红、白美学评价CAD/CAM个性化基台与全瓷冠在前牙区的应用

›› 2013, Vol. 4 ›› Issue (4): 186-190.

红、白美学评价CAD/CAM个性化基台与全瓷冠在前牙区的应用

张晓真¹,²,周国兴¹,戴文雍¹,赵毅¹,邱憬³,王洁¹,汤春波¹

1. 江苏省口腔医院
2. 南京医科大学
3. 南京医科大学附属口腔医院种植修复科

收稿日期:2013-11-20 修回日期:2013-12-13 出版日期:2013-12-25 发布日期:2014-01-09
通讯作者: 汤春波 E-mail:cbtang@njmu.edu.cn
基金资助:
江苏省卫生厅科技项目;江苏省六大人才”高峰项目;江苏高校优势学科建设工程资助项目;江苏省科技支撑计划资助项目

PES and WES evaluation of CAD/CAM custom abutments and all ceramic crowns in the anterior teeth area

Received:2013-11-20 Revised:2013-12-13 Online:2013-12-25 Published:2014-01-09

摘要/Abstract

摘要： 目的：研究计算机辅助设计及计算机辅助制作（CAD/CAM）个性化基台及全瓷冠的临床应用，应用红色美学（pink esthetic score，PES）及白色美学（white esthetic score，WES）评价其在前牙区修复的美学效果。方法：运用CAD/CAM个性化基台与全瓷冠修复前牙区种植病例共51例73件，戴用后按红色美学及白色美学评分标准评价其美学修复效果。结果：51例患者共73件CAD/CAM个性化基台及全瓷冠3个月后复查结果：PES 10分占9.59%，8~9分占71.23%，6~7分占17.81%，5分及以下占1.37%；WES 10分占39.73%，8~9分占60.27%，6~7分占0%，5分及以下占0%。6个月后复查结果：PES 10分占8.22%，8~9分占69.86%，6~7分占17.81%，5分及以下占4.11%；WES 10分占36.99%，8~9分占61.64%，6~7分占1.37%，5分及以下占0%。一年后复查结果：PES 10分占5.48%，8~9分占68.49%，6~7分占20.55%，5分及以下占5.48%；WES 10分占31.51%，8~9分占64.38%，6~7分占4.11%，5分及以下占0%。经过1~3年的随访，1例基台在扭矩控制时发生崩瓷，在观察期内1例螺丝松动。所有病例牙龈均较健康，牙龈未见明显退缩，无种植体周围炎的发生。结论：PES及WES评分标准客观、全面，计分方式可比性佳。CAD/CAM个性化基台及全瓷冠生物相容性佳，化学性能稳定，在种植美学前牙区适用范围更广，但仍需进一步跟踪观察其长期应用效果。

Abstract: Objective：To investigate the clinic application of computer aided design & computer aided manufacturing ( CAD/CAM) custom abutments and all ceramic crowns and evaluate their esthetic effect in the anterior teeth area according to the assessment criteria Pink Esthetic Score (PES) and White Esthetic Score (WES). Methods：Totally 73 CAD/CAM custom abutments and all ceramic crowns were used in 51 implant-supported prosthesis cases. The esthetic prosthetic effect was evaluated according to the assessment criteria PES and WES. Results：The 3-month-follow-up results of totally 73 CAD/CAM custom abutments and all ceramic crowns of 51 patients: the percentage of the PES scores of 10, 8-9, 6-7 and ≤5 was 9.59%, 71.23%, 17.81%, and 1.37%, respectively; the percentage of the WES scores of 10, 8-9, 6-7 and ≤5 was 39.73%, 60.27%, 0%, and 0%, respectively. The 6-month-follow-up results: the percentage of the PES scores of 10, 8-9, 6-7 and ≤5 was 8.22%, 69.86%, 17.81%, and 4.11%, respectively; the percentage of the WES scores of 10, 8-9, 6-7 and ≤5 was 36.99%, 61.64%, 1.37%, and 0%, respectively. The 1-year-follow-up results: the percentage of the PES scores of 10, 8-9, 6-7 and ≤5 was 5.48%, 68.49%, 20.55%, and 5.48%, respectively; the percentage of the WES scores of 10, 8-9, 6-7 and ≤5 was 31.51%, 64.38%, 4.11%, and 0%, respectively. During the follow-up of 1 to 3 years, there was only one abutment got fractured when the torque control was installed, and one loosened during observation. In all cases, the gingivae were in healthy condition, and no further obvious gingival retreat or periimplantitis occurred. Conclusions：PES and WES are objective, integrated and comparable. CAD/CAM custom abutments and all ceramic crowns have good biocompatibility and chemical stability, and can be more widely used in the anterior teeth area. However, their long term effects need to be confirmed by further follow-up.

