Del Curto Filippo, Saratti Carlo Massimo, Krejci Ivo
Int J Esthet Dent. 2018;13(1):50-64.
Since the first introduction of the Cerec system (Sirona) in the early 1980s, the use of computer-aided design/computer-aided manufacture (CAD/CAM) technology has spread widely in modern adhesive dentistry. Thanks to this innovative technology, it has been possible to carry out chairside restorations fully managed by the clinician, with the advantages of lower costs for the patient, more rapid execution of the restorations, and the exclusion of the provisional phase. With further improvements in chairside technologies and materials, specifically in the field of composite resin blocks, it is now possible to fabricate multiple ultrathin, minimally invasive or even noninvasive restorations in one single appointment. The clinical case presented here was solved using an innovative approach: It was entirely studied and realized chairside by a dentist on a computer, without any plaster cast or classic articulator. Vertical dimension of occlusion (VDO) augmentation was projected with the 'Incisal Tip' tool on the virtual articulator of the Cerec system. Eight composite resin overlays were designed on the non-prepared posterior teeth of a patient suffering from generalized tooth loss principally caused by a history of bulimia nervosa. The maxillary anterior teeth were restored with six palatal veneers modified with direct composites from the vestibular side, in order to improve the esthetic integration of the restorations. The mandibular posterior teeth were built up with direct composites.
自20世纪80年代初首次引入Cerec系统(西诺德公司)以来,计算机辅助设计/计算机辅助制造(CAD/CAM)技术在现代粘结牙科中得到了广泛应用。得益于这项创新技术,临床医生能够在椅旁完成完全自主管理的修复,具有降低患者成本、更快完成修复以及省去临时修复阶段等优点。随着椅旁技术和材料的进一步改进,特别是在复合树脂块领域,现在有可能在一次就诊中制作多个超薄、微创甚至无创修复体。这里展示的临床病例采用了一种创新方法:由一名牙医在计算机上完全在椅旁进行研究和制作,无需任何石膏模型或传统牙合架。利用Cerec系统虚拟牙合架上的“切端提示”工具预测了咬合垂直距离(VDO)的增加。在一名主要因神经性贪食症病史而患有广泛性牙齿缺失的患者未预备的后牙上设计了八个复合树脂覆盖体。上颌前牙用六个从唇侧用直接复合材料改良的腭面贴面进行修复,以改善修复体的美学整合。下颌后牙用直接复合材料进行堆塑。