中国实用口腔科杂志

中国实用口腔科杂志 ›› 2012, Vol. 5 ›› Issue (01): 4-12.

• 专题笔谈 • 上一篇    下一篇

复合树脂直接粘接修复技术在前牙美学修复中的应用

  

  1. 北京大学口腔医学院牙体牙髓科，北京  100081
  • 收稿日期:2011-12-28 出版日期:2012-01-15 发布日期:2012-02-28
  • 作者简介:沈嵩，博士、副教授、副主任医师、硕士研究生导师。现任北京大学口腔医学院牙体牙髓科副主任。先后毕业于北京医科大学口腔医学院和香港大学牙医学院。从事牙体牙髓病学的医疗、教学和科研工作20年，研究领域包括口腔微生物学、龋病学、根管系统的感染控制、复合树脂材料的临床应用及直接粘接美学修复技术。临床经验丰富，擅长显微疑难根管治疗和复合树脂直接粘接美学修复治疗。

  • Received:2011-12-28 Online:2012-01-15 Published:2012-02-28

摘要：

复合树脂充填材料用于牙体修复已超过半个世纪的时间，随着科技的进步，粘接系统和复合树脂材料已达到既牢固又美观的临床使用要求，成为牙体直接修复中的首选技术。复合树脂直接粘接修复技术的适应证包括修复各种原因造成的前牙牙体缺损及色泽、形态的异常等，修复的最终目的是恢复患牙的形态和美观。对于牙釉质的粘接需使用磷酸酸蚀粘接系统，对于牙本质的粘接则使用全酸蚀或自酸蚀牙本质粘接系统，修复材料则应选择复合树脂材料。修复中可根据患者的要求及患牙的条件选择单色、双色和多色树脂修复技术，以满足不同的美学修复目标。唇舌侧贯通的牙体组织缺损，应在舌侧充填具有遮色效果的树脂以减小口腔暗背景对修复体色泽的影响。唇面缺损的修复应体现牙体组织的细节和个性化解剖特征。对于外伤冠折牙齿的美学修复，可以用粘接系统将断离牙冠与剩余牙体组织对位粘接，必要时还可以用纤维桩增强固位。复合树脂直接粘接修复技术有保守、隐形、快捷等优势，但不适用于牙体组织缺损过大、色泽等严重异常的患牙。

关键词: 复合树脂, 直接粘接修复, 美学修复, 前牙修复

Abstract:

Composite resin materials have been introduced into operative dentistry for over 50 years. Along with the improvement of material sciences，the performance of adhesive systems and composite resins may fulfill the clinical requirement for the filling materials nowadays. Composite fillings have already been the first choice of direct restorations in operative dentistry. The indications of anterior composite restoration include various types of coronal defects of tooth. Acid etching technique should be used for the adhesion to enamel surfaces and total etching or self-etching adhesive systems should be adopted for the adhesion to dentinal surfaces. The filling materials should mostly be the composite resins. Single layer，double layer and multiple layer filling techniques can be conducted for various esthetic demands of patients. For the restoration of Class Ⅳ cavity，the opaque shades of composite resins should be used in the lingual surface. For the restoration of defects involving labial surface，the enamel shades of composite resins should be used for mimic the texture and anatomy of labial surface of tooth. Dental adhesive systems can also be employed in restoration of coronal fracture of anterior teeth due to trauma. The direct adhesive restoration technique possesses the advantages of conservation，“being invisible”，simpleness and convenience. However it is not suitable for restoring those teeth with severe coronal defects.

Key words: composite resin；direct adhesive restoration；esthetic restoration；anterior restoration