(100.26.179.251) 您好!臺灣時間:2021/04/21 22:09
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:陳鉉
研究生(外文):Hsuan Chen
論文名稱:牙齒研磨品質對CAD/CAM全瓷冠邊緣密合度的影響
論文名稱(外文):Effect of Preparation Quality on the Marginal Fitness of the CAD/CAM All-Ceramic Crown
指導教授:許明倫許明倫引用關係
指導教授(外文):Ming-Lun Hsu
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:牙醫學系
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2016
畢業學年度:104
語文別:英文
論文頁數:34
中文關鍵詞:數位牙科牙體製備口掃機全瓷冠
外文關鍵詞:Digital DentistryAbutment PreparationIntraoral ScannerAll-Ceramic CrownsDental Education
相關次數:
  • 被引用被引用:0
  • 點閱點閱:212
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
固定贋復牙冠的品質可以取決於牙冠邊緣的密合度。到目前,有大量的文章探討CAD/CAM全瓷冠邊緣的密合度,但絕大部分的研究方法是在口外模型上做牙冠,或是在接近完美的環境參數裡製作贋復體,幾乎沒有研究團隊把臨床變數列入考量,例如牙體製備的品質。此研究的目的是要針對製備體邊緣的品質,尋找它對最後CAD/CAM全瓷冠邊緣密合度的影響。經由十五位臨床牙醫師,每人在相同的環境下,在假人頭裡研磨三顆左上顎第一大臼齒,並由數位口內掃描機和特殊軟體客觀的決定製備的品質。接著利用CEREC系統在每一顆製備體上設計並研磨長石全瓷牙冠,然後使用TRIPLE-SCAN PROTOCOL以及相關軟體做3D分析。 在四十五顆製備體中,十九顆有瑕疵的被歸類為P-GROUP,二十六顆無瑕疵的被歸類為G-GROUP。兩組織間的邊緣密度分別是 82.13 (P-GROUP)和 62.12(G-GROUP),並使用T-TEST驗證達到統計學上的差異。在此研究範圍內,證實牙體製備的邊緣品質與CAD/CAM全瓷冠的邊緣密合度有直接相關。
Marginal fit of the crown is a key assessment of the fixed partial denture quality. Numerous studies have been performed to evaluate the marginal fit of CAD/CAM all-ceramic crowns fabricated under ideal conditions, but very few studies have investigated the impact of real clinical factors, such as the quality of the abutment preparation. The purpose of this study is to evaluate the effect of preparation quality on the marginal fit of CAD/CAM crowns. Fifteen dental clinicians made three preparations of the upper left first molar on the typodont, and the quality of the preparation was objectively determined using a preparation analyzer software. Feldspathic crowns were fabricated using the standard digital workflow on the CEREC System. The marginal fit of the crown was measured using the Triple-Scan Protocol, and digitally analyzed and measured in 3D with computer software. Out of 45 prepared abutments, 19 were rated “poor” (P-Group) and 26 were rated “good” (G-Group). The marginal gap means in the P- and G-groups were 82.13 (±9.41) um and 62.12 (±10.11) um, respectively. Statistical analysis with two-tailed t-test showed p-value < 0.01, indicating significant difference between the two groups. Within the limitations of this study, the quality of the margin preparation is correlated to the marginal fit of the CAD/CAM all-ceramic crown.
Acknowledgements i
Chinese Abstract ii
English Abstract iii
Table of Contents iv
Table of Figures v
List of Tables vi
Introduction 1
Literature Review 2
Method 5
A. Preparation 5
B. Crown Fabrication 7
C. Analysis 9
Triple-Scan Protocol 9
3D Marginal Fitness Analysis 10
Virtual Replica 10
Optical Microscope 11
D. Scanner Precision Verification 12
Results 13
Statistical Analysis 14
Discussion 15
Conclusions 27
Further Research 28
References 29

Figure 1: KaVo Typodont xxxv
Figure 2: Bur kit containing all the high-speed burs provided to each participant xxxvi
Figure 3: The CEREC Omnicam from DENTSPLY-Sirona xxxvii
Figure 4: Partial scan of the crown and supporting wax xxxviii
Figure 5: Partial scan of the prepared abutment xxxix
Figure 6: Partial scan of the crown-abutment complex xl
Figure 7: 3D distances to the opposing crown in the Marginal Ramp region. xli
Figure 8: 3D distances to the opposing crown model in the Axial Region xlii
Figure 9: 3D distances to the opposing crown model in the Occlusal Region xliii
Figure 10: Sites for measurement on the virtual replica xliv
Figure 11: Partial measurements of a single section in the virtual replica xlv
Figure 12: Imperfections xlvi
Figure 13: Illustration of the over-milling effect xlvii
Figure 14: Illustration of the under-milling effect xlviii

Table 1: Group designation and mean gap measurements . xlix
1. Tsirogiannis P, Reissmann DR, Heydecke G. Evaluation of the marginal fit of single-unit, complete-coverage ceramic restorations fabricated after digital and conventional impressions: A systematic review and meta-analysis. J Prosthet Dent. 2016.
