Department of Prosthodontics, Showa University School of Dentistry, Tokyo, Japan.
J Prosthodont. 2013 Jul;22(5):402-7. doi: 10.1111/jopr.12001. Epub 2013 Jan 4.
Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porcelain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed. The aim of this report was to describe the clinical application of a newly developed implant-supported FDP fabrication system, which uses PAZ, and to evaluate the outcome after a maximum application period of 36 months. Implants were placed in three patients with edentulous areas in either the maxilla or mandible. After the implant fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom abutments were first fabricated. Zirconia framework wax-up was performed on the custom abutments, and the CAD/CAM zirconia framework was prepared using the CAD/CAM system. Next, wax-up was performed on working models for porcelain crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive resin cement, and the PAZ was cemented. Cementation of the implant superstructure improved the esthetics and masticatory efficiency in all patients. No undesirable outcomes, such as superstructure chipping, stomatognathic dysfunction, or periimplant bone resorption, were observed in any of the patients. PAZ may be a potential solution for ceramic-related clinical problems such as chipping and fracture and associated complicated repair procedures in implant-supported FDPs.
最近，开发出了一种将 CAD/CAM 瓷冠附着在 CAD/CAM 氧化锆基底上的混合结构固定义齿修复体（FDP）。本报告旨在描述一种新开发的使用 PAZ 的种植体支持的 FDP 制造系统的临床应用，并评估最长 36 个月的应用期后的结果。在三个上颌或下颌无牙区的患者中植入了种植体。在种植体固位体与骨成功整合后，首先制作金铂合金或氧化锆定制基台。在定制基台上进行氧化锆基底蜡型制作，并使用 CAD/CAM 系统制备 CAD/CAM 氧化锆基底。然后，在工作模型上进行瓷冠制作的蜡型制作，并制作 CAD/CAM 瓷冠。使用黏接树脂水门汀将 CAD/CAM 氧化锆基底和 CAD/CAM 瓷冠黏接，然后黏接 PAZ。在所有患者中，种植体上部结构的黏接都改善了美观和咀嚼效率。在所有患者中，均未观察到不良结果，如上部结构崩瓷、咀嚼功能障碍或种植体周围骨吸收。PAZ 可能是种植体支持的 FDP 中与陶瓷相关的临床问题（如崩瓷和骨折）及其相关复杂修复程序的潜在解决方案。
