Vita In-Ceram全瓷修复体2年临床观察

目的 探讨Vita In-Ceram Alumina渗透陶瓷全瓷修复体的修复效果,为临床应用提供参考。方法 45例门诊患者,修复体共194件,其中上颌124件,下颌70件。前牙全冠165个,后牙全冠21个,前牙固定桥8个。通过3－24个月的观察,采用美国加利福尼亚科学会的质量评价体系对Vita In-Ceram Alumina渗透陶瓷前、后牙全冠与前牙固定桥修复进行临床效果评价。结果 对45例患者186颗全冠与8个前牙固定桥的临床观察结果表明,Vita In-Ceram Alumina渗透陶瓷全冠具有良好的边缘密合性,色泽稳定,强度高,其失败率为0．01％。应用Vita In-Ceram Alumina渗透陶瓷制作的前牙固定桥,效果满意。结论 Vita In-Ceram Alumina渗透陶瓷修复是一种效果良好的全瓷修复方式。     

氧化铝渗透陶瓷底瓷全瓷冠2年临床观察

目的 探讨氧化铝渗透陶瓷作为全瓷修复体底瓷的修复效果,为临床推广应用提供参考。方法 61例门诊患者,修复体159件,其中上颌98件,下颌61件。前牙全冠132个,后牙全冠27个。通过12～24个月的观察,采用美国加利福尼亚牙科学会的质量评价体系对氧化铝渗透陶瓷作为底瓷所做的前、后牙全冠修复进行临床效果评价。结果 对61例患者159颗全冠的临床观察结果 表明,氧化铝渗透陶瓷作为底瓷所制作的全瓷修复体具有良好的的边缘密合性,色泽稳定,强度高,其失败率为1.25%,效果满意。结论 氧化铝渗透陶瓷作为底瓷的全瓷冠修复是一种效果良好的全瓷修复方式。     

In—Ceram体系进展

陶瓷具有很好的性能,它能满足牙科修复的要求,如生物相容性好、美观、色泽稳定、不导电、低导热和在口腔环境内的抗降解能力。但其低强度和脆性一直影响着全瓷修复材料在牙科修复中的应用,尤其是固定桥和后牙冠修复。由法国Sadoun研制的德国Vita公司的In-Ceram技术,是第一个成功用于全瓷冠桥的临床修复技术,从固定桥修复的意义上说,也是目前唯一成功的全瓷修复技术。In-Ceram的核心是其高强度的玻璃渗透氧化铝陶瓷底层材料。后来Vita公司又相继推出In-Ceram Spinell,In-Ceram Zirconia及Celay/In-Ceram技术(将原来的In-Ceram产品命名为In-Ceram Alumina),使In-Ceram发展成为完整的体系,适用于嵌体、高嵌体、前后牙冠、前后牙桥的制作修复,不仅强度高,而且美观,边缘适合性好。现以In-Ceram Alumina为主介绍In-Ceram体系。     

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目的 探讨氧化锆全瓷冠桥修复体的修复效果,为临床应用提供参考.方法 对2008年1月至2009年6月佛山市禅城区口腔医院修复科收治的40例接受全瓷修复的患者,采用计算机辅助设计与计算机辅助制作(CAD/CAM)技术制作氧化锆全瓷冠桥修复体60件,其中上颌32件,下颌28件;前牙单冠24个,后牙单冠21个,前牙固定桥2个,后牙固定桥3个(均为3单位固定桥).分别在修复体黏结后1、3、6、12个月对患者进行随访观察,采用美国加利弗尼亚牙科学会的全瓷修复临床标准对修复体的临床效果进行评价,同时也对牙周健康状况进行评价,记录全瓷修复体牙冠的牙龈出血指数(BI)、牙周袋深度(PD)以及附着丧失(AL).结果 观察期间失访3例患者5件修复体,对剩余的37例患者55件修复体的临床观察结果显示,在黏结1个月后有2件修复体的边缘卡探针,有2颗氧化锆全瓷冠修复的牙齿出现牙龈炎.在黏结3个月后,有1个单冠出现裂纹,1例固定桥断裂,2颗牙齿出现牙龈红肿.在黏结6个月后,有1例桩核冠脱落,2颗牙齿出现牙髓炎或根尖周炎.所有复诊患者在12个月的临床观察中均未见边缘着色和继发龋,有5件修复体的颜色匹配稍差.在各时间点BI、PD和AL等指标与治疗前比较差异均无统计学意义(P＞0.05),各项指标比较差异亦无统计学意义(P＞0.05).结论 氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意.     

