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花葳蕾,王洁,吕凯歌.陶瓷厚度与基牙底色对4种常用CAD/CAM瓷修复体颜色的影响[J].口腔材料器械杂志,2023,32(2):109-115,142.

陶瓷厚度与基牙底色对4种常用CAD/CAM瓷修复体颜色的影响

Color match of CAD/CAM ceramic restorations with different thicknesses and backgrounds

投稿时间：2023-01-18 修订日期：2023-03-16

DOI：10.11752/j.kqcl.2023.02.06

英文关键词:CAD/CAM ceramics Coping thickness Translucent parameter Masking ability

基金项目:国家自然科学基金青年项目(编号:31600777)，中华口腔医学会青年临床科研基金(编号:CSA-P2019-03)，上海市卫健委青年项目(编号:20224Y0356)

作者	单位	E-mail
花葳蕾	上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海 200011
王洁	上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海 200011
吕凯歌	上海交通大学医学院附属第九人民医院口腔修复科, 上海交通大学口腔医学院, 国家口腔医学中心, 国家口腔疾病临床医学研究中心, 上海市口腔医学重点实验室, 上海 200011	lvkaige@126.com

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中文摘要:

目的研究4种不同厚度和半透明度CAD/CAM陶瓷在不同基牙底色上的遮色效果，为临床的陶瓷材料选择提供参考。方法 4种CAD/CAM陶瓷分别是： IPS e.max CAD（硅酸锂玻璃）,VITA SUPRINITY PC（氧化锆增强玻璃）,VITABLOCS Mark Ⅱ（长石基玻璃）和Vita Enamic（聚合物渗透陶瓷），制作成不同厚度(1 mm、1.5 mm、2 mm)的瓷块试样，在7种基牙底色(A1、A2、ND7色调复合树脂、白色(White)、黑色(Black)、钴铬合金(CC)、贵金属合金(PMA)下使用分光光度计检测Lab值，同一种瓷块2 mm厚度在A2色上的表现作为对照组，横向比较各种瓷块在不同基牙底色上的色差值以及半透明度。结果 Δ L、Δ a、Δ b值随着陶瓷厚度的增加逐渐减小，且在4种陶瓷间存在明显差异；半透明性参数均值按半透明度递减顺序依次为长石基玻璃＞硅酸锂玻璃＞氧化锆增强玻璃>聚合物渗透陶瓷；其中半透明度越大，其陶瓷的遮色效果反而越差；当厚度达到2 mm时，4种陶瓷在各种基牙底色下的Δ E（临床可接受颜色阈值）均<3.7 ； 4种陶瓷中Δ E与厚度呈线性负相关，Δ E与TP值线性正相关。结论陶瓷厚度、基牙底色和陶瓷种类影响CAD/CAM瓷修复体的颜色，4种陶瓷中，聚合物渗透陶瓷的半透明度最小，遮色能力最强，长石基玻璃的半透明度最大，遮色效果最差。

英文摘要:

Objective The aim of this study was to investigate the effect of thickness and backgrounds on the color of four CAD/CAM ceramic composites. Methods Four kinds of CAD/CAM ceramic composites, IPS. e.max CAD (lithium silicate glass ceramic) , Vita Suprinity PC (zirconia-reinforced glass ceramic), VITABLOCS Mark Ⅱ (feldspathic ceramic), Vita Enamic (polymer-infiltrated-ceramic-network ceramic ) and were used for this study. 120 A2 shade low translucency ceramic disk specimens with three different thicknesses (1 mm, 1.5 mm, 2 mm) were placed on 7 backgrounds: A1, A2, ND7 shade composite resin, precious gold-colored alloy (PMA), cobalt-chromium alloy (CC), and Black and White. Color measurements were performed to determine the specimens' CIELab values. CIE1976 formula was used to determine ΔEab color differences between specimens and A2 VITA classical shade (target). The data were then statistically analyzed. Results ΔL, Δa and Δb decreased in all groups with thickness increasing and perceptible color differences (ΔE*ab< 3.7) were obtained in all groups when thickness increased to 2 mm. TP values also generally decreased as the thickness increased in all groups and the order of TP values amongst the materials were as follows feldspathic ceramic > lithium silicate glass ceramic > zirconia-reinforced glass ceramic > polymer-infiltrated-ceramic-network ceramic. TP results demonstrated a significant difference in terms of material types and material thicknesses. Finally, ΔE values were negatively correlated with thickness and positively correlated with TP values. Conclusion Ceramic thickness, background type, material type and their interaction significantly affected the masking ability of CAD/CAM ceramics. The masking ability of CAD/CAM ceramics was positively correlated with thickness and negatively correlated with TP values. Among 4 types of ceramics, polymer-infiltrated-ceramic-network ceramic has the minimum TP value and the maximum masking ability, while feldspathic ceramic has the maximum TP value and the minimum masking ability.

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