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最小牙体预备量和改善美观的后牙固定局部义齿的存活率:一项体外研究。

Survival of posterior fixed partial dentures with minimal tooth reduction and improved esthetics: An in vitro study.

机构信息

Graduate student, Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.

Professor, Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Prosthet Dent. 2022 Apr;127(4):585-592. doi: 10.1016/j.prosdent.2020.09.047. Epub 2020 Dec 30.

Abstract

STATEMENT OF PROBLEM

Different designs of posterior minimally invasive fixed partial dentures (MIFPDs) still require additional tooth preparation for guide planes, occlusal rest seats, and grooves and/or slots to increase retention and resistance forms. Whether a design with less tooth reduction can be successful is unclear.

PURPOSE

This in vitro study compared the long-term survival and retention after cyclic loading of a conventional MIFPD and a posterior MIFPD that was designed for less tooth reduction and improved esthetics.

MATERIAL AND METHODS

Previously frozen extracted human premolars and molars were embedded in polymethylmethacrylate resin blocks to simulate the loss of a first molar. The block specimens were divided into 3 groups (n=10) according to prosthesis design: control, a conventional posterior MIFPD with partial-coverage retainers; A2S, a 2-part posterior MIFPD with a semiprecision attachment; and A3, a 3-part posterior MIFPD. The prostheses were cemented onto the abutments with 4-methacryloxyethyl trimellitate anhydride/methylmethacrylate-tri-n-butylborane (4-META/MMA-TBB) resin. The specimens were subjected to 2 500 000 cyclic loading cycles with a compressive force of 50 to 800 N in a universal testing machine. After cyclic loading, the intact prosthesis was removed by using tensile force at a crosshead speed of 1 mm/min until failure. The mode of failure and bonding interface were evaluated by using stereomicroscopy and scanning electron microscopy. The retention data were analyzed by using 1-way ANOVA and the Tukey honestly significant difference (HSD) test (α=.05).

RESULTS

No prosthesis detached during cyclic loading. The mean ±standard deviation retentive forces among the control (396.7 ±73.2 N), A2S (228.3 ±52.5 N), and A3 (529.9 ±86.2 N) groups were significantly different (P<.05). The hybridized enamel layer of the abutments had a consistent thickness after immersion in 6 mol/L hydrochloric acid.

CONCLUSIONS

The results suggest that the 2- and 3-part posterior MIFPDs should have a high long-term survival rate in the oral cavity.

摘要

问题陈述

不同设计的后牙微创固定修复体(MIFPD)仍然需要额外的牙体预备来制作导平面、咬合支托和凹口/槽,以增加固位和抗力形。减少牙体预备的设计是否能成功尚不清楚。

目的

本体外研究比较了常规 MIFPD 和后牙微创固定修复体的长期存活率和循环加载后的保留率,后者的设计减少了牙体预备量并改善了美观。

材料和方法

将先前冷冻的人前磨牙和磨牙嵌入聚甲基丙烯酸甲酯树脂块中,以模拟第一磨牙的缺失。根据修复体设计,将块状标本分为 3 组(n=10):对照组,带有部分覆盖式固位体的常规后牙 MIFPD;A2S 组,带有半精密附着体的 2 部分后牙 MIFPD;A3 组,带有 3 部分后牙 MIFPD。用 4-甲基丙烯酰氧基乙基偏苯三酸酐/甲基丙烯酸甲酯-三正丁基硼烷(4-META/MMA-TBB)树脂将修复体粘接到基牙上。在万能试验机上用 50 至 800 N 的压缩力对标本进行 250 万次循环加载。循环加载后,以 1mm/min 的十字头速度用拉伸力将完整的修复体移除,直至失效。用体视显微镜和扫描电子显微镜评估失效模式和结合界面。用单向方差分析和 Tukey Honestly 显著差异(HSD)检验(α=.05)分析保留数据。

结果

在循环加载过程中,没有修复体脱落。对照组(396.7±73.2 N)、A2S 组(228.3±52.5 N)和 A3 组(529.9±86.2 N)的平均保留力有显著差异(P<.05)。浸入 6mol/L 盐酸后,基牙的混合釉质层具有一致的厚度。

结论

结果表明,2 部分和 3 部分后牙 MIFPD 在口腔中应有较高的长期存活率。

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