玻璃渗透氧化铝陶瓷全冠美学再修复的临床观察122例

目的 观察玻璃渗透氧化铝陶瓷全冠修复的美学效果。方法 2009年1月—2011年1月常熟玉蕙口腔医院修复科收治的122例接受全瓷再修复的患者,前牙全冠264个,前磨牙全冠54个。通过24个月的观察,采用美国加利福尼亚牙科学会的标准观察结果。结果 玻璃渗透氧化铝陶瓷作为底瓷的全瓷修复体具有良好的边缘密合性,牙龈健康,色泽自然统一,患者认可度高;其失败率仅为1.25%。结论 玻璃渗透氧化铝陶瓷作为底瓷的全瓷冠修复是一种效果良好的美学修复方式。     

IPS-Empress全瓷冠临床观察

目的 :探讨IPS -Empress可铸玻璃陶瓷的修复效果 ,为临床应用提供参考。 方法 :对 68例 179个全瓷冠修复 3年观察 ,对前牙和后牙全瓷冠单冠修复的临床效果进行评价。结果 :68例 79个修复体具有良好的边缘密合性 ,色泽稳定 ,强度高 ,成功率达 86.0 8%。前牙成功率 97.68% ,后牙成功率 70 .0 0 %。结论 :IPS -Empress是一种修复效果较好的全瓷修复材料     

口腔修复学——冠桥

20052014 全瓷桩核与镍铬合金桩核在前牙修复中的受力比较；20052015 微型固位钉式无冠粘结固定义齿的临床应用研究；20052016 银粉加强型玻璃离子制作桩核的临床作用；20052017 245件金属烤瓷修复体制作及临床应用体会；20052018 不同厚度In-Ceram全瓷修复体的色差分析；20052019 根管固位的铸造高嵌体修复后牙缺损的临床观察……     

GI-Ⅱ型渗透陶瓷修复体的临床制作实验

目的:介绍GI-Ⅱ型渗透陶瓷底层瓷材料用于制作全瓷单冠及桥体的方法和技术.方法:选择四川大学华西口腔医院门诊右上中切牙,右上第一磨牙冠修复病例及左上侧切牙缺失双端固定桥修复病例,用GI-Ⅱ型渗透陶瓷作为底层瓷,Vitadur alpha作为饰面瓷,制作前后牙单冠及前牙桥全瓷修复体,口内试戴、粘固结果:修复体美观性能优越,边缘适合性好.结论:GI-Ⅱ型渗透陶瓷能够满足全瓷修复体对底冠的要求,制作出的全瓷修复体效果良好.     

三种全瓷冠的临床效果观察

目的总结应用3种陶瓷全瓷冠的临床效果,为全瓷冠的材料选择应用提供参考。方法选择门诊患者90例,采用IPS Empress热压铸造陶瓷、In-ceram渗透陶瓷以及Cerec2 CAD/CAM技术制作前牙全瓷冠各30件,临床定期观察。结果修复体咀嚼功能好,美观,适合性好,无食物嵌塞,无继发龋及龈炎。Cerec Vita MarkⅡ全瓷冠有1件冠折裂,2件出现裂纹;IPS EmpressⅡ全瓷冠有2件出现裂纹,未折裂;In-Ceram全瓷冠未出现裂纹、折裂现象。结论In-Ceram全瓷冠临床应用效果好。     

IPS e.max Press 热压铸后牙全瓷冠的临床研究

［摘要］ 目的 评价后牙IPS e.max press 全瓷铸造冠的临床效果。方法 共选取1 217例1 533颗后牙IPS e.max Press 铸瓷全冠修复体,修复3~24个月后,按照美国公共健康协会的修正标准进行修复体评估。结果 96.6%的修复体保持完整,未出现破裂、崩瓷、脱落、基牙冠折等并发症,患者满意度较高。结论 IPS e.max Press 全瓷修复体的近期修复效果良好。     

