粘接劑排溢溝對(duì)后牙氧化鋯全冠適合性的影響

曹程，李平，屈直

（錦州醫(yī)科大學(xué)1. 研究生院； 2. 附屬第二醫(yī)院修復(fù)科，遼寧 錦州 121000）

粘接劑排溢溝對(duì)后牙氧化鋯全冠適合性的影響

曹程1，李平1，屈直2

（錦州醫(yī)科大學(xué)1. 研究生院； 2. 附屬第二醫(yī)院修復(fù)科，遼寧 錦州 121000）

目的研究粘接劑排溢溝對(duì)后牙全冠適合性的影響。方法三維建模一顆下頜第一磨牙，在Rhinoceros 5.0軟件中設(shè)計(jì)4種預(yù)備體模型：A為常規(guī)全冠預(yù)備設(shè)計(jì)，B、C、D分別在A組的基礎(chǔ)上設(shè)計(jì)1、2、4個(gè)粘接劑排溢溝，3D打印樹(shù)脂預(yù)備體各5個(gè)。根據(jù)A預(yù)備體設(shè)計(jì)全冠，CAD/CAM制作氧化鋯全冠20個(gè)，完全隨機(jī)分為4組。三維掃描儀掃描試件，進(jìn)行偏差分析及壁厚分析。硅橡膠法復(fù)制冠與預(yù)備體之間的間隙，金相顯微鏡下觀察，并測(cè)量間隙大小。SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果全冠邊緣和內(nèi)部間隙從大到小依次為A組、B組、C組、D組，兩兩比較差異有統(tǒng)計(jì)學(xué)意義（P ＜ 0.05）。結(jié)論粘接劑排溢溝能顯著提高全冠的適合性，且排溢溝數(shù)量越多，全冠適合性越好。

粘接劑排溢溝； 邊緣適合性； 內(nèi)部適合性

Abstract ObjectiveTo study the effect of adhesive overflow grooves on the marginal and internal adaptation of a molar zirconia full crown.MethodsA three-dimensional model of a mandibular first molar was established. Four crown preparations （A-D） were designed：a was a conventional full crown design，and B，C，and D included 1，2，and 4 adhesive overflow grooves，respectively，designed on the basis of A. Five resin preparations were created for each group using three-dimensional （3D） printing. According to the a design data，20 CAD/CAM zirconia crowns were prepared and randomly divided into four groups. The tooth，preparations，and crowns underwent 3D scanning for 3D deviation analysis and 3D wall thickness analysis. The gap between the crown and the preparation was replicated with silicone rubber，and then observed with a metallographic microscope and measured. Data were statistically analyzed with SPSS 17.0.ResultsAmong the groups，marginal and internal clearance was A＞B＞C＞D. The comparison between every two groups was statistically different （P ＜ 0.05）.ConclusionIncreases in the number of overflow grooves result in significant increases in the marginal adaptation and internal adaptation of a full crown.

Keywordsadhesive overflow groove； marginal adaptation； internal adaptation

全冠適合性是修復(fù)體與預(yù)備牙之間的間隙，包括邊緣適合性和內(nèi)部適合性［1］，其體現(xiàn)牙冠與牙體接觸的密合程度，臨床上用粘接劑厚度來(lái)表示［2］。提高全冠的適合性，不僅能提升美學(xué)效果、增加冠的固位、延長(zhǎng)牙冠的使用壽命，還能在長(zhǎng)期使用中減少粘接劑溶解和微滲漏［3-4］。因此提高全冠適合性具有重要的臨床意義。

影響全冠適合性的因素很多，其中冠的粘接是造成冠適合性下降的重要因素之一。冠在粘接就位過(guò)程中，內(nèi)壓會(huì)不斷升高，過(guò)高的內(nèi)壓會(huì)阻礙粘接劑的排溢，多余的粘接劑滯留在修復(fù)體和預(yù)備牙之間，增加了冠的浮出量，降低了冠的適合性［5-7］。……