热压铸造陶瓷制作前牙瓷贴面的临床效果观察

Esthetic restoration for anterior teeth with the hot pressed porcelain laminate veneers

目的:探讨采用热压铸造瓷块制作前牙瓷贴面的临床修复效果。方法 :选择要求进行前牙修复的患者32例,共206颗牙。其中,氟斑牙患者20例,轻度四环素牙患者8例,牙唇侧釉质发育不全或釉质表面有明显裂纹患者4例。根据邻牙颜色、皮肤和唇颜色选择瓷块颜色,进行失蜡热压铸造成型,并经过口内试戴、仔细修形后,再在超薄贴面的边缘嵴、切缘等部位进行特殊艺术化染色处理,采用VariolinkⅡ树脂粘固剂黏结超薄瓷贴面。结果:根据改进的USPHS标准评价临床美学修复效果:瓷贴面的半透性极佳,边缘完整性好,与预备体边缘终止线对接密合。经7年多使用,瓷贴面边缘无着色,且能吸收牙龈和邻牙的色泽而产生良好的变色龙作用,同时精雕后的瓷面能够产生自然牙釉质的表面特征。经7年多临床观察,206个瓷贴面仅有5个发生瓷体折裂和脱落。结论:采用热压铸造陶瓷制作瓷贴面,具有操作简单、修复体强度高、磨除牙体组织少、美观效果好等特点,特别适用于氟斑牙、轻度四环素牙、自然磨损牙的美学修复。

PURPOSE： To evaluate the esthetic effect of anterior porcelain veneers fabricated with the heat pressed glass ceramic.METHODS： Thirty-two patients,who wanted to receive a aesthetic restorative treatment for 206 anterior teeth were selected.Among them,20 were for dental fluorosis,8 were for light tetracycline stained teeth,the other 4 were labial enamel hypoplasia or obvious crack on the surface of enamel.According to the color of adjacent teeth 、skin and lips,heat pressed IPS e.max ingots of different color were chosen to mold the restorations.Afterwards,special straining technique was conducted on the marginal ridge and incisor ridge of the veneers after carefully trimmed in the mouth.Restorations were them bonded with Variolink Ⅱ resin cement.After 7 years of follow-up,a modified USPHS criterion was used to evaluate the esthetic effect.RESULTS： The translucency of veneers was superior.Marginal integrity of the veneers was perfect and it docked well with the marginal terminate line of the abutment.There was no edge coloring after the veneers were used for 7 years,and the veneers produce an excellent chameleon effect by absorbing the color of adjacent teeth and gums,at the same time,veneers could produce a feature of surface morphology of natural enamel after careful carve.In the long-term clinical observation,5 of the 206 veneers were fractured or fell off.CONCLUSIONS： This porcelain laminate veneers fabricated from the heat pressed IPS e.max Press ingots include the following advantages,such as simple operating procedure,high mechanical strength,very little dental tissue was ground off and nice aesthetic effect.Ultra-thin veneers are especially suitable for aesthetic practice to dental fluorosis,light tetracycline and natural worn teeth.