臺灣博碩士論文加值系統

近年來，電腦輔助設計與製造（Computer-aided design and computer-aided manufacturing,CAD/CAM）的數位牙科全瓷冠贋復物之盛行，然而臨床上還是有諸多病患的條件得依賴陶瓷燒付金屬牙冠(Porcelain fused to metal crown , PFM)修復。而熱壓式金屬陶瓷（Press on metal ceramic, POM）製作方式漸漸興起，POM的製作過程有別於傳統式的PFM製成較節省時間，也能讓牙醫師與牙技師在臨床治療方法上多一項選擇。但在與金屬之鍵結強度上是否如同行之已久的PFM，壓鑄玻璃陶瓷的金屬瓷牙是否禁得起口腔內的環境冷熱變化，都是需要研究的課題。
本研究目的是比較傳統長石類陶瓷，與熱壓鑄式白榴石陶瓷和三種不同金屬之鍵結強度。 按照ISO9693(1999)標準，製作60個矩形樹脂模型(resin pattern)試片，分別鑄造成不同的金屬試片(金合金、鈀金合金和鎳鉻合金)，在不同金屬試片上燒付陶瓷 (PFM組暨對照組)，以及熱壓鑄陶瓷 (POM組)，之後進行三點彎曲測試。對於經過20000次冷熱循環後的各金屬試片進行三點彎曲測試。實驗結果顯示PFM金合金(Au-F) 50.19 MPa（p<0.05）與陶瓷間具有最高之鍵結強度，其次為鈀金合金及鎳鉻合金；而POM鈀金合金(Pd-P)則為最低之鍵結強度36.91 MPa(p<0.05)。實驗結果證明20000次冷熱循環前與後，在PFM組不同金屬-陶瓷試片的鍵結強度有明顯降低(p<0.05)，而在POM組則沒有顯著差異(p>0.05)，冷熱循環對試片的鍵結強度有顯著影響。
綜觀所有測試結果來說，結論是雖然使用POM法製作的試片之鍵結強度並不優於PFM , 但POM法試片之鍵結強度符合ISO9693之標準，所以在牙醫師與牙技師和病人的經濟考量下，POM法也會是臨床贋復治療選擇的方法之一。

Computer-aided design and computer-aided manufacturing (CAD/CAM) all-ceramic crowns have become popular dental prosthesis in recent years. However many patients still need to rely on porcelain fused to metal (PFM) crown restoration due to their clinical conditions. There has been a new technique called Press-on-Metal (POM) that has gradually become widely accepted in the market. The production process of POM differs from the traditional PFM. Apart from being more time-saving in the fabrication process, POM also offers another treatment option to both the dentist and technician in clinical practice. Nevertheless whether the bonding strength of porcelain to metal win POM is similar to the traditional PFM and whether POM restorations can withstand temperature changes in the mouth are still yet to be investigated.
The purpose of this study was to compare the traditional feldspathic ceramic, and die-cast key leucite ceramic and three different metals knot strength. According to ISO9693 (1999) standard, making rectangular resin pattern 60, test pieces were cast metal (gold alloy, palladium and cobalt-chromium alloy), respectively, then the respective test pieces sticking tiles metal (PFM cum control group), and a hot ceramic plate (POM group), followed by three-point bending test. Three-point bending tests were further performed after 20,000 thermal cycles. The results showed that the control group of gold alloys and ceramics had the highest bond strength (Au-F) 50.19 MPa (p<0.05), followed by palladium alloys and nickel-chromium alloys; while the POM group palladium alloy (Pd-P) had the lowest bond strength 36.91MPa (p>0.05). Experimental results show that 20,000 times before and after thermal cycling, the PFM Group of different metal-ceramic specimen bond strength was significantly lower (p<0.05), while no significant difference POM group (p>0.05), hot and cold cycles on the bond strength of the specimen has a significant impact.
Looking at all the tests results, the conclusion is that although the bond strength using POM method of making the test piece is not superior to PFM, but the bond strength POM method of specimen in line with ISO9693 standards, so the dentists and dental technicians and patients economic considerations, POM law will be one of the clinical method of prosthetic treatment options.

中文摘要 I
英文摘要 Ⅱ
總目錄 Ⅳ
表目錄 Ⅵ
圖目錄 Ⅶ
第一章前言 1
1-1研究的動機及目的 2
第二章 文獻回顧 4
2-1牙科PFM贋復物的歷史與現況 4
2-2牙科PFM用金屬 4
2-2-1金合金 6
2-2-2 鈀金合金 7
2-2-3鎳鉻合金 8
2-3牙科陶瓷材料 9
2-3-1牙科PFM用長石類陶材 9
2-3-2牙科PFM用白榴石陶材 11
2-4金屬與陶瓷間的結合性質 11
第三章 材料與實驗方法 15
3-1實驗材料 15
3-2-1試片製備 17
3-2-1-1基底金屬試片製備 17
3-2-1-2陶瓷部分製備 17
3-2-2三點彎曲試驗 20
3-2-3冷熱循環試驗 20
3-3 SEM和EDS分析 21
3-4 統計分析 21
第四章 結果 22
4-1三點彎曲強度 22
4-2 表面形態 23
4-3冷熱循環後的三點彎曲強度 32
第五章 討論 33
5-1三點彎曲強度 33
5-2冷熱循環後對三點彎曲強度影響 34
第六章 結論 36
第七章 參考文獻 37

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