中国实用口腔科杂志

中国实用口腔科杂志

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前牙超薄瓷贴面美学修复临床效果评价

张蕾，钱冬冬，骆小平   

  1. 南京大学医学院附属口腔医院，南京市口腔医院口腔修复科，江苏  南京  210008
  • 出版日期:2018-08-15 发布日期:2018-09-21

  • Online:2018-08-15 Published:2018-09-21

摘要：

目的    评价超薄瓷贴面用于前牙美学修复的临床效果。方法    对2012年2月至2013年2月于南京市口腔医院口腔修复科就诊的54例要求改善前牙美观患者的126颗前牙，采用IPS e.max Press热压铸二硅酸锂玻璃陶瓷系统高半透性HT色系瓷块制作超薄瓷贴面，口内试戴满意后用光固化树脂黏结剂黏固。修复完成后第1、6个月及第1、2、3、4、5年复诊，参照改良美国公共卫生署（USPHS）评价标准，从继发龋、边缘适合性、外形、颜色匹配和破裂等方面对临床效果进行评价。结果    本研究共制作了126颗超薄瓷贴面进行前牙修复。修复完成后1个月复诊，2颗贴面（1.6%）颜色匹配为B级，其余指标均达A级。修复完成后6个月、1年和2年复诊，所有修复体各项指标均达A级。修复完成后3年复诊，2颗贴面（1.6%）边缘可探及间隙，边缘适合性评为B级。修复完成后4年复诊，2颗贴面（1.6%）切端折裂1 mm，破裂指标为C级。修复完成5年复诊，1颗贴面（0.8%）失访；1颗贴面（0.8%）远中切角部分折裂，破裂指标为C级；5颗贴面（4.0%）边缘有较明显的轻度着色，颜色匹配为B级。所有患牙修复后均无牙髓敏感症状、未见继发龋和牙龈炎。结论    超薄瓷贴面的透光性极佳，颜色自然协调，边缘适合性非常好，临床效果令医患满意，是一种理想的前牙美学修复方法。

关键词: 二硅酸锂玻璃陶瓷, 超薄瓷贴面, 透光性, 美学修复

Abstract:

Objective    To evaluate the clinical aesthetic efficacy of ultra-thin veneers for anterior teeth. Methods    Totally 126 anterior teeth of 54 patients were chosen and restored in Department of Prosthodontics，Nanjing Stomatological Hospital between February 2012 and February 2013. Ultra-thin ceramic veneers were made from IPS e.max Press HT （high translucency） lithium disilicate glass ceramic ingots，and cemented with light-cured resin cement. Patients were interviewed and examined at 1 month，6 months，1 year，2 years，3 years，4 years and 5 years respectively. The clinical evaluation of ultra-thin ceramic veneers was carried out with reference to the criteria of USPHS from the aspects of secondary caries，marginal suitability，appearance，color match and integrity. Results    Totally 126 anterior teeth were restored with ultra-thin ceramic veneers made of IPS e.max Press. After 1 month，2 veneers （1.6%） were B class in color match，and the other indicators were A class. At 6 months，1year and 2 years after restoration，all veneers achieved A class in each evaluation indicator. After 3 years，gap was detected at the margin of 2 veneers （1.6%），which were B class in marginal suitability. After 4 years，2 veneers （1.6%） were C class in integrity with 1mm incisal fracture. At 5 years after restoration，1 veneer （0.8%） was C class in integrity with disto-incisal fracture; slight discoloration was observed in 5 veneers （4.0%），which were B class in color match，and one veneer was lost in follow-up. All the veneers were clinically effective with no sensitivity symptoms，no secondary caries or gingivitis. Conclusion    Ultra-thin ceramic veneers have the advantages of excellent translucency，natural appearance and acceptable marginal suitability，and have been an ideal choice for anterior aesthetic restoration.

Key words: lithium disilicate glass ceramic, ultra-thin veneer, translucency, aesthetic restorations