Clinical long-term results of VITA In-Ceram Classic crowns and fixed partial dentures: A systematic literature review

PURPOSE: VITA In-Ceram Classic is a system designed to fabricate all-ceramic crowns and fixed partial dentures (FPDs) with a glass-infiltrated aluminum oxide core material. This systematic literature review gives an overview of the clinical performance of the VITA In-Ceram Classic Alumina, Spinell, and Zirconia restorations. MATERIALS AND METHODS: Based on a systematic literature review, an evidence-based selection and assessment of clinical studies of VITA In-Ceram Classic ceramics was carried out. RESULTS: A total of 299 publications were found, 21 of which met the inclusion criteria. Only a few meaningful studies of In-Ceram Alumina FPDs and In-Ceram Zirconia crowns and FPDs were found. The 5-year survival rate of In-Ceram Alumina crowns and In-Ceram Spinell crowns ranged from 91.7% to 100% and is similar to the survival rate of conventional metal-ceramic crowns. The 5-year survival rate of single-retainer In-Ceram Alumina resin-bonded FPDs (RBFPDs) was 92.3%, which is higher than that of 2-retainer RBFPDs. CONCLUSION: In-Ceram Classic Alumina can be recommended for anterior and posterior crowns as well as for anterior single-retainer RBFPDs. Further studies should be initiated to evaluate in detail the clinical performance of In-Ceram Classic Alumina FPDs. In-Ceram Classic Spinell can be recommended for anterior crowns, especially if highly esthetic results are requested. For In-Ceram Classic Zirconia crowns or FPDs no statement can be made presently because of insufficient data.     

CAD/CAM氧化锆全瓷冠修复临床疗效评价

目的：探讨CAD／CAM氧化锆全瓷冠的修复效果。方法：选择82例（192颗患牙）,分别在CAD／CAM氧化锆全瓷冠粘接后1、3、6、12个月进行随访观察。采用美国公共健康协会的修订标准对修复体的临床效果进行评价。结果：观察期间失访4例,随访78例共181件修复体,结果显示CAD／CAM全瓷冠颜色达到好以上91．2％,CAD／CAM氧化锆全瓷冠的崩瓷率2．76％,与修复体部位有明显相关性（P〈0．01）,在粘接12个月后有1个修复体的边缘密合度欠佳,所有复诊患者在12个月的临床观察中均未见边缘着色,继发龋和基牙松动。结论：氧化锆全瓷修复体具有良好的稳定性和生物相容性,近期临床效果满意。     

In-ceram氧化锆基全瓷冠的适合性评价

目的评价3种In-ceFan3氧化锆基全瓷冠的边缘和内部间隙。方法制作In-Ceram YZ全瓷冠、In-ce-rainZirconia全瓷冠和Wolceram全瓷冠各12个,采用树脂粘接剂粘固于人工预备的离体上颌前磨牙上,经过温度循环试验后．沿近远中向和颊舌向片切试件,用扫描电镜观察并测量全瓷冠组织面与牙体组织之间的间隙,3组试件的数据用SPSS12．0软件进行统计学分析。结果3种全瓷冠的间隙宽度中,均是边缘间隙宽度最小,[牙合]面间隙宽度最大。In-CeramYZ全瓷冠的边缘间隙宽度为（19．86±1．81）μm,肩台间隙宽度为（92．66±0．64）μm,[牙合]面间隙宽度为（128．06±1．38）μm,在3种全瓷冠中最小;Wolceram全瓷冠的边缘间隙宽度为（29．43±0．84）μm,肩台间隙宽度为（117．89±1．73）μm。轴壁间隙宽度为（112．50±1．71）μm．[牙合]面间隙宽度（168．11±1．33）μm．在3种全瓷冠中最大。结论3种In-Ceram氧化锆基全瓷冠的间隙宽度均在临床可接受范围内,其中In-CeramYZ和In-CeramZirconia全瓷冠的边缘和内部间隙较Wolceram全瓷冠小。     

Flexural Strength of Glass-Infiltrated Zirconia/Alumina-Based Ceramics and Feldspathic Veneering Porcelains

