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中华口腔医学研究杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 215 -221. doi: 10.3877/cma.j.issn.1674-1366.2021.04.004

基础研究

不同加工工艺及材料制作瓷嵌体适合性的实验研究
张凤1, 游月华2, 周珊羽3, 魏素华4,()   
  1. 1. 香港大学深圳医院口腔科,深圳 518053
    2. 南方医科大学附属深圳龙华人民医院口腔科,深圳 518109;南方医科大学口腔医学院,广州 510515
    3. 南方医科大学附属深圳龙华人民医院口腔科,深圳 518109
    4. 中山大学附属口腔医院,光华口腔医学院,广东省口腔医学重点实验室,广州 510055
  • 收稿日期:2021-06-03 出版日期:2021-08-01
  • 通信作者: 魏素华

In vitro investigation on the marginal and internal fit of inlays made by different processing techniques and materials

Feng Zhang1, Yuehua You2, Shanyu Zhou3, Suhua Wei4,()   

  1. 1. Department of Stomatology, the University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
    2. Department of Stomatology, Longhua People′s Hospital Affiliated to Southern Medical University, Shenzhen 518109, China; School of Stomatology, Southern Medical University, Guangzhou 510515, China
    3. Department of Stomatology, Longhua People′s Hospital Affiliated to Southern Medical University, Shenzhen 518109, China
    4. Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincal Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2021-06-03 Published:2021-08-01
  • Corresponding author: Suhua Wei
  • Supported by:
    National Natural Science Foundation of China(81901014); Scientific and Technological Innovation Fund Social Public Welfare Research Project of Longhua Shenzhen(JCYJ201902)
引用本文:

张凤, 游月华, 周珊羽, 魏素华. 不同加工工艺及材料制作瓷嵌体适合性的实验研究[J]. 中华口腔医学研究杂志(电子版), 2021, 15(04): 215-221.

Feng Zhang, Yuehua You, Shanyu Zhou, Suhua Wei. In vitro investigation on the marginal and internal fit of inlays made by different processing techniques and materials[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2021, 15(04): 215-221.

目的

研究比较采用粉浆堆塑工艺、热压铸造工艺及计算机辅助设计与制作(CAD-CAM)技术制作的不同材料瓷嵌体的边缘适合性。

方法

通过数控铣床制备有机玻璃模型30个,采用随机数字表法分为三组,每组10个,分别采用粉浆堆塑工艺制作In-Ceram Spinell嵌体(In-Ceram Spinel组),热压铸造工艺制作IPS e.max Press嵌体(IPS e.max Press组),CAD-CAM技术制作Cercon Zirconia嵌体(Cercon Zirconia组)。嵌体试件粘接完成,通过肉眼观察和扫描电镜(SEM)测量,记录并分析嵌体边缘微观形貌及嵌体与窝洞洞壁间的内间隙、边缘间隙和绝对边缘间隙,采用SAS软件进行统计学处理,组间两两比较采用LSD-t检验。

结果

不同加工方式及材料的嵌体可获得肉眼可见的光滑表面。SEM下Cercon Zirconia组嵌体组织面最为平滑连续,边缘完整适合。测量所得各组的内间隙,In-Ceram Spinell组为(94 ± 41)μm、IPS e.max Press组为(64 ± 20)μm、Cercon Zirconia组为(72 ± 25)μm,均在临床可接受范围120 μm内;Cercon Zirconia组的边缘间隙[(100 ± 37)μm]和绝对边缘间隙[(119 ± 38)μm]均在120 μm以内。各组边缘适合性的比较,IPS e.max Press组与Cercon Zirconia组组间差异均无统计学意义(t内间隙 = 0.8410,P内间隙 = 0.4114,t边缘间隙 = 1.499,P边缘间隙 = 0.1512,t绝对边缘间隙 = 1.630,P绝对边缘间隙 = 0.1206);In-Ceram Spinell组内间隙宽度大于IPS e.max Press组,差异有统计学意义(t = 2.146,P = 0.0457),其绝对边缘间隙大于Cercon Zirconia组,差异也有统计学意义(t = 2.305,P = 0.0333)。

结论

不同加工方法制作的In-Ceram Spinell嵌体、IPS e.max Press嵌体和Cercon Zirconia嵌体均能获得良好的内部适合性,可满足临床牙体缺损修复需求;其中CAD-CAM技术制作Cercon Zirconia嵌体有更好的边缘适合性,值得临床推广应用。

Objective

The purpose of this study was to investigate and compare the marginal and internal fit of ceramic inlays made by slurry molding, heat-pressed and computer aided design/computer aided manufacturing (CAD-CAM) techniques restoring the cavities with the same figuration and size.

