基牙预备量、基牙颜色与水门汀颜色对数字化加工的前牙单层玻璃陶瓷全冠修复体颜色影响的实验研究

Effects of the thickness of tooth preparation,abutment color,and resin cement shade on the color of digital-guided glass full-crown restoration for anterior teeth

目的:研究基牙预备量、基牙颜色与水门汀颜色对数字化设计加工的前牙不同厚度的单层玻璃陶瓷全冠修复体颜色的影响。方法:按照基牙预备量(1.0、1.5 mm)、基牙颜色(IPS-ND2、ND5、ND8)以及树脂水门汀颜色(Translucent-TR、B0.5 opaque-B0.5、White opaque-WO)3个影响因素将由树脂基牙-水门汀-全瓷冠组成的全瓷冠修复体模型随机分为18组,每组10个试件。单层玻璃陶瓷全冠使用计算机辅助设计与制作(CAD/CAM)方法加工。树脂基牙使用对应颜色的IPS Nature Die树脂充填制作。各组全瓷冠修复模型使用VITA Easyshade分光光度计测定每个全瓷冠颊侧中部的颜色,使用L^(*)a^(*)b^(*)系统记录色度值,并计算色差值。使用三因素方差分析检测不同因素对全瓷冠修复体色差的影响。结果:基牙预备量、基牙颜色、水门汀颜色以及三者的交互作用均对CAD/CAM加工前牙单层玻璃陶瓷全冠颜色存在显著的影响,差异具有统计学意义(P<0.001)。结论:使用CAD/CAM单层玻璃陶瓷全冠进行前牙修复时,应根据基牙颜色合理设计基牙预备量和冠厚度,选择适宜颜色的水门汀进行粘接,以期达到微创、美观、持久的修复效果。

Objective:To evaluate the effects of the thickness of tooth preparation,abutment color,and resin cement shade on the color of digital-guided glass full-crown restoration for incisor with different thickness of crown.Methods:The all-ceramic crown restorations were randomly divided into 18 groups according to three factors of the thickness of tooth preparation(1.0 mm and 1.5 mm),abutment color(IPS-ND2,ND5,ND8)and resin cement shade(Translucent-TR,B0.5 opaque-B0.5,White opaque-WO),with 10 specimens in each group.The monothetic glass ceramic crown was fabricated by CAD/CAM.The abutments were made using IPS nature die resin according to different colors as designed.The all-ceramic crowns in each group were temporally fixed on the resin abutment with the try-in paste for the color assessment using VITA Easyshade spectrophotometer and the results were recorded by L^(*)a^(*)b^(*)system.Results:The thickness of tooth preparation,abutment color and resin cement shade and their interaction all showed a significant effect on the color of digital-manufactured monothetic glass ceramic crown for incisor(P<0.001).Conclusions:In case of restoration with all ceramic crown that fabricated by CAD/CAM technique in anterior teeth,clinicians should make an optimal design of the tooth preparation and the thickness of the crown,according to the different abutment color.Furthermore,a resin cement with proper color should be selected for cementation in order to achieve an aesthetic and durable restoration.