CAD/CAM 制作的种植体支持临时冠的体外性能。
In-vitro performance of CAD/CAM-fabricated implant-supported temporary crowns.
机构信息
Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042, Regensburg, Germany.
出版信息
Clin Oral Investig. 2017 Nov;21(8):2581-2587. doi: 10.1007/s00784-017-2057-7. Epub 2017 Jan 21.
OBJECTIVES
The aim of this study was to investigate the in-vitro performance and fracture resistance of a temporary computer-aided designed and computer-aided manufactured polymethylmethacrylate (CAD/CAM-PMMA) material as implant or tooth-supported single crown with respect to the clinical procedure (permanently bonded/temporarily cemented).
MATERIALS AND METHODS
Sixty-four crowns were fabricated on implants or human molar teeth simulating (a) labside procedure on prefabricated titanium-bonding base ([TiBase] implant crown bonded in laboratory, screwed chairside), (b) labside procedure ([LAB] standard abutment and implant crown bonded in laboratory, screwed chairside), (c) chairside procedure ([CHAIR] implant crown bonded to abutment), and (d) reference ([TOOTH] crowns luted on prepared human teeth). Crowns were made of a CAD/CAM-PMMA temporary material (TelioCAD, Ivoclar-Vivadent). For investigating the influence of fixation, half of the crowns were permanently (P) or temporarily (T) bonded. Combined thermal cycling and mechanical loading (TCML) was performed simulating a 5-year clinical situation. Fracture force was determined. Data were statistically analyzed (Kolmogorov-Smirnov test, one-way ANOVA; post hoc Bonferroni, α = 0.05).
RESULTS
All restorations survived TCML without visible failures. Fracture results varied between 3034.3 (Tooth-P) and 1602.9 N (Tooth-T) [TOOTH], 1510.5 (TiBase-P) and 963.6 N (TiBase-T) [TiBase], 2691.1 (LAB-P) and 2064.5 N (LAB-T) [LAB], and 1609.4 (Chair-P) and 1253.0 N (Chair-T) [CHAIR]. Tested groups showed significantly (p < 0.001) different fracture values. Failure pattern was characterized by fractures in mesial-distal, buccal-oral, or mixed (mesial-distal/buccal-oral) directions, with differences for the individual groups.
CONCLUSIONS
Temporary CAD/CAM crowns showed no different in-vitro performance but provided different fracture results that depended on cementation, screw channel, and type of abutment.
CLINICAL RELEVANCE
All bonded and screwed PMMA crowns were in a range where clinical application seems not restricted.
目的
本研究旨在研究一种临时计算机辅助设计和制造的聚甲基丙烯酸甲酯（CAD/CAM-PMMA）材料作为种植体或牙支持的单冠的体外性能和抗折强度，其临床操作（永久性粘结/临时粘结）。
材料和方法
在模拟（a）预制钛粘结基底上的实验室程序[TiBase]（实验室粘结的种植体冠，椅旁螺丝固定）、（b）实验室程序[LAB]（标准基台和种植体冠在实验室粘结，椅旁螺丝固定）、（c）椅旁程序[CHAIR]（粘结到基台上的种植体冠）和（d）参照[TOOTH]（粘结到预备好的人牙上的冠）的情况下，在种植体或人磨牙上制作了 64 个冠。冠由 CAD/CAM-PMMA 临时材料（TelioCAD，Ivoclar-Vivadent）制成。为了研究固定的影响，一半的冠永久性（P）或临时（T）粘结。模拟 5 年临床情况进行热循环和机械加载（TCML）联合测试。测定断裂力。数据进行统计学分析（Kolmogorov-Smirnov 检验，单因素方差分析；事后 Bonferroni，α=0.05）。
结果
所有修复体在 TCML 后均无可见失效。断裂结果在[TOOTH]之间变化，从 3034.3N（Tooth-P）到 1602.9N（Tooth-T），从 1510.5N（TiBase-P）到 963.6N（TiBase-T），从 2691.1N（LAB-P）到 2064.5N（LAB-T），从 1609.4N（Chair-P）到 1253.0N（Chair-T）。测试组的断裂值有显著差异（p<0.001）。失效模式表现为近远中、颊舌或混合（近远中/颊舌）方向的断裂，各组之间存在差异。
结论
临时 CAD/CAM 冠在体外性能上没有差异，但提供了不同的断裂结果，这取决于粘结、螺丝通道和基台类型。
临床相关性
所有粘结和螺丝固定的 PMMA 冠都在临床应用范围内。
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