口腔疾病防治 ›› 2017, Vol. 25 ›› Issue (11): 723–728.doi: 10.12016/j.issn.2096-1456.2017.11.009

• 临床研究 • 上一篇    下一篇

椅旁CAD/CAM系统修复失败的原因分析

马骏驰1(), 李谨1, 曾晓燕2, 胡建2()   

  1. 1. 南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院特诊科,江苏 南京(210029)
    2. 南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院修复科,江苏 南京(210029)
  • 收稿日期:2017-08-04 修回日期:2017-09-18 出版日期:2017-11-20 发布日期:2018-09-03
  • 作者简介:

    【作者简介】 马骏驰,副主任医师,博士, Email:mjc2001_73@sohu.com

  • 基金资助:
    江苏高校优势学科建设工程资助项目(2014-37)

Analysis of reasons for failure of chair-side CAD/CAM ceramic restorations

Junchi MA1(), Jin LI1, Xiaoyan ZENG2, Jian HU2()   

  1. 1. Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University; Department of V.I.P., Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
    2. Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University; Department of Prosthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
  • Received:2017-08-04 Revised:2017-09-18 Online:2017-11-20 Published:2018-09-03

摘要:

目的 分析椅旁CAD/CAM系统(CEREC®)全瓷修复病例的失败原因,以期提高临床成功率。方法 收集行椅旁CAD/CAM全瓷修复病例资料1 129例,通过临床检查和瓷睿刻生物再造软件,对其中失败病例的修复类型和失败原因进行研究,并对结果进行统计学分析。结果 共有61例失败的椅旁CAD/CAM全瓷修复体,失败率为5.4%。失败病例的修复体类型为,嵌体10例,高嵌体38例,嵌体冠2例,全冠11例。失败形式表现为,修复体折裂33例、修复体失粘结13例、基牙折裂15例。失败原因主要为咬合面瓷层厚度不足、预备体线角过锐,牙体缺损过多,以及基牙预备时抗力、固位设计不佳。结论 咬合面瓷层厚度不足是椅旁CAD/CAM全瓷修复失败最常见的原因。

关键词: 椅旁CAD/CAM, 失败风险因素, 全瓷修复, 瓷块折裂, 高嵌体

Abstract:

Objective To investigate the failure reasons of all-ceramic restorations fabricated with chair-side CAD-CAM technology (CEREC®) and to improve the clinical survival of all-ceramic restorations. Methods All-ceramic single-tooth restorations of CEREC® in stomatology hospital of Jiangsu province between 2013 and 2016 were summarized. By clinical examination and CEREC Biogeneric surveying, the failure reasons and related restoration types were evaluated. These results were analyzed with Chi-square test and Spearman correlation analysis. Results A total of 61 cases with restoration types of 11 inlays, 38 onlays, 2 endocrowns, and 11 all-crowns, resulted in a failure rate of 5.4% in all-ceramic single-tooth restorations in 1-4 years follow-up. The reasons for failure included ceramic fracture (n=33), debonding (n=13), tooth fracture (n=15), which attributed to thin ceramic thickness (n=27), acute line angle (n=6), insufficient enamel bulk (n=3), insufficient retention type (n=10), insufficient resistance type (n=15). Conclusion The most common reason for failure in CEREC® restorations was insufficient preparation space in occlusal surface.

Key words: Chair-side CAD / CAM, Risk of failure, All-ceramic restoration, Ceramic fracture, Onlay

中图分类号: 

  • R783.4

表1

修复失败病例的失败形式与修复类型的分布"

失败形式 修复类型 总计
嵌体 高嵌体 嵌体冠 全冠
修复体折裂 2 19 1 11 33
基牙折裂 8 7 0 0 15
修复体失粘结 0 12 1 0 13
总计 10 38 2 11 61

图1

右上颌第一前磨牙修复体折裂病例 a和b:临床照片, 右上颌第一前磨牙高嵌体颊尖折裂, a为颊面观, b为咬合面观; c:14、15预备体的瓷睿刻数值模型; d:设计完成的14、15高嵌体就位后的数值模型(红色区域为咬合厚度不足区,厚度为1.08 mm)。"

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