【作者】 邱丽芳；

【导师】 蔡玉惠；

【作者基本信息】 南京医科大学 ， 口腔临床医学， 2007， 硕士

【摘要】 金瓷修复体以其良好的形态、色泽与功能，已成为临床应用较为广泛的修复方法之一，深受广大患者青昧。修复体颜色自然逼真，是表现人造牙自然美的重要方面，也是修复体成功与否的重要因素。在临床上常见金瓷修复体与所参照比色板的颜色存在差异，源于外界环境和瓷系统的影响已成为金瓷修复体准确再现天然牙色彩的障碍。本实验应用CIE1976L^*a^*b^*颜色系统，采用高像素数码摄影及计算机处理技术，研究不同背景、光源、瓷系统下镍铬合金烤瓷冠和金合金烤瓷冠的色彩，分析三种因素对修复体的颜色影响规律，为临床比色提供一定的参考依据。第一部分三种不同背景对金瓷修复体颜色的影响目的：比较三种不同背景下金瓷修复体之间及其与Vitapan classical比色板的色彩差异。材料和方法：取具有（?）活动代型的标准模型一副，精确复制（?）代型12个，分两组，分别制作A₂色镍铬合金烤瓷冠和金合金烤瓷冠，每组各6件，6套VITA比色板A₂色片作对照。选用灰、黑、红三种不同背景，应用CIE1976L^*a^*b^*颜色系统，采用高像素数码摄影及计算机处理技术，在标准光源及相同条件下，采集了两组金瓷修复体的12个试件与6个A₂比色片的图片，分别测量、分析其色度值。结果：同种金瓷修复体在三种不同背景之间的色度差明显大于1.5NBS；无论在何种背景下，金瓷修复体与比色片之间的色度差△E均大于1.5NBS，其中在红色背景下修复体与比色片的色度差最大，黑色次之，灰色最小；在同种背景下，两组烤瓷冠之间的色度差大于1.5NBS，金合金烤瓷冠与比色片的色度差均小于镍铬合金烤瓷冠与比色片的色度差。结论：三种不同背景下金瓷修复体之间及其与VITS比色板存在肉眼可见的颜色差异，灰色背景要优于其他两种。第二部分三种不同光源对金瓷修复体颜色的影响目的：比较三种不同光源下金瓷修复体之间及其与Vitapan classical比色板的色彩差异。材料和方法：取具有（?）活动代型的标准模型一副，精确复制（?）代型12个，分两组，分别制作A₂色镍铬合金烤瓷冠和金合金烤瓷冠，每组各6件，6套VITA比色板A₂色片作对照。选用目光色、冷白色、暖白色三种不同光源，在灰色背景下，应用CIE1976L^*a^*b^*颜色系统，采用高像素数码摄影及计算机处理技术，采集两组金瓷修复体的12个试件与6个A₂比色片的图片，分别测量、分析其色度值。结果：同种金瓷修复体在三种不同光源之间的色度差明显大于1.5NBS；无论在何种光源下，金瓷修复体与比色片之间的色度差△E均大于1.5NBS，其中日光色光源下，修复体与比色片的色度差最小；在同种光源下，两组烤瓷冠之间的色度差大于1.5NBS，金合金烤瓷冠与比色片的色度差均小于镍铬合金烤瓷冠与比色片的色度差。结论：三种不同光源下金瓷修复体之间及其与VITA比色板存在肉眼可见的颜色差异，日光色光源要优于其他两种。第三部分两种不同瓷系统对金瓷修复体颜色的影响目的：比较两种不同瓷系统时金瓷修复体之间及其与Vitapan classical比色板的色彩差异。材料和方法：取具有（?）活动代型的标准模型一副，精确复制（?）代型24个，分两组，分别制作A₂色镍铬合金烤瓷冠和金合金烤瓷冠，每组各12件，其中6个堆筑Vita VMK 95 A₂系列瓷粉，6个堆筑DeguDent KISS A₂系列瓷粉，6套VITA比色板A₂色片作对照。应用CIE1976L^*a^*b^*颜色系统，采用高像素数码摄影及计算机处理技术，在标准光源及灰色背景下，采集了两组金瓷修复体的24个试件与6个A₂比色片的图片，分别测量、分析其色度值。结果：两种瓷系统之间比较，无论是镍铬合金烤瓷冠还是金合金烤瓷冠，明度值（L*）无显著差异，色相（a^*b^*）存在显著差异，在彩度（C*）上，Vita VMK 95瓷粉的彩度大于DeguDent KISS瓷粉，色度差△E均大于1.5NBS；两种瓷系统分别与比色片比较，明度值均存在显著差异，色度差均大于1.5NBS，但Vita VMK 95瓷粉与比色片的色度差要小于DeguDent KISS瓷粉与比色片的色度差。结论：在色相上Vita VMK 95瓷粉比DeguDent KISS瓷粉偏黄红，不同瓷系统对金瓷修复体的颜色有影响；在临床选色时，尽量选用与瓷粉相匹配的比色板。更多还原

