不同加工方法及材料制作部分贴面的边缘形貌分析

Analysis of edge morphology of partial veneers made by different processing techniques and materials

目的:比较采用粉浆堆塑工艺、热压铸造工艺及计算机辅助设计/计算机辅助制造(computer aided design/computer aided manufacturing,CAD/CAM)技术制作的不同材料部分贴面的边缘形貌。方法:选择无明显磨耗、龋坏,表面釉质光滑完整的人前磨牙30颗,随机分为5组,每组6颗,分别采用耐火代型粉浆堆塑工艺制作Noritake~长石质烤瓷部分贴面,热压铸造工艺制作IPS E. max Press部分贴面,CAD/CAM技术制作VITA MarkⅡ、VITA Suprinity、VITA Enamic部分贴面。部分贴面试件粘接完成后,按照临床步骤进行边缘修整及抛光,获得在离体牙上粘接完成的部分贴面。通过肉眼观察、扫描电镜及色散能谱,记录并分析部分贴面边缘微观形貌及粘接剂暴露宽度。结果:不同加工方式及材料的部分贴面在粘接后经过修整、抛光,可获得肉眼可见的较光滑的材料表面及菲薄的刃状边缘。Noritake烤瓷组边缘较粗糙,粘接剂带状暴露量为(106. 00±9. 17)μm; E. max Press组边缘较平整,粘接剂暴露量为(138. 33±20. 59)μm; Enamic组边缘平滑,粘接剂暴露宽度较大,为(186. 00±5. 66)μm; MarkⅡ组与Suprinity组边缘虽有粗糙不平,但粘接剂暴露较少,分别为(50. 67±7. 51)μm及(65. 67±17. 90)μm;除MarkⅡ组与Suprinity组外,其余各组间差异均有统计学意义。结论:不同加工方法及材料制作的部分贴面,经过粘接、修整及抛光后,均可获得刃状边缘,但各组粘接剂有不同程度暴露,暴露量大小为MarkⅡ组/Suprinity组<Noritake组<E. max Press组<Enamic组,可见不同加工方式和材料制作的部分贴面边缘形貌存在差异。

Objective: To compare the edge morphology of partial veneers made of different materials by slurry molding, heat-pressed and computer aided design/computer aided manufacturing (CAD/CAM) techniques. Methods: Thirty premolars with smooth surface and intact enamel were selected and randomly divided into five groups, 6 specimens for each group. Group A were made from feldspathic porcelain (NoritakeR) by slurry molding, while Group B were made from lithium disilicate glass ceramic (IPS E.maxR Press) by heat-pressed. Group C/D/E were respectively made from feldspar porcelain block (VITA Mark ⅡR), zirconia-reinforced glass ceramic (VITA SuprinityR) and hybrid ceramic with a ceramic-polymer network (VITA EnamicR) by CAD/CAM techniques. All the partial veneers luted with light-cured composite resin. Then the partial veneers were trimmed and polished to achieve the smooth finishing margin, clinical polishing sets were used according to the product descriptions. Scanning electron microscope (SEM) was used to observe the edge morphology of prostheses and the exposure of resin cements. Results: The smooth surface and knife-like edge of the partial veneers could be obtained after bonding, trimming and polishing. The edges of Group A were slightly rough and the width of the exposed adhesive was (106.00±9.17)μm. In Group B, the edges were smoother than Group A, and the exposed wide adhesive strip was visible, which was (138.33±20.59)μm. In Group E, the edges were smooth too, and the width of exposed adhesive strip was (186.00±5.66)μm. The edges of Group C and Group D were rough and uneven, and the adhesive was rarely exposed, they were (50.67±7.51)μm and (65.67±17.90)μm. There were all significant differences between two groups, except Group C and Group D. Conclusion: After trimming and polishing in accordance with clinical procedures, the expected knife-like edge can be obtained in all groups. The width of the exposed resin adhesive of each group is different, the order: Mark Ⅱ/Suprinity<Noritake<E.max Press<Enamic. The edge morpho-logy of partial veneers in different processing technic and materials are different.