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饰面与整体式二硅酸锂瓷冠在边缘嵴上负载的寿命预测。

Lifetime prediction of veneered versus monolithic lithium disilicate crowns loaded on marginal ridges.

机构信息

Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil.

Department of Prosthodontics, Unigran University School of Dentistry, Dourados, MS, Brazil.

出版信息

Dent Mater. 2019 Mar;35(3):511-522. doi: 10.1016/j.dental.2019.01.007. Epub 2019 Jan 25.

Abstract

OBJECTIVE

To evaluate the probability of survival of monolithic and porcelain veneered lithium disilicate crowns comprised by a conventional or modified core when loaded on marginal ridges.

METHODS

Lithium disilicate molar crowns (n=30) were fabricated to be tested at mesial and distal marginal ridges and were divided as follows: (1) bilayered crowns with even-thickness 0.5mm framework (Bi-EV); (2) bilayered crowns with modified core design (Bi-M-lingual collar connected to proximal struts), and: (3) monolithic crowns (MON). After adhesively cemented onto composite-resin prepared replicas, mesial and distal marginal ridges of each crown (n=20) were individually cyclic loaded in water (30-300N) with a ceramic indenter at 2Hz until fracture. The 2-parameter Weibull was used to calculate the probability of survival (reliability) (90% 2-sided confidence bounds) at 1, 2, and 3 million cycles and mean life.

RESULTS

The reliability at 1 and 2 million cycles was significantly higher for MON (47% and 19%) compared to Bi-EV (20% and 4%) and Bi-M (17% and 2%). No statistical difference was found between bilayered groups. Only the MON group presented crown survival (7%) at 3 million cycles. The mean life was highest for MON (1.73E+06), lowest for Bi-M (573,384) and intermediate for Bi-E (619,774). Fractographic analysis showed that the fracture originated at the occlusal surface. The highest reliability was found for MON crowns. The modified framework design did not improve the fatigue life of crowns.

SIGNIFICANCE

Monolithic lithium disilicate crowns presented higher probability of survival and mean life than bilayered crowns with modified framework design when loaded at marginal ridges.

摘要

目的

评估传统或改良核层构成的整体式和烤瓷贴面锂硅石全冠在边缘脊负载下的生存概率。

方法

制作锂硅石磨牙全冠(n=30),在近中及远中边缘脊进行测试,分组如下:(1)双层冠,等厚 0.5mm 基底(Bi-EV);(2)改良核层设计的双层冠(Bi-M-连接颊舌侧支柱的双侧领环);(3)整体式冠(MON)。用复合树脂预备体上的树脂复制体,将各牙冠(n=20)的近中及远中边缘脊分别进行水载循环加载(30-300N),用陶瓷压头以 2Hz 加载,直至断裂。采用两参数威布尔分布计算 1、2 和 300 万次循环的生存概率(可靠性)(90%双侧置信区间)和平均寿命。

结果

MON 组在 1 和 200 万次循环的可靠性显著高于 Bi-EV 组(47%和 19%)和 Bi-M 组(17%和 2%)。双层组间无统计学差异。只有 MON 组在 300 万次循环时有牙冠存活(7%)。MON 组的平均寿命最高(1.73E+06),Bi-M 组最低(573384),Bi-E 组居中(619774)。断裂形态分析显示,断裂起源于牙合面。MON 牙冠的可靠性最高。改良基底设计并未提高牙冠的疲劳寿命。

意义

在边缘脊负载下,整体式锂硅石全冠的生存概率和平均寿命均高于改良基底设计的双层冠。

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