- 學位論文
選擇性雷射熔融技術製備氧化鋯牙冠於後牙贗復體之臨床評估
Clinical evaluation of 3D-printed zirconia crowns fabricated by selective laser melting (SLM) for posterior teeth restorations. A Short-Term Pilot Study.
摘要
隨著現代社會美學意識抬頭，美學牙冠的引入符合病人對於贗復結果的高度期待，本研究旨在評估運用選擇性雷射熔融技術製備氧化鋯牙冠於後牙的臨床表現，透過紀錄分析醫療器材臨床試驗受試者數據資料，以評估整體贗復體之品質，同時了解患者配戴後牙周健康狀況，以提供未來贗復體數位化生產3D列印氧化鋯全瓷牙冠適用於臨床贗復用途之參考。本臨床試驗共有10位受試者參與，產出10顆3D列印氧化鋯全瓷牙冠，贗復體位於小臼齒或大臼齒，根據改良式美國加州牙醫學會量表（Modified United States Public Health Service criteria，簡稱Modified USPHS criteria）評估整體牙冠品質，分別於義齒贗復當下0週、2週、6週、24週時紀錄，牙周健康狀況評估，紀錄牙菌斑指數、牙齦流血發炎指數、牙周囊袋深度，以及對咬齒質磨損。本研究經資料數據蒐集完成之後，以敘述性分析及魏克生符號檢定（Wilcoxon signed-rank test），軟體以JMP® for Mac OX 16.0 學生版本套裝軟體進行。本臨床試驗研究結果顯示，在24週的追蹤期間，氧化鋯牙冠評估結果配戴成功率達100%。牙菌斑指數在第0週與第6週的組別比較中有顯著上升，牙齦流血發炎指數、牙周囊袋深度雖有上升趨勢但無統計上顯著差異（p>0.05）。對咬齒質磨損程度於試驗追蹤期間保持平穩而無改變。24週的追蹤期間發生1例支柱牙牙齒因垂直牙根斷裂宣告贗復失敗，最終予以拔除，生物性併發症機率為11.1%。基於本次臨床試驗研究之研究結果，結果顯示運用選擇性雷射熔融技術製備氧化鋯牙冠適用於後牙臨床贗復用途，其密合性對於牙周組織無產生不良反應，於短期前導研究之限制下，3D列印氧化鋯全瓷牙冠可作為臨床可接受的牙齒贗復體之選擇。
並列摘要
With the increasing esthetic demands from patients nowadays, zirconia crown offers an alternative option to achieve those expectation. Thus, this study aimed to assess the clinical performance of digital three-dimensional (3D) printed zirconia crowns for tooth restorations and also to evaluate the quality of these crowns using the Modified United States Public Health Service (USPHS) criteria. A total of 10 patients requiring teeth restorations involving 10 teeth were treated with digital 3D-printed zirconia crowns placed on premolar and molar teeth. All restorations were accessed at the time of crowns placement 0 week(baseline) and 2 weeks, 6 weeks, and 24 weeks after the cementation. The plaque index, gingival index, probing depth, crown marginal integrity, and attrition of the antagonist teeth were evaluated. According to the Modified California Dental Association quality evaluation system, 100% of the crowns met satisfactory grades while the success rate is 100%. Despite the significant increase in plaque index after 6-weeks, there were no deterioration in gingival index and probing depth. Moreover, no wear were found on the antagonist teeth at 24 weeks post-treatment. Out of the 10 crowns, one tooth had to be extracted due to vertical root fracture. In conclusion, digital 3D-printed zirconia can be clinically acceptable prosthetic options. The digital 3D-printed zirconia crown had no detectable adverse effects on periodontal tissues after 24 weeks. Therefore, 3D-printed zirconia crown serves as an alternative option to patients, particularly those with high esthetic expectations.