【摘要】：目的:本實(shí)驗(yàn)旨在研究CAD/CAM技術(shù)條件下,不同的肩臺(tái)寬度對(duì)全解剖式二氧化鋯冠抗壓縮破壞力的影響,以及模擬口腔冷熱微環(huán)境的冷熱循環(huán)實(shí)驗(yàn)前后全鋯冠的抗壓縮破壞力有無(wú)變化,從而為臨床的牙體預(yù)備、加工廠的修復(fù)體制作以及全鋯冠的推薦使用年限提供依據(jù)。方法:1金屬代型的制作通過基牙的設(shè)計(jì)軟件Abutment Designer對(duì)日進(jìn)齒科標(biāo)準(zhǔn)下頜第一磨牙進(jìn)行基牙掃描,參考《口腔修復(fù)學(xué)》教材中的基牙預(yù)備原則進(jìn)行基牙設(shè)計(jì)�；赖念A(yù)備標(biāo)準(zhǔn)為:鄈面功能尖磨除1.5mm,非功能尖磨除1.0mm,軸面聚合度為8°,刃狀或平齦淺凹直角肩臺(tái),各部位無(wú)倒凹、無(wú)應(yīng)力集中區(qū)。根據(jù)實(shí)驗(yàn)設(shè)計(jì)肩臺(tái)寬度分別為刃狀、0.3mm、0.5mm、1.0mm。將設(shè)計(jì)好的預(yù)備體3D模型數(shù)據(jù)傳輸給CAD切割機(jī),選擇專用的鑄造蠟以1:1的比例加工24個(gè)預(yù)備體蠟型,常規(guī)包埋、鑄造、打磨、噴砂完成金屬代型的制作。2修復(fù)體的制作將24個(gè)金屬代型用橡皮泥固定在掃描儀觀測(cè)臺(tái)上,掃描出預(yù)備體的3D模型,隨即將數(shù)據(jù)導(dǎo)入到Dental Designer軟件,系統(tǒng)會(huì)自動(dòng)生成下頜第一磨牙的標(biāo)準(zhǔn)解剖形態(tài)的修復(fù)體。根據(jù)實(shí)驗(yàn)需要利用虛擬調(diào)改刀修整至鄈面厚度為均勻的1.0mm厚度,冠邊緣處與金屬代型的肩臺(tái)平滑相接。即全鋯冠的肩臺(tái)處冠的厚度分別為刃狀、0.3mm,0.5mm,1.0mm,然后把所得到的數(shù)據(jù)傳遞給CAD切割機(jī)。完成全鋯冠的制作。具體分組:鄈面厚度1.0mm,刃狀肩臺(tái)、0.3mm、0.5mm、1.0mm各6個(gè)分別定為A、B、C、D組。用D組的代型再制作出一組鈷鉻烤瓷冠,E組作為作為對(duì)照組。全部試件用3M玻璃離子粘接于代型上。用萬(wàn)能實(shí)驗(yàn)機(jī)測(cè)量斷裂時(shí)的抗壓縮破壞力。統(tǒng)計(jì)學(xué)分析后選擇肩臺(tái)寬度為0.5mm組進(jìn)行冷熱循環(huán)實(shí)驗(yàn)。即鄈面厚度1.0mm,肩臺(tái)寬度0.5mm組再制作18個(gè)全鋯冠修復(fù)體,依據(jù)不同的冷熱循環(huán)次數(shù)分為三組,分別為C1、C2、C3。3冷熱循環(huán)實(shí)驗(yàn)將C1、C2、C3進(jìn)行冷熱循環(huán)實(shí)驗(yàn),循環(huán)次數(shù)分別為10000次、20000次、30000次。實(shí)驗(yàn)參數(shù):5℃和55℃的恒溫水箱中各浸泡30s,間隔5s,冷熱交替直至達(dá)到預(yù)計(jì)次數(shù)。4抗壓縮破壞力實(shí)驗(yàn)將制作完成的全鋯冠及鈷鉻烤瓷冠用3M玻璃離子分別粘固于相應(yīng)金屬代型上,指壓就位,以15Kg的力持續(xù)加壓5min,去除多余的粘固劑,室溫靜置24小時(shí)后備用。將粘結(jié)好的全冠按順序依次置于萬(wàn)能試驗(yàn)機(jī)上進(jìn)行強(qiáng)度測(cè)試,加載頭以0.5mm/s的恒定速度加載于全冠的功能尖上,直至全冠破壞為止,記錄數(shù)值。5統(tǒng)計(jì)學(xué)分析使用SPSS13.0軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。Kolmogorov-Smirnov和Shapiro-Wilk檢驗(yàn)數(shù)據(jù)是否符合正態(tài)性分布(ɑ=0.1)。Levenes test對(duì)數(shù)據(jù)進(jìn)行方差齊性檢驗(yàn)(ɑ=0.1)。在本次實(shí)驗(yàn)中數(shù)據(jù)均滿足正態(tài)性及方差齊性檢驗(yàn)(P0.1),實(shí)驗(yàn)數(shù)據(jù)可以用均數(shù)±標(biāo)準(zhǔn)差表示(SX±)。用單因素方差分析比較不同肩臺(tái)寬度全鋯冠的抗壓縮破壞力有無(wú)組間差別,若組間有差別再用Student-Newmen-Keuls進(jìn)行組間的兩兩比較。P0.05認(rèn)為有統(tǒng)計(jì)學(xué)意義。結(jié)果:1各組全冠的抗壓縮破壞力A 組:(3855.00 ± 305.47)N,B 組:(2731.70 ± 261.80)N,C 組:(3698.30± 276.87)N,D 組:(3841.70± 544.88)N,E 組:2992.17± 168.41 N,C1 組:(3220.00 ± 504.38)N,C2 組:(3148.33 ± 425.60)N,C3 組:(3572.00± 545.30)N。2肉眼觀察對(duì)所有的42例全鋯冠樣本進(jìn)行宏觀觀察分析。所有全鋯冠的實(shí)驗(yàn)試件均為全瓷層的斷裂,裂紋走向具有相似性。首先出現(xiàn)在加載點(diǎn)的下方,然后從加載點(diǎn)向外延伸。主要裂紋走向有兩種:沿功能尖的邊緣嵴裂成兩部分(20例);沿功能尖的牙尖嵴裂開(17例),其余無(wú)特殊規(guī)律(5例)。鈷鉻烤瓷冠的破壞為瓷層的破壞與剝脫。3統(tǒng)計(jì)學(xué)分析各組實(shí)驗(yàn)數(shù)據(jù)均符合正態(tài)性及方差齊性,5組全冠的抗壓縮破壞力進(jìn)行單因素方差分析:各組間的抗壓縮破壞力有統(tǒng)計(jì)學(xué)意義(P0.05),即組間存在差異。