2. Şeker E, Ozcelik TB, Rathi N, Yilmaz B. Evaluation of marginal fit of CAD/CAM restorations fabricated through cone beam computerized tomography and laboratory scanner data. J Prosthet Dent. 2016;115(1):47-51.
3. Abdel-Azim T, Rogers K, Elathamna E, Zandinejad A, Metz M, Morton D. Comparison of the marginal fit of lithium disilicate crowns fabricated with CAD/CAM technology by using conventional impressions and two intraoral digital scanners. J Prosthet Dent. 2015;114(4):554-559.
4. Guerini V. A History of Dentistry: From the Most Ancient Times Until the End of the Eighteenth Century. Lea & Febiger; 1909.
5. Bremner MDK. The Story of Dentistry: From the Dawn of Civilization to the Present. Dental Items of Interest Publishing Company; 1939.
6. Yang X, Lv P, Liu Y, Si W, Feng H. Accuracy of Digital Impressions and Fitness of Single Crowns Based on Digital Impressions. Materials (Basel). 2015;8(1):3945-3957.
7. Colpani JT, Borba M, Della Bona A. Evaluation of marginal and internal fit of ceramic crown copings. Dent Mater. 2013;29(2):174-180.
8. Baig MR, Tan KB-C, Nicholls JI. Evaluation of the marginal fit of a zirconia ceramic computer-aided machined (CAM) crown system. J Prosthet Dent. 2010;104(4):216-227.
9. Huang Z, Zhang L, Zhu J, Zhao Y, Zhang X. Clinical Marginal and Internal Fit of Crowns Fabricated Using Different CAD/CAM Technologies. J Prosthodont. 2015;24(4):291-295.
10. Jacob HB, Wyatt GD, Buschang PH. Reliability and validity of intraoral and extraoral scanners. Prog Orthod. 2015;16:38.
11. Pradies G, Zarauz C, Valverde A, Ferreiroa A, Martinez-Rus F. Clinical evaluation comparing the fit of all-ceramic crowns obtained from silicone and digital intraoral impressions based on wavefront sampling technology. J Dent. 2015;43(2):201-208.
12. Tidehag P, Ottosson K, Sjögren G. Accuracy of Ceramic Restorations Made Using an In-office Optical Scanning Technique: An In Vitro Study. Oper Dent. 2013:308-316.
13. Brawek PK, Wolfart S, Endres L, Kirsten A, Reich S. The clinical accuracy of single crowns exclusively fabricated by digital workflow-the comparison of two systems. Clin Oral Investig. 2013;17(9):2119-2125.
14. Schaefer O, Watts DC, Sigusch BW, Kuepper H, Guentsch A. Marginal and internal fit of pressed lithium disilicate partial crowns in vitro: A three-dimensional analysis of accuracy and reproducibility. Dent Mater. 2012;28(3):320-326.
15. Ucar Y, Akova T, Akyil MS, Brantley WA. Internal fit evaluation of crowns prepared using a new dental crown fabrication technique: Laser-sintered Co-Cr crowns. J Prosthet Dent. 2009;102(4):253-259.
16. Bindl A, Mörmann WH. Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. J Oral Rehabil. 2005;32(6):441-447.
17. Hack GD, Patzelt SBM. Evaluation of the Accuracy of Six Intraoral Scanning. Am Dent Assoc. 2015;10(4):1-5.
18. Kokubo Y, Ohkubo C. Clinical marginal and internal gaps of Procera AllCeram crowns. J Oral Rehabil. 2005;32:526-530.
19. Kuhn K, Ostertag S, Ostertag M, Walter MH, Luthardt RG, Rudolph H. Comparison of an analog and digital quantitative and qualitative analysis for the fit of dental copings. Comput Biol Med. 2015;57:32-41. doi:10.1016/j.compbiomed.2014.11.017.
20. Nawafleh NA, Mack F, Evans J, Mackay J, Hatamleh MM. Accuracy and reliability of methods to measure marginal adaptation of crowns and FDPs: A literature review. J Prosthodont. 2013;22(5):419-428.
21. Ng J, Ruse D, Wyatt C. A comparison of the marginal fit of crowns fabricated with digital and conventional methods. J Prosthet Dent. 2014;112(3):555-560.
22. Oyague RC, Sanchez-Jorge MI, Sanchez Turrion A. Evaluation of fit of zirconia posterior bridge structures constructed with different scanning methods and preparation angles. Odontology. 2010;98(2):170-172.
23. Okamoto K, Nakamura T, Tanaka H, et al. In Vitro Study on marginal and internal fit of CAD / CAM all-ceramic crowns. Japanese Soc Dent Mater Devices. 2005;24(3):456-459.
24. Holst S, Karl M, Wichmann M, Matta R. A new triple-scan protocol for 3D fit assessment of dental restorations. Quintessence Int. 2011;42(8):651-657.
