口腔医学研究 ›› 2020, Vol. 36 ›› Issue (3): 264-268.DOI: 10.13701/j.cnki.kqyxyj.2020.03.018

• 修复材料性能研究 • 上一篇    下一篇

离体下颌前磨牙预备状况与贴面抗折性的关系

尹路*, 杨常委, 郑燕芬, 林娉婷, 黄红蓝   

  1. 厦门医学院附属口腔医院修复科 福建 厦门 361003
  • 收稿日期:2019-02-28 出版日期:2020-05-15 发布日期:2020-05-15
  • 通讯作者: 尹路,E-mail:yinlu7989@hotmail.com
  • 作者简介:尹路(1979~),男,福建厦门人,博士,副主任医师,主要研究方向为全瓷贴面和种植修复。
  • 基金资助:
    厦门市科技局科技惠民项目(编号:3502Z20174025);厦门医学院课题资助项目(编号:2017001);口腔生物材料福建省高校工程研究中心开放课题[XMMCKQ001(省级课题)]

Fracture Resistance of Ceramic Veneers on Mandibular Premolar with or without Preparation

YIN Lu*, YANG Changwei, ZHENG Yanfen, LIN Pingting, HUANG Honglan   

  1. Department of Prosthodontics, Affiliated Stomatological Hospital, Xiameng Medical College, Xiameng 361003, China
  • Received:2019-02-28 Online:2020-05-15 Published:2020-05-15

摘要: 目的:旨在比较下颌前磨牙牙体预备和不预备后制备全瓷贴面和复合树脂贴面的抗折力。方法:40个新鲜离体下颌前磨牙随机分为4组(n=10):NPR组(牙体不预备直接0.2 mm厚树脂贴面修复);NPC组(牙体不预备直接0.2 mm厚铸瓷贴面修复);P2C组(牙体预备0.2 mm,修复0.2 mm厚铸瓷贴面);P5C组(牙体预备0.5 mm,修复0.5 mm厚铸瓷贴面),预备面均包绕颊侧延伸颌面1 mm。所有试件常规粘接后进行冷热循环实验(10000次/5~55 ℃),在万能材料试验机下进行抗折测试(2 KN,0.5 mm/min),断裂面放大10倍分析,数据方差检验。结果:各组抗折力均值分别为:NPR=(690.33±233),NPC=(790.52±408),P2C=(1131.34±341),P5C=(983.56±202)。所有组均有统计学差异(P<0.05),NPR、NPC组抗折力均小于P2C,然后P5C组抗折力与其余各组差距不明显。断裂分析显示断裂面呈现混合断裂(60%),内聚断裂(20%),根裂(15%),粘接断裂(5%)。结论:微量(0.2 mm)的前磨牙牙体预备后修复全瓷贴面可获得最大抗折力,当预备超过0.5 mm时可能会发生牙体折裂。

关键词: 全瓷贴面, 抗折力, 二硅酸锂, 断裂模式, 复合树脂

Abstract: Objective: To compare the fracture resistance of ceramic veneers and composite resin veneers with or without dental preparation. Methods: Forty freshly extracted mandibular premolars were selected and randomly assigned into four groups (n=10): NPR =no dental preparation and direct veneer with 0.2 mm thick composite resin; NPC = no dental preparation and 0.2 mm thick lithium disilicate ceramic veneer (IPS e.max Press, Ivoclar Vivadent); P2C = tooth preparation of 0.2 mm and 0.2 mm thick ceramic veneer (IPS e.max Press); and P5C = tooth preparation of 0.5 mm and 0.5 mm-thick ceramic veneer (IPS e.max Press). In all groups, the restorations covered 1 mm of the occlusal surface of the buccal cusp, and the thickness of this area was the same as the buccal area (0.2 mm or 0.5 mm). After the luting procedure, all groups were thermocycled (10,000 cycles, 5 ℃~55 ℃) and subjected to fracture resistance test under compression (Instron 4 444). The mode of failure analysis was performed under a ×10 magnification. Results: The mean fracture resistance (men ± standard deviation) was NPR =690.33±233, NPC=790.52±408, P2C=1 131.34±341, and P5C=983.56±202. There were significant differences of the fracture resistance values between all groups (P<0.05). The mean values of NPR and NPC groups were significantly lower than that of P2C. However, P5C presented intermediate values and had no significant difference from the other groups. The mode of failure for all groups was mixed (60%), cohesive failures (20%), root failures (15%), and adhesive failures (5%). Conclusion: Minimally invasive tooth preparation (0.2 mm) allowed achieving higher fracture resistance in premolars restored with lithium disilicate ceramic veneers. Attention should be given to the 0.5 mm preparation since fractures could happen at this situation.

Key words: ceramic veneers, fracture resistance, lithium disilicate, mode of failure, resin composite