進(jìn)行組間的兩兩比較,B組、E組與A組、C組、D組之間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。而B組、E組之間差異無(wú)統(tǒng)計(jì)學(xué)意義,A組、C組、D組之間差異也沒有統(tǒng)計(jì)學(xué)意義。相同肩臺(tái)寬度(0.5mm組),在冷熱循環(huán)10000次、20000次、30000次后,其抗壓縮破壞力沒有統(tǒng)計(jì)學(xué)差異。結(jié)論:1通過與鄈面厚度為1.5mm的鈷鉻烤瓷冠強(qiáng)度對(duì)比表明,對(duì)于鄈面厚度為1.0mm的全鋯冠而言,無(wú)論是刃狀還是0.3mm或以上的肩臺(tái)均可滿足臨床的需要。2冷熱循環(huán)次數(shù)對(duì)全鋯冠抗壓縮破壞力沒有影響(限于本實(shí)驗(yàn)30000次以內(nèi))。
[Abstract]:OBJECTIVE: To study the effects of different shoulder widths on the compression resistance of fully dissected zirconia crowns under CAD/CAM conditions, and whether the compression resistance of the full-dissected zirconia crowns has changed before and after the cold-hot cycling test in simulated oral cold and hot microenvironment, so as to prepare Clinical teeth, fabricate prosthetic system of the processing factory and Methods: 1. The metal substitution was made by Abutment Designer to scan the mandibular first molars, and the abutment teeth were designed according to the principle of abutment teeth preparation in the textbook of prosthodontics. According to the experiment, the width of shoulder platform is designed as edge, 0.3 mm, 0.5 mm, 1.0 mm. The 3D model of the prepared body is transmitted to CAD cutter, and the special casting wax is selected to process 24 preparations in 1:1 ratio. Body wax, routine embedding, casting, grinding, sandblasting complete the production of metal substitutes. 2 Prosthetic production of 24 metal substitutes with rubber mud fixed on the scanner observatory, scanned the 3D model of the reserve, and then imported the data into Dental Designer software, the system will automatically generate the restoration of the standard anatomical form of the first mandibular molar. The crown edge of the zirconium crown is smoothly connected with the shoulder platform of the metal model. The thickness of the crown at the shoulder platform of the zirconium crown is 0.3 mm, 0.5 mm, 1.0 mm respectively, and then the obtained data is transmitted to the CAD cutter. The whole zirconium crown is made. Specific grouping: 1. Group A, B, C and D were made with the substitutes of group D. Group E was used as the control group. All the specimens were bonded with 3M glass ions to the substitutes. Eighteen zirconium crowns were fabricated in group 1.0 mm thick and 0.5 mm wide, and were divided into three groups according to the number of cycles: C1, C2 and C3.3. The cycles of C1, C2 and C3 were 10 000, 20 000 and 30 000, respectively. The zirconium