边缘密合性和粘结剂类型对全冠修复体微渗漏的影响

Effects of Marginal Fit and Cement Types on Microleakage of Full-coverage Crown Systems

摘要:

〔摘 要〕 目的：评估边缘密合性和不同的粘结剂对全冠修复体微渗漏的影响。方法：选取 2019 年 5 月至 2020 年 1 月 深圳市第二人民医院口腔科拔除的 36 颗形态大小相似的离体上中切牙，并随机分为三组，每组各 12 颗。第 1 组采用计算 机辅助设计与制造（CAD/CAM）制作的氧化锆全瓷冠修复，第 2 组采用热压玻璃陶瓷全冠修复，第 3 组采用铸造钴铬合金 全冠修复。各组均按照标准技术进行处理。再将每组分成两个亚组，分别用自粘结树脂粘结剂（A）或玻璃离子粘结剂（B） 进行粘结。将样品进行冷热循环后浸入碱性品红溶液中，取出后近远中向及颊舌向切片。在体视显微镜下对每个部位的表 面进行数字照相。使用五点量表对微渗漏进行评分，并使用图像分析软件测量每组样品的边缘间隙。结果：第 1 组的平均 边缘密合值为（82.7 ± 9.91）μm；第 2 组为（92.6 ± 9.53）μm；第 3 组为（96.5 ± 11.10）μm，第 1 组的平均边缘密合值明 显小于第 2、3 组，差异具有统计学意义（P ＜ 0.05）。各组微渗漏得分 “0” 的比率分别为：1A 为 83 %，1B 为 50 %，2A 为 50 %，2B 为 16 %，3A 为 33 %，3B 为 0 %。其中 1A 的微渗漏量最低，而 2B 和 3B 的微渗漏量均比 1A 高，差异具有 统计学意义（P ＜ 0.05）。同一组别中，粘结剂 A 的微渗漏程度均低于粘结剂 B，其差异具有统计学意义（P ＜ 0.05）。结论： 边缘间隙差异和粘结剂类型均对微渗漏有显著影响。采用自粘结树脂粘结剂粘结的全冠其微渗漏水平较低；而与热压玻璃 陶瓷全冠及铸造钴铬合金冠相比，采用 CAD/CAM 制作的氧化锆全瓷冠显示出较小的边缘间隙差异和较小的微渗漏。

Abstract:

〔Abstract〕 Objective To evaluate the effects of both marginal fit and cementing with different luting agents on the microleakage of full-coverage crown systems. Methods Thirty-six extracted upper central incisors were prepared for fullcoverage crowns and were divided into three groups. Group 1: CAD/CAM-fabricated zro2, group 2: heat-pressed lithium-disilicate, and group 3: cast cr-co copings. Copings were made following standard techniques, and groups were assigned cementation with either self-adhesive resin cement (A) or glass-ionomer luting cement (B). The specimens were subjected to thermocycling, immersed in basic fuchsin solution, sectioned mesiodistally and buccolingually. The surface of each section was digitally photographed under a stereomicroscope. Microleakage was scored using a five-point scale, and the marginal gap was measured using image analysis software. Results The marginal discrepancy of each group was (82.7 ± 9.91)μm, (92.6 ± 9.53)μm and (96.5 ± 11.10)μm respectively. Group 1 showed signifi cantly smaller gaps than Group 2 and 3 (P < 0.05). Self-adhesive resin cement (A) showed a lower level of microleakage than glass-ionomer luting cement (B) in all groups (P < 0.05). Microleakage scores of '0' were 83 % for 1A, 50 % for 1B, 50 % for 2A, 16 % for 2B, 33 % for 3A and none for 3B. Conclusion Marginal discrepancy and cement type both had significant effects on microleakage. lower levels of microleakage were recorded with self-adhesive resin cement, while CAD/CAM-fabricated zro2 copings showed smaller marginal discrepancy and less microleakage in comparison to cast cr-co.