【摘要】 目的研究数字化口内扫描与传统硅橡胶印模法应用于前牙瓷贴面修复1年的临床效果区别。方法将佛山市口腔医院修复种植科2017年1月至2019年12月需行前牙贴面修复的就诊患者40例纳入本临床研究,其中男14例、女26例,平均年龄40岁。根据随机数表法将患者分为两组,其中20例患者(47颗患牙)纳入试验组,采用数字化口内扫描及打印树脂模型法制取工作模型;20例患者(40颗患牙)纳入对照组,采用传统硅橡胶印模灌制石膏模型法制取工作模型。贴面粘接完成后1周(基线)、3个月、1年复查,记录制取印模时间、印模制取过程患者的舒适度、修复体初戴时间及修复体临床效果(包括边缘适合性、修复体完整性、边缘染色、颜色匹配、继发龋及牙龈健康情况等),采用t检验比较试验组及对照组制取印模时间和修复体初戴时间;采用卡方检验比较印模制取过程患者的舒适度及贴面的临床客观指征。结果采用数字化口内扫描及打印树脂模型法制取工作模型的试验组所需模型制取时间为(1.98±0.17)min,与采用传统硅橡胶印模灌制石膏模型法制取工作模型的对照组[(10.93±0.74)min]相比明显缩短,差异有统计学意义(t=-53.005,P<0.001);试验组中,15例患者评价制取印模的舒适度为Ⅰ级、5例患者评价舒适度为Ⅱ级;对照组中,只有5例患者评价舒适度为Ⅰ级、13例患者为Ⅱ级、2例为Ⅲ级。与对照组相比,试验组患者对制取印模过程的舒适度较高,存在明显差异(χ~2=11.69,P=0.003)。试验组的修复体初戴时间为(9.28±0.44)min,与对照组[(9.42±0.42)min]相比,两组间差异无统计学意义(t=-1.025,P=0.312)。所有瓷贴面复查期内修复体完整性、颜色匹配、继发龋等检查项目表现优秀,粘接3个月后有2例贴面出现边缘轻微染色及轻微牙龈炎症。粘接1年后,5例瓷贴面的边缘适合性评价降低,出现卡探针,但无明显可见的间隙;10例贴面出现边缘轻微染色;4例贴面的牙龈有轻微炎症,贴面的修复效果均在临床可接受范围内,两组间差异无统计学意义(P>0.05)。结论数字化口内扫描及打印树脂模型法可达到与传统硅橡胶灌制石膏模型法相当的前牙瓷贴面修复临床效果,能有效提高患者就诊舒适度,缩短就诊时间。更多还原

【Abstract】 Objective To compare the clinical outcomes of anterior porcelain veneer between conventional impression technique using silicone material and intraoral scanning in one year.Methods Forty patients received anterior teeth veneers from January 2017 to December 2019 in the Department of Prosthodontics and Implantology of Foshan Stomatological Hospital were included in this clinical study,including 14 males and 26 females,with an average age of 40 years old. According to the random number table method,the patients were randomly divided into two groups. Twenty patients(47 teeth) were included in the experimental group where digital impressions with an intraoral scanner and 3D-printed resin models were used. The other 20 patients(40 teeth)were included in the control group where working models were made by the conventional impression with silicone materials and poured with gypsum. The duration of impression taking,restoration adjusting and the patients′ satisfaction were recorded. Clinical evaluations were implemented at one week(baseline),three and twelve months after cementation of the veneers, including marginal adaptation, restoration integrity, marginal staining, color matching,secondary caries and gingival health. The recorded data were statistically analyzed. In detail,t test was used to compare the duration of impression taking,restoration adjusting between the experimental and control group;Chi square test was used to compare the satisfaction of patients in the process of impression taking and the effect of impression techniques on clinical outcomes of veneers.Results The duration of impression taking of the experimental and control group was(1.98 ± 0.17)and(10.93 ± 0.74)min,respectively,which was statistically significant(t =-53.005,P<0.001). Fifteen patients evaluated the comfort of impression taking as grade Ⅰ,and five patients as grade Ⅱ in the experimental group;in contrast,only five patients evaluated as gradeⅠ,thirteen patients as gradeⅡ,the rest as gradeⅢ in the control group. Compared with the control group,the comfort of the experimental group was higher(χ~2=11.69,P = 0.003). The adjusting time of the experimental group was(9.28 ± 0.44)min,and that of the control group was(9.42 ± 0.42)min,where there was no significant difference(t =-1.025,P = 0.312).During 1-year follow-up period,all porcelain veneers performed well of restoration integrity,color matching,and secondary caries. After three months of cementation,two veneers showed slight marginal staining and gingivitis. One year after cementation,the marginal adaptation evaluation of five porcelain veneers decreased,with the probe stuck,but there was no obvious gap. There were ten cases of veneers with slight marginal staining and four cases with mild gingival inflammation. The clinical outcomes of all porcelain veneers were within the clinical acceptable range,and there was no significant difference between the two groups(P>0.05).Conclusion Compared with the conventional technique,the intraoral scanning could achieve a comparable short-term clinical outcome,which seemed a more efficient approach with higher satisfaction from the patients.更多还原