25. Podhorsky A, Rehmann P, Wostmann B. Tooth preparation for full-coverage restorations - a literature review. Clin Oral Investig. 2015;19(5):959-968.
26. Reich S, Uhlen S, Gozdowski S, Lohbauer U. Measurement of cement thickness under lithium disilicate crowns using an impression material technique. Clin Oral Investig. 2011;15(4):521-526.
27. Christensen G. Marginal fit of gold inlay castings. Oper Dent. 1966;16(2):297-305.
28. McLean J, Von Fraunhofer J. The estimation of cement film thickness by an in vivo technique. Br Dent J. 1971;131(3):107-111.
29. Boening KW, Walter MH, Reppel PD. Non-cast titanium restorations in fixed prosthodontics. J Oral Rehabil. 1992;19(3):281-287.
30. Tsukada G, Tanaka T, Kajihara T, Torii M, Inoue K. Film thickness and fluidity of various luting cements determined using a trial indentation meter. Dent Mater. 2006;22(2):183-188.
31. Quintas AF, Oliveira F, Bottino MA. Vertical marginal discrepancy of ceramic copings with different ceramic materials, finish lines, and luting agents: An in vitro evaluation. J Prosthet Dent. 2004;92(3):250-257.
32. Anadioti E, Aquilino SA, Gratton DG, et al. 3D and 2D Marginal Fit of Pressed and CAD/CAM Lithium Disilicate Crowns Made from Digital and Conventional Impressions. J Prosthodont. 2014;23(8):610-617.
33. Renne W, Wolf B. Evaluation of the Marginal Fit of CAD/CAM Crowns Fabricated Using Two Different Chairside CAD/CAM Systems on Preparations of Varying Quality. J Esthet Restor Dent. 2015;27(4):194-202.
34. Renne W, McGill ST, Forshee KV, Defee MR, Mennito AS. Predicting marginal fit of CAD/CAM crowns based on the presence or absence of common preparation errors. J Prosthet Dent. 2012;108(5):310-315.
35. Satterthwaite JD, Grey NJA. Peer-group assessment of pre-clinical operative skills in restorative dentistry and comparison with experienced assessors. Eur J Dent Educ. 2008;12(2):99-102.
36. Goepferd SJ, Kerber PE. A comparison of two methods for evaluating primary class II cavity preparations. J Dent Educ. 1980;44(9):537-542.
37. Jenkins SM, Dummer PM, Gilmour a S, Edmunds DH, Hicks R, Ash P. Evaluating undergraduate preclinical operative skill; use of a glance and grade marking system. J Dent. 1998;26(8):679-684.
38. Boitelle P, Tapie L, Mawussi B, Fromentin O. 3D fitting accuracy evaluation of CAD/CAM copings - comparison with spacer design settings. Int J Comput Dent. 2016;19(1):27-43.
39. Moldovan O, Luthardt RG, Corcodel N, Rudolph H. Three-dimensional fit of CAD/CAM-made zirconia copings. Dent Mater. 2011;27(12):1273-1278.
40. Ahrberg D, Lauer HC, Ahrberg M, Weigl P. Evaluation of fit and efficiency of CAD/CAM fabricated all-ceramic restorations based on direct and indirect digitalization: a double-blinded, randomized clinical trial. Clin Oral Investig. 2016;20(2):291-300.
41. Marshall GF, Stutz GE. Handbook of Optical and Laser Scanning, Second Edition. CRC Press; 2011.
42. Su T-S, Jian S. Intraoral digital impression technique: A review. J Prosthodont. 2014;(3):1-9.
43. Ender A, Attin T, Mehl A. In vivo precision of conventional and digital methods of obtaining complete-arch dental impressions. J Prosthet Dent. 2016;115(3):313-320.
44. Fasbinder DJ. Computerized technology for restorative dentistry. Am J Dent. 2013;26(3):115-120.
45. Al-jubouri O, Azari A. Article An introduction to dental digitizers in dentistry ; systematic review. J Chem Pharm Res. 2015;7(8):10-20.
46. Buchi DL, Ebler S, Hammerle CH, Sailer I. Marginal and internal fit of curved anterior CAD/CAM-milled zirconia fixed dental prostheses: an in-vitro study. Quintessence Int (Berl). 2014;45(10):837-846.
47. Yao J, Li J, Wang Y, Huang H. Comparison of the flexural strength and marginal accuracy of traditional and CAD/CAM interim materials before and after thermal cycling. J Prosthet Dent. 2014;112(3):649-657.
48. Buso L, Oliveira-Júnior OB, Hiroshi Fujiy F, et al. Biaxial flexural strength of CAD/CAM ceramics. Minerva Stomatol. 2011;60(6):311-319.
49. Crowns CADCAMA. Marginal and Internal Fit of Cerec 3 CAD/CAM All-Ceramic Crowns. Int J Prosthodont. 2003;16(3):244-248.
50. Rekow ED, Harsono M, Janal M, Thompson VP, Zhang G. Factorial analysis of variables influencing stress in all-ceramic crowns. Dent Mater. 2006;22(2):125-132.


連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