华西口腔医学杂志 ›› 2019, Vol. 37 ›› Issue (1): 37-41.doi: 10.7518/hxkq.2019.01.007

• 基础研究 • 上一篇    下一篇

上部结构材料和形态设计对种植支持固定修复体被动适合性的影响

宋珊,郑政,杨丽媛,高旭()   

  1. 山东省口腔组织再生重点实验室,山东大学口腔医院修复科,济南 250012
  • 收稿日期:2018-06-05 修回日期:2018-11-02 出版日期:2019-02-01 发布日期:2019-02-01
  • 通讯作者: 高旭 E-mail:gaoxu@sdu.edu.cn
  • 作者简介:宋珊,住院医师,硕士,E-mail: sunnysymphony@163.com
  • 基金资助:
    山东省科技发展计划(2014GGH218021)

Effect of materials and superstructure designs on the passive fit of implant-supported fixed prostheses

Shan Song,Zheng Zheng,Liyuan Yang,Xu Gao()   

  1. Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Dept. of Prostho-dontics, School of Stomatology, Shandong University, Jinan 250012, China
  • Received:2018-06-05 Revised:2018-11-02 Online:2019-02-01 Published:2019-02-01
  • Contact: Xu Gao E-mail:gaoxu@sdu.edu.cn
  • Supported by:
    Science and Technology Development Project of Shandong Province(2014GGH218021)

摘要:

目的 研究氧化锆全瓷和纯钛烤瓷两种上部结构材料及360°颈环设计对计算机辅助设计和制作种植支持固定修复体被动适合性的影响。方法 制作32个弹性模量与牙槽骨相近的环氧树脂块并在每个树脂块上植入两枚种植体,模拟左下颌第二前磨牙至第二磨牙缺失后的种植修复。在每个种植体颈部4个方向上分别粘接应力感应器。制作4组不同材料及形态设计的三单位种植支持固定修复上部结构,每组8个。A组为常规氧化锆全瓷冠组,B组为360°氧化锆颈环基底全瓷冠组,C组为常规纯钛烤瓷冠组,D组为360°纯钛金属颈环基底烤瓷冠组。利用应力感应装置分别测量每颗种植体饰瓷烧结前、后种植体上部结构在粘接时对种植体周围结构引起的应变。结果 饰瓷烧结前,不同的上部结构材料引起种植体周围结构的应变有明显不同,氧化锆组应变较小(P<0.01),不同形态设计造成应变的差异也有统计学意义,有颈环组应变较小(P<0.01),上部结构材料与形态设计对种植体周围结构应变的产生存在交互作用,氧化锆有颈环组应变最小(P<0.01)。经饰瓷烧结,各组应变均增加,不同材料对烤瓷前、后应变差异无明显影响(P>0.05),形态设计对烤瓷前后应变差异的影响有统计学意义,有颈环组差异较小(P<0.01)。结论 氧化锆全瓷比纯钛金属烤瓷修复体具有更好的被动适合性;360°颈环有利于提高种植支持固定修复体被动适合性,并减轻由烧结饰瓷带来的不良影响。

关键词: 种植支持固定修复体, 种植体上部结构, 被动适合性, 应变

Abstract:

Objective This study aimed to compare the passive fits of implant-supported cement-retained computer aided design/computer aided manufacturing (CAD/CAM) bridges fabricated with different implant superstructure designs from zirconia and titanium. Methods A total of 32 cubic clods with the same dimensions and with elastic modulus similar to that of mandibles were used. Each clod received two one-stage implants to simulate a partially edentulous jaw that was missing teeth between the lower left second premolar and second molar. Four linear strain gauges were bonded on the region surrounding each implant on the mesial, buccal, distal, and lingual aspects. A total of 32 identical frameworks were fabricated through CAD/CAM after scanning. The frameworks were allocated into four different groups (n=8) in accordance with material types and superstructure designs. Group A included zirconia ceramic implant-supported fixed prostheses with regular marginal designs. Group B comprised zirconia ceramic implant-supported fixed prostheses with full circumferential zirconia-collar marginal designs. Group C consisted of titanium ceramic implant-supported fixed prostheses with regular marginal designs. Group D included titanium ceramic implant-supported fixed prostheses with full circumferential titanium-collar marginal designs. Strain development before and after ceramic veneering was recorded during cement setting. Data were statistically analyzed by using SPSS software. Results Before ceramic veneering, material types affected the strains of prostheses, and zirconia frameworks showed lower strain than other frameworks (P<0.01). Designs affected the strains of prostheses, and frameworks with full collar marginal design showed lower strain than other frameworks (P<0.01). These two factors showed interactions (P<0.01). The strain of decorative porcelain increased after sintering. The two groups of different materials did not significantly differ (P>0.05). Nevertheless, the full circumferential collar marginal design reduced discrepancies among groups (P<0.01). Conclusion The passive fits of zirconia prostheses were better than those of titanium-based porcelain-fused-to-metal restorations. The full circumferential collar marginal design can help reduce fit inaccuracy, as well as the adverse effects of ceramic veneering.

Key words: implant-supported prostheses, superstructure of implant, passive fit, strain

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