crowns and cobalt-chromium porcelain crowns were bonded to the corresponding metal substitutes by 3M glass ions respectively in the constant temperature water tank for 30 seconds, 5 seconds apart, alternating heat and cold until the expected number of times was reached. Bonded crowns were placed sequentially on the universal testing machine for strength testing. The loading head was loaded on the functional tip of the crown at a constant speed of 0.5mm/s until the crown was destroyed. The recorded values were statistically analyzed using SPSS13.0 software. Kolmogorov-Smirnov and Shapiro-Wilk were used to test whether the data were true or not. Levenes test was used to test the data for the homogeneity of variance (_ = 0.1). In this experiment, the data were all tested for the homogeneity of normality and variance (P 0.1). The experimental data can be expressed by mean (+) standard deviation (SX (+). The compressive failure resistance of full zirconium crowns with different shoulder widths was compared by one-way ANOVA. P 0.05 showed that there was statistical significance. Results: 1 The anti-compression destructive power of all crowns in group A: (3855.00 (+305.47) N, group B: (2731.70 (+261.80) N, group C: (3698.30 (+276.87) N, group D: (3841.70 (+544.88) N, group E: 2992.17 (+168.41), group C1: (3220.00 (+50.50). 4.38) N, C2 group: (3148.33 + 425.60) N, C3 group: (3572.00 + 545.30) N. There were two kinds of fracture: the marginal ridge of the functional cusp was divided into two parts (20 cases), the ridge of the functional cusp was split (17 cases), and the rest had no special rule (5 cases). The destruction of the cobalt-chromium porcelain crown was the destruction and exfoliation of the porcelain layer. Analysis: There were significant differences in the anti-compression destructive power among groups (P 0.05), that is, there were differences between groups. There were significant differences between groups B, E and A, C and D (P 0.05). There was no significant difference in the compressive destructive force between the two groups after 10 000 cycles, 20 000 cycles and 30 000 cycles. Conclusion: 1. Comparing with the strength of cobalt-chromium porcelain crowns with 1.5 mm of VI thickness, the edge-shaped or 0.3 mm or more of the full zirconium crowns with 1.0 mm of VI thickness can meet the clinical needs. It has no effect on the compressive strength of all zirconium crown (limited to 30000 times in this experiment).
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R783.3

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