Purpose: To compare the flexural strength of two glass-infiltrated high-strength ceramics and two veneering glass-ceramics.
Materials and Methods: Four ceramic materials were tested: two glass-infiltrated high-strength ceramics used as framework in metal-free restorations [In-Ceram Zirconia IZ (Gr1) and In-Ceram Alumina IA (Gr2)], and two glass-ceramics used as veneering material in metal-free restorations [Vita VM7 (Gr3) and Vitadur-α (Gr4)]. Bar specimens (25 × 5 × 2 mm³) made from core ceramics, alumina, and zirconia/alumina composites were prepared and applied to a silicone mold, which rested on a base from a gypsum die material. The IZ and IA specimens were partially sintered in an In-Ceram furnace according to the firing cycle of each material, and then were infiltrated with a low-viscosity glass to yield bar specimens of high density and strength. The Vita VM7 and Vitadur-α specimens were made from veneering materials, by vibration of slurry porcelain powder and condensation into a two-part brass Teflon matrix (25 × 5 × 2 mm³). Excess water was removed with absorbent paper. The veneering ceramic specimens were then removed from the matrix and were fired as recommended by the manufacturer. Another ceramic application and sintering were performed to compensate the contraction of the feldspar ceramic. The bar specimens were then tested in a three-point bending test.
Results: The core materials (Gr1: 436.1 ± 54.8; Gr2: 419.4 ± 83.8) presented significantly higher flexural strength (MPa) than the veneer ceramics (Gr3: 63.5 ± 9.9; Gr4: 57.8 ± 12.7).
Conclusion: In-Ceram Alumina and Zirconia were similar statistically and more resistant than VM7 and Vitadur-α.     

Full-ceramic CAD/CIM anterior crowns and copings

The purpose of the investigation was to examine the marginal and internal fit of Cerec anterior crowns and crown copings. The marginal and internal fit of Cerec anterior crowns (n = 18) and copings was examined on each of six anterior model tooth preparations, with different types of butt-margin crown preparation design on different teeth: 1.) straight flat (tooth 22), 2.) following the CEJ with mid-approximally steep curvature angles of 90 degrees mesial and 40 degrees distal (tooth 21) and 3.) same as 2, but with obtuse angles of 130 degrees and 150 degrees (tooth 41). The anterior crowns were machined on Cerec 2 units using Mark II ceramic (Vita), and the Cerec copings using In-Ceram Spinell (Vita). Laboratory slip-cast In-Ceram spinell anterior crown copings served as controls (n = 18). All reconstructions were seated (with adhesive) on the preparations, and the width of the marginal interface was measured circumferentially using SEM at 150x magnification. After cross-sectioning all samples in the bucco-oral direction, the internal fit was measured using this same technique. The marginal width of computer machined Cerec CAD/CIM anterior crowns (59.9 +/- 5.6 microns) was significantly (p < 0.01) lower than that of machined (73.4 +/- 12 microns) and slip-cast In-Ceram spinell copings (75.5 +/- 17 microns). The internal fit values of the slip-cast copings (94.1 +/- 20 microns) were significantly (p < 0.001) lower than those of the Cerec Mark II anterior crowns (141.3 +/- 21 microns) and copings (146.8 +/- 17 microns). Cerec CAD/CIM machined anterior full-ceramic crowns and copings showed excellent fit in comparison with slip-cast In-Ceram spinell copings. In terms of the marginal and internal fit, there were no significant differences (p > 0.05) between the different butt-margin preparation designs. Selected clinical cases demonstrate the high esthetics of anterior Cerec crowns.     

