椅旁瓷睿刻非典型瓷嵌体修复后牙Ⅱ类洞的临床效果

Clinical effect of CEREC chairside on atypical ceramic inlay restoring class Ⅱ cavity

目的探讨椅旁瓷睿刻（CEREC）非典型瓷嵌体修复后牙Ⅱ类洞的临床效果。方法随机选择30例后牙早期邻面龋坏、采用树脂填充治疗失败要求再治疗的患者，去除尽原填充物及龋坏组织，去除倒凹，形成清晰圆钝的边缘线，按照CERECACCAD／CAM系统标准程序，采用西诺德CEREC Blocs瓷块制作35件嵌体，临床试戴及调改，3MVeneer树脂粘结剂粘固。由两位资深修复科医师于修复后即刻以及修复后3个月、6个月、12个月、24个月复诊时按照改良USPHS标准对修复体进行评价。结果修复完成后即刻评价各项标准结果均为A，2年内未发现修复体脱落现象，24个月复查时有3颗嵌体边缘崩裂。在粘结初期，有2例患者有轻微的牙本质敏感症状，后期消失。其余各时期各项指标评价结果为A的比例均超过90％，其中颜色匹配和固位两方面的效果最令人满意。结论CEREC非典型瓷嵌体可有效修复后牙Ⅱ类洞，短期效果良好，远期效果还需要进一步的观察。

Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class Ⅱ cavity. Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly. The original fillings, secondary carious tissues and undercut parts were removed. The clear and round edge lines were prepared. With Sirona CEREC Blocs, 35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures. After clinical trial and modification, the inlays were bonded with 3M Veneer resin adhesive cement. Evaluation was done immediately and 3, 6, 12 and 24 months after restoration. Two senior prosthodontists did the evaluation according to the modified USPHS criteria. Results The evaluation results were all A when estimated immediately after restoration. None inlay falled off during the first two years. However, 3 inlay were found to be damaged when reviewed at the 24th month. There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually. Generally speaking, more than 90% of inlay restorations had reached the USPHS criteria A. Color match and retention represented better effects. Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity, short-term effect is good, but long-term effect still needs further observations.