Akbar Jaber Hussain, Petrie Cynthia S, Walker Mary P, Williams Karen, Eick J David
Department of Restorative Dentistry, Kuwait University, Kuwait.
J Prosthodont. 2006 May-Jun;15(3):155-63. doi: 10.1111/j.1532-849X.2006.00095.x.
The purpose of this study was to compare marginal discrepancies of Cerec 3 CAD/CAM composite crowns, fabricated on human prepared teeth with two different finish line designs, chamfer and shoulder.
Sixteen human molar teeth were used to prepare full crowns. Eight teeth were prepared with a 1-mm-wide chamfer finish line and the other eight with a 1.2- to 1.5-mm circumferential shoulder. Cerec 3 crowns were fabricated from optical impressions using Paradigm MZ100 composite polymer. Marginal adaptation was evaluated in two ways: (1) using modified United States Public Health Service (USPHS) criteria to evaluate eight preselected sites on each crown margin, and (2) using scanning electron microscopy (SEM) to measure marginal gaps on all four axial walls with 15 measurements on each wall (60 measurements per crown). An evaluation of the number of acceptable crowns, determined by having all measured sites per tooth with margin gap size less than 100 microm, as a function of finish line design was also conducted.
In both chamfer and shoulder groups, there were only two crowns (out of eight) with clinically acceptable ratings for all eight measurement sites according to USPHS criteria. Fisher's chi-square analysis showed that there was no statistically significant difference in marginal adaptability as a function of finish line design ( p>0.05). With SEM imaging, overall mean marginal gaps for the chamfer group were 65.9+/-38.7 microm (range 35.0 to 130.0 microm), and for the shoulder group were 46.0+/-9.2 microm (range 26.3 to 55.6 microm); this difference was not found to be statistically significant ( p>0.05). While crown assessment based on mean marginal discrepancy measurements indicated that both the chamfer and shoulder groups were considered clinically acceptable (<100 microm); crown acceptability based on all measurement sites being less than 100 mum indicated that in the chamfer and shoulder groups there were four and three acceptable crowns out of eight, respectively. The Fisher's chi-square test indicated no statistically significant difference between the groups ( p>0.05). An agreement rate of 81.2% was calculated between the two evaluation methods, modified USPHS criteria and SEM measurements.
Based on mean marginal discrepancy measurements, the typical marginal assessment technique, Cerec 3 Paradigm MZ100 crown restorations appear to have acceptable marginal adaptability (mean discrepancies <100 microm). Thus, the evidence from this investigation would suggest that the finish line preparation design had no effect on marginal adaptation for Cerec 3 composite crowns.
本研究的目的是比较在人类预备牙上制作的、具有两种不同肩台设计(倒角和肩台)的Cerec 3 CAD/CAM复合全冠的边缘差异。
使用16颗人类磨牙制备全冠。8颗牙制备1毫米宽的倒角肩台,另外8颗制备1.2至1.5毫米的圆周肩台。使用Paradigm MZ100复合聚合物通过光学印模制作Cerec 3全冠。通过两种方式评估边缘适合性:(1)使用改良的美国公共卫生服务(USPHS)标准评估每个冠边缘的8个预选部位;(2)使用扫描电子显微镜(SEM)测量所有四个轴壁上的边缘间隙,每个壁测量15次(每个冠测量60次)。还进行了一项评估,确定根据边缘间隙尺寸小于100微米的每个牙齿所有测量部位来确定可接受全冠数量与肩台设计的关系。
在倒角组和肩台组中,根据USPHS标准,8个测量部位在临床上均达到可接受评级的全冠均仅有2个(共8个)。Fisher卡方分析表明,作为肩台设计函数的边缘适合性在统计学上无显著差异(p>0.05)。通过SEM成像,倒角组的总体平均边缘间隙为65.9±38.7微米(范围35.0至130.0微米);肩台组为46.0±9.2微米(范围26.3至55.6微米);未发现此差异具有统计学意义(p>0.05)。虽然基于平均边缘差异测量的全冠评估表明倒角组和肩台组在临床上均被认为是可接受的(<100微米);但基于所有测量部位均小于100微米的全冠可接受性表明,倒角组和肩台组在8个全冠中分别有4个和3个可接受全冠。Fisher卡方检验表明两组之间无统计学显著差异(p>0.05)。改良USPHS标准和SEM测量这两种评估方法之间的一致率为81.2%。
基于平均边缘差异测量这一典型的边缘评估技术,Cerec 3 Paradigm MZ100全冠修复体似乎具有可接受的边缘适合性(平均差异<100微米)。因此,本研究的证据表明,肩台预备设计对Cerec 3复合全冠的边缘适合性没有影响。