Podhorsky Anke, Rehmann Peter, Wöstmann Bernd
Department of Prosthodontics, School of Dental Medicine, Justus-Liebig-University, Schlangenzahl 14, 35392, Giessen, Germany,
Clin Oral Investig. 2015 Jun;19(5):959-68. doi: 10.1007/s00784-015-1439-y. Epub 2015 Mar 7.
The objective of this review was to assess the current knowledge about tooth preparation for full-coverage restorations regarding the following aspects: biological parameters, preparation geometry, and technical conditions.
A systematic literature search was conducted using three electronic databases (MEDLINE, DIMDI, and Cochrane databases) in order to identify relevant citations; additionally, the process was augmented by a hand search.
A number of 117 citations were relevant; 11 of these were reviews, 23 were clinical studies, 82 were in vitro investigations, and one was animal research.
The basic form of a preparation has not changed substantially over the years, although new materials like all-ceramic systems have their own demands with regard to the details of the preparation's geometry. Estimating how much of the tooth structure can be removed without harming the tooth remains one of the biggest problems, if not the main difficulty, during tooth preparation. As the periodontal tissues may be affected by the restoration margin, a supragingival position of the margin should be preferred whenever possible. No finish line design has yet proven to be superior with regard to the marginal accuracy of the subsequent restoration. Instead, good detectability of the margin for the dental technician or intraoral scanning devices appears to be of primary importance in order to achieve a good fitting restoration.
A detailed look at the covered aspects regarding tooth preparations can help to improve clinical outcomes in daily practice.
本综述的目的是评估目前关于全冠修复体牙体预备在以下方面的知识:生物学参数、预备体几何形状和技术条件。
使用三个电子数据库(MEDLINE、DIMDI和Cochrane数据库)进行系统的文献检索,以识别相关引文;此外,通过手工检索对该过程进行补充。
有117篇引文相关;其中11篇为综述,23篇为临床研究,82篇为体外研究,1篇为动物研究。
多年来,预备体基本形式变化不大,尽管全瓷系统等新材料对预备体几何形状细节有其自身要求。在牙体预备过程中,估计在不损害牙齿的情况下可以去除多少牙体组织仍然是最大的问题之一,即便不是主要困难。由于牙周组织可能受到修复体边缘的影响,因此应尽可能优先选择龈上边缘位置。就后续修复体的边缘精度而言,尚未证明哪种肩台设计更优。相反,为了获得贴合良好的修复体,对于牙科技师或口内扫描设备来说,边缘具有良好的可探测性似乎至关重要。
详细了解牙体预备所涵盖的方面有助于改善日常临床治疗效果。