陶进京 黄罡 衣颖杰 吴国锋

[摘要]目的：探讨虚拟牙合架在计算机辅助设计与制作（CAD/CAM）铣削氧化锆中的应用，观察其短期修复效果。方法：选取2018年9月-2019年9月南京市口腔医院修复科就诊的单颗前牙缺失并采用氧化锆粘接桥修复的患者为研究对象，使用虚拟牙合架辅助设计，3个月、6个月、12个月后按照美国公共卫生协会评价标准观察修复体边缘、颜色、继发龋、松动及脱落情况。结果：共完成12例患者14件氧化锆粘接桥，其中1件修复体6个月内脱落，余修复体边缘、颜色、继发龋、松动及脱落评价均为A级。结论：虚拟牙合架可以为CAD/CAM铣削氧化锆粘接桥修复体咬合调整提供帮助，但长期应用效果仍待观察。

[关键词]虚拟牙合架;氧化锆;CAD/CAM;粘接桥

[中图分类号]R783.3    [文献标志码]A    [文章编号]1008-6455（2021）06-0139-04

Application of Virtual Articulator in CAD/CAM Zirconia Bonding Bridge

TAO Jin-jing1，HUANG Gang1，YI Ying-jie2，WU Guo-feng2

（1.Department of Dental Laboratory; 2.Department of Prosthodontics， Nanjing Stomatological Hospital， Medical School of Nanjing University， Nanjing 210008， Jiangsu，China）

Abstract：Objective To investigate the application of virtual articulator in CAD/CAM zirconia bonding bridge and observe its short-term repair effect. Methods Patients suffered from single incisor missing and received zirconia bonding bridge restorations between September 2018 and September 2019 were enrolled. Prosthodontic treatment was aided by virtual articulator.3， 6，12 months after treatment， restorations were evaluated according to the American Public Health Association Standard， including color， restoration margins， secondary caries， loosening and detachment. Results  A total of 14 zirconia bonding bridges were completed in 12 patients， of which 1 was detached within 6 months， and the rest were rated as Grade A for margins，color，secondary caries， and loosening. Conclusion The virtual articulator is helpful for the occlusion adjustment of CAD/CAM zirconia bonded bridge， but the long-term effect remains to be observed.

Key words： virtual articulator; zirconia; CAD/CAM; bonding bridge

單颗前牙缺失牙列缺损的修复，种植义齿、固定桥及可摘局部义齿修复虽然都能够满足修复缺失牙的要求，但却存在着各自不可避免的局限性。骨量、近远中间隙不足等限制了种植义齿修复的应用，固定桥修复对邻牙的损害亦是不可避免的，而可摘局部义齿舒适性、美观性不佳，在单颗前牙缺失修复中的应用也十分有限。全瓷粘接桥因磨牙量少、美观性好而成为越来越多口腔修复医师的选择之一。玻璃陶瓷和氧化锆是最为常见的两种全瓷材料，玻璃陶瓷色泽、通透性更好，氧化锆虽然强度更高，但因无法被氢氟酸酸蚀，其粘接可靠性一直饱受质疑。氧化锆的粘接也是口腔修复领域研究的热点，尤其对于粘接桥修复技术而言，粘接可靠与否决定了修复的成败。……