臺灣博碩士論文加值系統

氧化鋯全瓷冠不僅恢復自然牙齒原有的功能和美觀也能提供相當金屬薄蓋冠的強度，全瓷冠的配色在牙醫美學中成為很大的挑戰，即使目前臨床利用先進的電腦比色儀比色分析自然牙色彩資訊，然後依照儀器提供的指示製作氧化鋯全瓷冠，仍然無法精準地將其色彩重現，此乃由於製作指示並沒有提供氧化鋯薄蓋冠不同厚度所對應顏色的參考資料，且其製作過程也缺乏標準操作流程，因此本研究擬探討氧化鋯厚度變化及VITA A系列氧化鋯專用染色劑對氧化鋯試片最終顏色分佈及光線穿透率之影響。本研究擬選擇3種臨床最常使用的色系：VITA A2、A3與A3.5及廠商提供對應色系之氧化鋯專用染色劑CL1、CL2、CL3、FS3和FS4等5種色系，製作氧化鋯試片直徑11.22mm，厚度為0.3mm、0.4mm、0.5mm、0.6mm和0.7mm等五組，每組3片，總計105片。對照組以對應VITA A2、A3與A3.5色系之Shofu牙本質瓷製成，然後分別利用分光光度計與自組式光學穿透儀來分析不同厚度試樣的色彩分佈狀況及透光程度，由結果發現：氧化鋯試片不同厚度對CIELab色座標有顯著影響(p<0.05)，試片的光線穿透率隨試片厚度及染色濃度增加而下降。使用國際照明委員會於1976年提出的色差公式來比較氧化鋯試片與對照組之色差範圍，若參考臨床全瓷材料之可接受色差範圍2.75ΔΕ*ab，則發現0.4至0.6mm CL2、CL3、FS4染色組之氧化鋯試片與0.4至0.7mm之A2、A3與A3.5對照組呈色相同；而0.3mm CL1、FS3、FS4氧化鋯試片的光線穿透率近似0.7mm之A2與A3及0.6mm之A3.5對照組，0.4mm CL1及FS3、0.3mm CL2及CL3則與0.7mm之A3.5對照組之穿透率相近似。根據本研究所得試片厚度變化與顏色及光線穿透率之關係資料，可以供瓷牙技師在臨床氧化鋯全瓷冠製作上有更多的參考資訊，進而完成顏色配對之贗復物，未來仍需做更深入的研究，解決牙科臨床所面臨關於顏色再現的問題。

Zirconia all-ceramic restorations not only restored functional and aesthetic aspect of the natural teeth but also provided the same strength as the metal copings. The color matching of all-ceramic restorations present a particular challenge in aesthetic dentistry. Until recently, computer color matching was utilized to analyze the color information of natural teeth in dental clinical settings. We can't precisely reproduce the color even if we attempt to make the all-ceramic restoration in accordance with the prescription offered by the instrument. This is because there were no references about the thickness of zirconia copings from the prescription, and also there is no standard procedure on fabricating the all-ceramic restorations. Therefore, the purpose of this study is to evaluate the effect of the thickness and the shade of VITA A series of the zirconia shading liquid based on the color distribution and translucency of zirconia coping. We chose the commonly used shade in the dental clinical setting: VITA A2, A3 and A3.5 as the same shade of 5 kinds of zirconia shading liquid: CL1,CL2, CL3, FS3 and FS4. 11.22 mm in diameter with zirconia specimen, thickness of zirconia specimen: 0.3mm, 0.4mm, 0.5mm, 0.6mm and 0.7mm. Each group are consisted of 3 discs, totaling 105 specimens. Control group are consisted of VITA A2, A3, and A3.5 shade Shofu layered dentin porcelain. The spectrophotometer is then used to measure the color distribution and the custom-built optical transmisson spectrophotometer is used specifically to measure the transmittance. The result showed that different thickness of zirconia specimens have significantly influence to CIELab color coordinates (p<0.05), transmittance of specimens were decreased with the thickness and the concentrations of zirconia colouring agents increased. To compare the zirconia specimen and control group, the formula were supplied in 1976 by Commission international del’Eclairage is used to measure color differences, and acceptable clinical range is established as followed: 2.75ΔΕ*ab. The result showed CL2, CL3 and FS4 zirconia specimens in 0.4mm to 0.6mm were similar color as A2, A3, and A3.5 control group in 0.4mm to 0.7mm. 0.3mm CL1, FS3 and FS4 zirconia specimens were similar transmittance as 0.7mm A2 and A3 control group, and 0.6mm A3.5 control group. 0.4mm CL1and FS3 and 0.3mm CL2 and CL3 zirconia specimens were similar transmittance as 0.7mm A3.5 control group. According to the result of this study, there were references of the zirconia specimens that varied in thickness, color and transmittance distribution, all of which can be the important criterions for the dental technician on fabricating restorations in the dental clinic, and finishing color matching restorations. Further researches are necessary must to investigate these parameters more thoroughly, so as to solve the known issue of the zirconia coping in terms of color matching in dental clinics.

正文目錄----------------------------------------------------------------------I
圖次目錄---------------------------------------------------------------------IV
表次目錄---------------------------------------------------------------------XI
方程式目錄------------------------------------------------------------------XIV
中文摘要---------------------------------------------------------------------XV
英文摘要-------------------------------------------------------------------XVII
第一章、緒論--------------------------------------------------------------------1
第一節、前言--------------------------------------------------------------------1
第二節、文獻回顧----------------------------------------------------------------3
(一)氧化鋯陶瓷介紹--------------------------------------------------------------3
1.牙科全瓷冠介紹----------------------------------------------------------------3
2. 氧化鋯晶體結構---------------------------------------------------------------7
(二)色彩光學特性對全瓷冠配色的意義-----------------------------------------------11
1.色視覺之三要素------------------------------------------------------11
2.色彩之三屬性-----------------------------------------------------------------18
(三)色彩之表示方法--------------------------------------------------------20
1.曼塞爾（Munsell）色彩系統----------------------------------------------------20
2.國際照明委員會（簡稱CIE）色彩系統----------------------------------------------22
(四)全瓷內冠後製程中影響配色之因素------------------------------------------28
1.參與人員之溝通---------------------------------------------------------------28
2.材料結構--------------------------------------------------------------------28
3.染劑成份--------------------------------------------------------------------29
第三節、研究動機與目的----------------------------------------------------------31
第二章、材料與方法-------------------------------------------------------------32
第一節、實驗設備---------------------------------------------------------------32
第二節、實驗材料---------------------------------------------------------------42
第三節、實驗步驟流程-----------------------------------------------------------46
第三章、結果------------------------------------------------------------------54
第一節、氧化鋯試片分光測色結果--------------------------------------------------54
第二節、控制組與氧化鋯試片色差結果-----------------------------------------------86
第三節、氧化鋯試片光線穿透率結果------------------------------------------------103
第四節、控制組與氧化鋯試片光線穿透率比較結果-------------------------------------120
第四章、討論-----------------------------------------------------------------131
第一節、實驗設計之探討--------------------------------------------------------131
(一)實驗材料選擇-------------------------------------------------------------131
(二)實驗方法選擇-------------------------------------------------------------132
第二節、實驗結果的觀察與分析---------------------------------------------------133
(一)氧化鋯試片不同厚度對顏色之影響---------------------------------------------133
(二)氧化鋯試片不同厚度對顏色之影響---------------------------------------------137
第三節、研究限制與未來--------------------------------------------------------141
第五章、結論-----------------------------------------------------------------142
參考文獻---------------------------------------------------------------------143

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