籚ita氧化鋯單層試件與雙層試件相比，L*值較小，a*值過大，偏紅。 色度值不同組材料間比較結(jié)果表明IPS-M組的L*、a*、b*最小，Cercon-M組a*、b*較大，偏紅黃，Vita-M組a*值較大，b*較小，偏紅藍(lán)。 透明度同組材料單雙層結(jié)構(gòu)間比較結(jié)果表明Cercon和Upcera兩組高透明的氧化鋯單層與雙層試件的透明度差異沒有統(tǒng)計(jì)學(xué)意義，IPS組和Vita組單層與雙層試件的CR值差異有統(tǒng)計(jì)學(xué)意義。 透明度不同組材料間對(duì)比結(jié)果表明IPS單層試件透明度最高，Vita單層試件透明度最低。 二、臨床部分： 色度值結(jié)果表明：8組冠的L*間的差異沒有統(tǒng)計(jì)學(xué)意義； IPS組的a*、b*值與氧化鋯組的差異有統(tǒng)計(jì)學(xué)意義，a*、b*值偏小。 全瓷材料的結(jié)構(gòu)對(duì)L*、a*、b*值均沒有影響;全瓷材料的種類對(duì)a*、b*值有顯著影響(P＜0.001);全瓷材料的種類和結(jié)構(gòu)的交互作用對(duì)a*值有影響(P=0.040)。 目測評(píng)價(jià)結(jié)果表明：Vita-M組與Cercon-M組臨床接受度最低，評(píng)分均大于3.5，臨床上不被接受；其他6組臨床接受度較高，臨床上均可接受。 全瓷材料的結(jié)構(gòu)和種類對(duì)目測評(píng)分均有顯著性影響，且存在交互作用。 結(jié)論 在本實(shí)驗(yàn)條件下，研究表明： 利用雙層結(jié)構(gòu)進(jìn)行全冠修復(fù)設(shè)計(jì)時(shí)，四種全瓷材料的顏色再現(xiàn)能力及臨床接受程度相同； 利用單層結(jié)構(gòu)進(jìn)行全冠修復(fù)設(shè)計(jì)時(shí)，推薦使用透明度高的全瓷材料。
[Abstract]:Objective to compare the differences of color reproduction of four kinds of all-ceramic materials designed and made of flake specimens and full crown prostheses. It provides reference for clinical design and selection of all-ceramic materials. Method 1. Laboratory part: four kinds of all ceramic materials were used: the square sheet specimens with diameter of 10mm were made by using four kinds of all ceramic materials, the CerconHT zirconia / Cercon group (Vita In-ceram YZ zirconia Vita group) and the IPS E. maxsl IPS group. Each group was divided into two groups: monolayer structure group (M) and double layer structure group (group B). Monolayer specimen: 1.60mm 鹵0.02 thickness zirconia or cast porcelain specimen is directly formed by cutting or hot die-casting with single all-ceramic material by CAD / CAM. Double-layer specimen: made of zirconia or cast porcelain substrate and ceramic ornaments sintered on the substrate surface. The zirconia sample is 0.50mm zirconia 1.10mm decoration porcelain, and the cast porcelain sample is 0.80mm cast porcelain 0.80mm decoration porcelain (thickness error is controlled at 鹵0.02 mm). The colorimetric values and transmittance of CIE1976LX / B * were measured and compared with each other. Second, clinical part: in clinical screening patients, respectively, routine tooth preparation model colorimetry, Four monolayer (total zirconium / cast porcelain crowns) and double layer (zirconia / cast porcelain inner crown) crowns of four different all-ceramic materials were made at the dental technical processing center. After fitting, all crowns were measured by CIE1976L / C / B * chroma. Ten doctors and technicians trained in colorimetry were evaluated visually to compare the clinical acceptance of the prosthesis. The results showed that the chromaticity value of the single and double layers of the Upcera group was 2.85, and the color difference was acceptable in the Cercon-M group, while the single layer sample of cast porcelain was smaller than that of the single layer of the cast porcelain, and the results were as follows: (1) in the laboratory, the chromaticity value of the single layer sample was 2.85, and the color difference was acceptable for the group Cercon-M, while the single layer sample of cast porcelain was smaller. Vita zirconia monolayer specimen has a lower L* value than the double layer specimen, which is too large and red. The results of comparison among the different groups of color values showed that the minimum Cercon-M group in IPS-M group was larger than that in the other two groups, while the red yellow Vita-M group had a larger a * value and a little red blue value in IPS-M group. The results showed that there was no significant difference in transparency between Cercon and Upcera high transparent zirconia monolayers and bilayers. The CR values of IPS and Vita monolayers were significantly different from those of double layers. The results showed that the transparency of IPS monolayer specimen was the highest and the transparency of Vita monolayer specimen was the lowest. Second, the clinical part: the results of chroma value showed that there was no significant difference between the crown L * of the two groups, but the difference between the IPS group and the zirconia group was small. The results showed that there was no significant difference in the color value between the two groups, but the difference between the IPS group and the zirconia group was smaller than that in the control group. The structure of all-ceramic material had no effect on the value of LP0.040 ~ *, the type of all-ceramic material had a significant effect on the value of ~ (1) (P < 0.001), and the interaction between the type and structure of all-ceramic material had an effect on the value of a ~ * (P _ (0.040). The results of visual evaluation showed that the clinical acceptance of the two groups was the lowest, the scores were higher than 3.5, and the other 6 groups had higher clinical acceptance and could be accepted clinically. The structure and type of all-ceramic materials have a significant effect on visual test score, and there is an interaction between them. Conclusion under the condition of this experiment, the results show that the color reproduction ability and clinical acceptance of the four kinds of all-ceramic materials are the same when the double-layer structure is used for the crown restoration design. All-ceramic materials with high transparency are recommended when using monolayer structure for crown restoration design.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.1

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