粘结固位可提高氧化锆全冠的抗疲劳性能。

Adhesive Cementation Promotes Higher Fatigue Resistance to Zirconia Crowns.

作者信息

Campos F, Valandro L F, Feitosa S A, Kleverlaan C J, Feilzer A J, de Jager N, Bottino M A

出版信息

Oper Dent. 2017 Mar/Apr;42(2):215-224. doi: 10.2341/16-002-L. Epub 2016 Nov 28.

DOI:10.2341/16-002-L

PMID:27892840

Abstract

OBJECTIVE

The aim of this study was to investigate the influence of the cementation strategy on the fatigue resistance of zirconia crowns. The null hypothesis was that the cementation strategy would not affect the fatigue resistance of the crowns.

METHODS AND MATERIALS

Seventy-five simplified molar tooth crown preparations were machined in glass fiber-filled epoxy resin. Zirconia crowns were designed (thickness=0.7 mm), milled by computer-aided design/computer-aided manufacturing, and sintered, as recommended. Crowns were cemented onto the resin preparations using five cementation strategies (n=15): ZP, luting with zinc phosphate cement; PN, luting with Panavia F resin cement; AL, air particle abrasion with alumina particles (125 μm) as the crown inner surface pretreatment + Panavia F; CJ, tribochemical silica coating as crown inner surface pretreatment + Panavia F; and GL, application of a thin layer of porcelain glaze followed by etching with hydrofluoric acid and silanization as crown inner surface pretreatment + Panavia F. Resin cement was activated for 30 seconds for each surface. Specimens were tested until fracture in a stepwise stress fatigue test (10,000 cycles in each step, 600 to 1400 N, frequency of 1.4 Hz). The mode of failure was analyzed by stereomicroscopy and scanning electron microscopy. Data were analyzed by Kaplan-Meier and Mantel-Cox (log rank) tests and a pairwise comparison (p<0.05) and by Weibull analysis.

RESULTS

The CJ group had the highest load mean value for failure (1200 N), followed by the PN (1026 N), AL (1026 N), and GL (1013 N) groups, while the ZP group had the lowest mean value (706 N). Adhesively cemented groups (CJ, AL, PN, and GL) needed a higher number of cycles for failure than the group ZP did. The groups' Weibull moduli (CJ=5.9; AL=4.4; GL=3.9; PN=3.7; ZP=2.1) were different, considering the number of cycles for failure data. The predominant mode of failure was a fracture that initiated in the cement/zirconia layer. Finite element analysis showed the different stress distribution for the two models.

CONCLUSION

Adhesive cementation of zirconia crowns improves fatigue resistance.

摘要

目的

本研究旨在调查粘结策略对氧化锆全冠疲劳抗力的影响。无效假设为粘结策略不会影响全冠的疲劳抗力。

方法与材料

在玻璃纤维增强环氧树脂中加工75个简化磨牙全冠预备体。按照推荐设计（厚度 = 0.7 mm）氧化锆全冠，通过计算机辅助设计/计算机辅助制造进行研磨，并烧结。使用五种粘结策略（n = 15）将全冠粘结到树脂预备体上：ZP，用磷酸锌水门汀粘结；PN，用Panavia F树脂水门汀粘结；AL，用125μm氧化铝颗粒进行空气颗粒喷砂作为全冠内表面预处理 + Panavia F；CJ，用摩擦化学硅涂层作为全冠内表面预处理 + Panavia F；以及GL，在全冠内表面预处理 + Panavia F之前先涂一层薄瓷釉，然后用氢氟酸蚀刻并进行硅烷化处理。每种表面的树脂水门汀均活化30秒。在逐步应力疲劳试验（每步10,000次循环，600至1400 N，频率1.4 Hz）中对标本进行测试直至断裂。通过体视显微镜和扫描电子显微镜分析失效模式。数据通过Kaplan - Meier和Mantel - Cox（对数秩）检验以及成对比较（p < 0.05）和威布尔分析进行分析。

结果

CJ组的失效载荷平均值最高（1200 N），其次是PN组（1026 N）、AL组（1026 N）和GL组（1013 N），而ZP组的平均值最低（706 N）。粘结性粘结组（CJ、AL、PN和GL）比ZP组达到失效所需的循环次数更多。考虑到失效数据的循环次数，各组的威布尔模量（CJ = 5.9；AL = 4.4；GL = 3.9；PN = 3.7；ZP = 2.1）不同。主要的失效模式是在水门汀/氧化锆层起始的断裂。有限元分析显示两种模型的应力分布不同。