CAD/CAM ZIRCONIA VS. SLIP-CAST GLASS-INFILTRATED ALUMINA/ZIRCONIA ALL-CERAMIC CROWNS: 2-YEAR RESULTS OF A RANDOMIZED CONTROLLED CLINICAL TRIAL

The aim of this randomized controlled clinical trial was to compare the early clinical outcome of slip-cast glass-infiltrated Alumina/Zirconia and CAD/CAM Zirconia all-ceramic crowns. A total of 30 InCeram^® Zirconia and Cercon^® Zirconia crowns were fabricated and cemented with a glass ionomer cement in 20 patients. At baseline, 6-month, 1-year, and 2-year recall appointments, Californian Dental Association (CDA) quality evaluation system was used to evaluate the prosthetic replacements, and plaque and gingival index scores were used to explore the periodontal outcome of the treatments. No clinical sign of marginal discoloration, persistent pain and secondary caries was detected in any of the restorations. All InCeram^® Zirconia crowns survived during the 2-year period, although one nonvital tooth experienced root fracture coupled with the fracture of the veneering porcelain of the restoration. One Cercon^® Zirconia restoration fractured and was replaced. According to the CDA criteria, marginal integrity was rated excellent for InCeram^® Zirconia (73%) and Cercon^® Zirconia (80%) restorations, respectively. Slight color mismatch rate was higher for InCeram^® Zirconia restorations (66%) than Cercon^® Zirconia (26%) restorations. Plaque and gingival index scores were mostly zero and almost constant over time. Time-dependent changes in plaque and gingival index scores within and between groups were statistically similar (p>0.05). This clinical study demonstrates that single-tooth InCeram^® Zirconia and Cercon^® Zirconia crowns have comparable early clinical outcome, both seem as acceptable treatment modalities, and most importantly, all-ceramic alumina crowns strengthened by 25% zirconia can sufficiently withstand functional load in the posterior zone.     

In vitro marginal fit of three all-ceramic crown systems

STATEMENT OF PROBLEM: Studies on marginal discrepancies of single restorations using various systems and materials have resulted in statistical inferences that are ambiguous because of small sample sizes and limited numbers of measurements per specimen. PURPOSE: The purpose of this study was to compare the marginal adaptation of single anterior restorations made using different systems. MATERIAL AND METHODS: The in vitro marginal discrepancies of 3 different all-ceramic crown systems (Celay In-Ceram, conventional In-Ceram, and IPS Empress 2 layering technique), and a control group of metal ceramic restorations were evaluated and compared by measuring the gap dimension between the crowns and the prepared tooth at the marginal opening. The crowns were made for 1 extracted maxillary central incisor prepared with a 1-mm shoulder margin and 6-degree tapered walls by milling. Thirty crowns per system were fabricated. Crown measurements were recorded with an optical microscope, with an accuracy of +/-0.1 microm, at 50 points spaced approximately 400 microm along the circumferential margin. The criterion of 120 microm was used as the maximum clinically acceptable marginal gap. Mean gap dimensions and standard deviations were calculated for marginal opening. The data were analyzed with a 1-way analysis of variance (alpha=.05). RESULTS: Mean gap dimensions and standard deviations at the marginal opening for the incisor crowns were 87 +/- 34 microm for control, 83 +/- 33 microm for Celay In-Ceram, 112 +/- 55 microm for conventional In-Ceram, and 46 +/- 16 microm for the IPS Empress 2 layering technique. Significant differences were found among the crown groups (P<.05). Compared with the control group, the IPS Empress 2 group had significantly smaller marginal discrepancies (P<.05), and the conventional In-Ceram group exhibited significantly greater marginal discrepancies (P<.05). There was no significant difference between the Celay In-Ceram and the control group. CONCLUSION: Within the limitations of this study, the marginal discrepancies were all within the clinically acceptable standard set at 120 microm. However, the IPS Empress 2 system showed the smallest and most homogeneous gap dimension, whereas the conventional In-Ceram system presented the largest and more variable gap dimension compared with the metal ceramic (control) restoration.     

仪器比色与视觉比色的临床研究

目的：通过临床实验比较视觉比色与仪器比色制作烤瓷修复的颜色准确性。方法：临床纳入26名自愿者,分别使用视觉比色和仪器比色的方法（Shade Eye NCC）选择修复体色调。相应的修复体制作完成并戴入口内,测色仪测量修复体及天然牙的色度学参数。计算两种选色方法制作的修复体与天然牙的色彩。结果：视觉比色方法修复体与天然牙色彩值为3.87（1.67）,而仪器比色的色差值为3.21（1.23）。配对t检验表明,两种比色方法制作的修复体与天然牙的颜色差别无统计学差异。结论：视觉比色与仪器比色方法制作的修复体颜色准确性相似。