优化设计Upcera超透氧化锆全瓷修复体的临床应用

Clinical application of optimal designed Upcera super transparent zirconia all-ceramic restorations

目的：总结运用CAD/CAM系统优化设计Upcera超透氧化锆材料针对修复空间有限的病例进行修复的效果,并探讨其临床应用价值.方法：选择21例（23件）修复空间有限且要求行氧化锆全瓷修复患者,通过Sirona inEOS采集诊断蜡型与代型的光学印模,并将两者叠加,运用系统软件设计出（牙合）面与诊断蜡型（牙合）面一致、而颊面和邻面虚拟回切约1～1.5 mm的氧化锆底核,经Sirona inLab MC XL加工Upcer超透氧化锆材料后,完成局部饰瓷.嘱患者定期随访,并参照改良美国加州牙科协会评价标准对修复体进行评价,同时对患者进行满意度问卷调查.结果：经过6～12个月随访,除1件修复体因基牙根折拔除外,其余修复体均保持形态完整、色泽协调、边缘密合、咀嚼功能良好、无食物嵌塞等现象,患者对修复体美观和功能均满意（满意度＞95.5％）.结论：通过CAD/CAM系统优化设计,制作了类似“颊烤”的超透氧化锆全瓷冠,在针对某些特殊病例修复时,如修复空间有限、紧咬牙、夜磨牙等患者,短期效果较好.

PURPOSE：To summarize the clinical application of special designed Upcera ST zirconia all-ceramic restorations in cases with limited occlusal space. METHODS ：Twenty-one patients with 23-unit restorations were enrolled in this study. First, the shape of abutment teeth and diagnostic wax-up were captured and digitized by Sirona inEos system. Then, each individually shaped framework to grant a defined ST zirconia base core was created by the reduced program of inLab software. Finally, all restorations were veneered with VITA VM9 and evaluated at placement using modified U.S.Public Health Service Criteria 6 to 12 months after restoration. Patients were inquired with satisfaction questionnaire at the same time. RESULTS： During 6 to 12 months of follow-up visit, except for one of 23 restorations was rated as failure by fractured root, none was replaced due to framework fracture or unrestorable delamination of the ceramic veneer. The shape and colour of all restorations were satisfactory. CONCLUSIONS： To ensure optimum long-term clinical results of all-ceramic crown restorations, one important key is to overcome the fragmentation of dental prosthesis through modifying the shape of restoration. Based on the results of this study, the specially designed processing technology shows sufficient stability for ST zireonia all-ceramic restorations within a short term, which is deserved to be used in selected cases.