【Abstract】 In virtue of good shape, color and function, the metal ceramicrestoration has been one of the widely used means in clinical work. Ittakes the fancy of the patients. Natural and lifelike color of therestorations is the important aspect to show natural beauty of humanteeth.It is also the standard to determine that if the restoration issuccessful.In clinical work,the color difference between restorations andshade guide is often in existence. It is often affected by outsidesurroundings and different porcelain systems. In thisexperiment, CIE₁₉₇₆L^*a^*b^* color system and a digital camera andcomputer were selected to study the effect of backgrounds,light sourcesand porcelain systems on the color difference of metal ceramicrestorations. The results will provide some references for better colorselection.PartⅠ: The color difference of metal ceramicrestorations on three different backgroundsObjective: To study the color difference of metal ceramic restorationsand VITA shade guide on three different backgrounds. Materials andMethods: Two types of metal ceramic restorations were made on thebasis of the same die. A₂ shade slice in the shade guide was selected to be the contrast. Gray,black and red backgrounds, CIE₁₉₇₆L^*a^*b^* colorsystem, a digital camera, computer and a standard light source wereselected to measure and compare the characteristic of A₂ shade slice inthe shade guide and two types of metal ceramic restorations. Results: Tothe same type of metal ceramic restorations,the color difference waslarger than 1.5NBS on three different backgrounds dramatically.Nomatter what background, the color difference between metal ceramicrestorations and VITA shade guide was larger than 1.5NBS. Thedifference was the biggest on red background.And it took second place onblack background.On gray background, it was the smallest.On the samebackground,the color difference between nichrome metal porcelaincrowns and noble metal porcelain crowns was larger than 1.5NBS.Ascompared to shade guide,the latter was better than the former.Conclusion: Color differences were found between the shade guide andmetal ceramic restorations on different backgrounds. The color of metalporcelain crowns on gray background was better than that on black andred background.PartⅡ: The color difference of metal ceramicrestorations in three different light sourcesObjective: To study the color difference of metal ceramic restorationsand VITA shade guide in three different light sources. Materials andMethods: Two types of metal ceramic restorations were made on the basis of the same die. A₂ shade slice in the shade guide was selected to bethe contrast.Daylight, cool white light and warm white lightsources,CIE₁₉₇₆L^*a^*b^* color system, a digital camera, computer andgray background were selected to measure and compare the characteristicof A₂ shade slice in the shade guide and two types of metal ceramicrestorations. Results: To the same type of metal ceramic restorations,thecolor difference was larger than 1.5NBS in three different light sourcesdramatically.No matter what light source, the color difference betweenmetal ceramic restorations and VITA shade guide was larger than1.5NBS. The difference was the smallest in the daylight source. In thesame light source,the color difference between nichrome metal porcelaincrowns and noble metal porcelain crowns was larger than 1.5NBS.Conclusion: Color differences were found between the shade guide andmetal ceramic restorations in different light sources. The color of metalporcelain crowns in the daylight source was better than that in warmwhite and cool white light sources.PartⅢ: Effect of the variation of porcelain on thecolor difference of metal ceramic restorationObjective:To study the effect of the different porcelain systems on thecolor difference of metal ceramic restorations and VITA shade guide.Materials and Methods: Two types of metal ceramic restorations weremade on the basis of the same die. A₂ shade slice in the shade guide were selected to be the contrast. Vita VMK 95 A₂ and DeguDent KISS A₂porcelain systems, CIE₁₉₇₆L^*a^*b^* color system, a digital camera,computer, a daylight source and gray background were selected tomeasure and compare the characteristic of A₂ shade slice in the shadeguide and two types of metal ceramic restorations. Results:There is nodifference of value between two porcelain systems.But the hue andchroma had significant difference.To the chroma,Vita VMK 95 porcelainsystem is larger than DeguDent KISS porcelain system.The colordifference between Vita VMK 95 porcelain system and shade guide issmaller than that of DeguDent KISS porcelain system. Conclusion:To thehue,Vita VMK 95 porcelain power was more yellow and redder thanDeguDent KISS porcelain power. Different porcelain system had aneffect on the color of metal ceramic restorations. The shade guide shouldcoordinate with porcelain system then you can achieve a maximum effect.更多还原