Methods

The material of the sample was organic glass. Thirty samples were prepared into standard cavities using computer numerically controlled system and assigned to three groups (n = 10 each) according to different processing techniques and materials using a random number table method. The In-Ceram Spinell group was restored with In-Ceram Spinel inlays made by slurry molding technique, while the IPS e.max Press group was restored with IPS e.max Press inlays made by heat-pressed technique and the Cercon Zirconia group was restored with Cercon Zirconia inlays made by CAD-CAM technique. Scanning electron microscope (×300 magnification) was used to observe the edge morphology of inlays and measure the gaps between the inlay and cavity. The data were analyzed using SAS, and the inter-group comparison was examined by LSD-t test.

Results

All of the inlays showed smooth surfaces. The even and smooth surface and integrated margin were obtained in Cercon Zirconia group. The internal gap (IG) of the three groups, In-Ceram Spinell group: (94 ± 41) μm; IPS e.max Press group: (64 ± 20) μm and Cercon Zirconia group: (72 ± 25) μm, were less than 120 μm. The marginal gap (MG) , (100 ± 37) μm, and the absolute marginal discrepancy (AMD) , (119 ± 38) μm, of Cercon Zircon group were less than 120 μm. There were no statistically significant differences between IPS e.max Press and Cercon Zirconia group (tIG = 0.8410, PIG = 0.4114, tMG = 1.499, PMG = 0.1512, tAMD = 1.630, PAMD = 0.1206) . Statistical difference was found in IG between In-Ceram Spinell and IPS e.max Press group (t = 2.146, P = 0.0457) , as well as in AMG (t = 2.305, P = 0.0333) between In-Ceram Spinell and Cercon Zirconia group.

Conclusions

The In-Ceram Spinell, IPS e.max Press and Cercon Zirconia inlays fabricated by different processing techniques provided clinically acceptable marginal and internal fit. The Cercon Zircon inlay made by CAD-CAM technique showed better results than the IPS e.max Press and the In-Ceram Spinell inalys.

图1 有机玻璃模块经洞型预备、嵌体制作和粘接、包埋切割后得到嵌体试件 A:有机玻璃模块经数控铣床预备后形成邻嵌体标准洞型,设定邻面洞型侧为远中面,对侧为近中面;B:各组嵌体采用双固化树脂粘接于标准洞型;C:环氧树脂包埋粘接嵌体的有机玻璃模块,沿近远中向对半切割,得到嵌体试件
图2 瓷嵌体试件电子显微镜扫描图片各测量位点 A:内间隙(IG)为洞壁与嵌体的垂直距离;B:边缘延伸过长的嵌体,洞壁最突出处至嵌体的垂直距离为边缘间隙(MG),与嵌体最突出处的距离为绝对边缘间隙(AMD);C:边缘延伸不足的嵌体,嵌体最突出处至洞壁的垂直距离为MG,与洞缘最突出处的距离为AMD
图3 各组瓷嵌体试件边缘区域电子显微镜扫描图片 A:In-Ceram Spinell组嵌体组织面欠平整,瓷表面可见散在空隙;B:IPS e.max Press组嵌体边缘延伸不足,外侧可见宽大连续的条带形粘接剂层;C:Cercon Zirconia组嵌体边缘完整适合,粘接剂残留较少
表1 不同加工方法制作嵌体试件的间隙宽度统计学结果(μm,±s
图4 三种加工方法制作嵌体间隙宽度差别的LSD-t检验结果 A:内间隙(IG)宽度的比较,In-Ceram Spinell组与IPS e.max Press组比较,差异有统计学意义(aP<0.05);B:边缘间隙(MG)宽度的比较,各组组间差异均无统计学意义;C:绝对边缘间隙(AMD)宽度的比较,In-Ceram Spinell组与Cercon Zirconia组比较,差异有统计学意义(aP<0.05)
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