张晓真周国兴戴文雍赵毅邱憬王洁汤春波. 红、白美学评价CAD/CAM个性化基台与全瓷冠在前牙区的应用[J]. , 2013, 4(4): 186-190.

参考文献

[1]Belser UC, Grütter L, Vailati F, et al.Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45 patients with a 2- to 4-2009 follow-up using pink and white esthetic scores[J].J Periodontol,2009,80(1):140-151.
[2]宿玉成.美学区种植修复的评价和临床程序[J].口腔医学研究,2008,24(3):241-244.
[3]王敏, 夏海斌.全瓷基台的研究进展[J].国际口腔医学杂志,2009,36(5):610-612.
[4]Prestipino V, Ingber A.All-ceramic implant abutments: esthetic indications[J].J Esthet Dent,1996,8(6):255-262.
[5]Nakamura K, Kanno T, Milleding P, et al.Zirconia as a dental implant abutment material: a systematic review[J].Int J Prosthodont,2010,23(4):299-309.
[6]吴艳玲, 张修银.CAD/CAM全瓷修复体抗折性研究进展[J].口腔颌面修复学杂志,2009,10(3):181-185.
[7]汪振华, 李珂, 王媛媛, 等.CAD/CAM全瓷冠在后牙种植修复中的临床应用[J].中国口腔种植学杂志,2009,14(1):13-14.
[8]Tselios N, Parel SM, Jones JD.Immediate placement and immediate provisional abutment modeling in anterior single-tooth implant restorations using a CAD/CAM application: a clinical report[J].J Prosthet Dent,2006,95(3):181-185.
[9]冯华英, 光寒冰, 方赵平.CAD/CAM加工个性化全瓷基台的临床应用[J].口腔医学,2012,32(12):771-772.
[10]Jemt T.Regeneration of gingival papillae after single-implant treatment[J].Int J Periodontics Restorative Dent,1997,17(4):326-333.
[11]Fuster-Torres MA, Albalat-Estela S, Alca?iz-Raya M, et al.CAD / CAM dental systems in implant dentistry: update[J].Med Oral Patol Oral Cir Bucal,2009,14(3):141-145.
[12]Ardlin BI.Transformation-toughened zirconia for dental inlays, crowns and bridges: chemical stability and effect of low-temperature aging on flexural strength and surface structure[J].Dent Mater,2002,18(8):590-595.
[13]Bressan E, Paniz G, Lops D, et al.Influence of abutment material on the gingival color of implant-supported all-ceramic restorations: a prospective multicenter study[J].Clin Oral Implants Res,2011,22(6):631-637.
[14]Brodbeck U.The ZiReal Post: A new ceramic implant abutment[J].J Esthet Restor Dent,2003,15(1):10-23.
[15]Kou W, Molin M, Sj?gren G.Surface roughness of five different dental ceramic core materials after grinding and polishing[J].J Oral Rehabil,2006,33(2):117-124.
[16]任志新, 刘维贤.氧化锆全瓷基台与钛基台种植体支持氧化锆全瓷单冠的应力分布[J].辽宁医学杂志,2009,23(5):245-247.
[17]Scarano A, Piattelli M, Caputi S, et al.Bacterial adhesion on commercially pure titanium and zirconium oxide disks: an in vivo human study[J].J Periodontol,2004,75(2):292-296.
[18]Bresciano M, Schierano G, Manzella C, et al.Retention of luting agents on implant abutments of different height and taper[J].Clin Oral Implants Res,2005,16(5):594-598.
[19]Henriksson K, Jemt T.Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-2003 follow-up study[J].Int J Prosthodont,2003,16(6):626-630.