【作者】 颜玲玲；

【导师】 张少锋； 贾骏；

【作者基本信息】 第四军医大学 ， 口腔修复学， 2007， 硕士

【摘要】 非贵烤瓷熔附金属修复体以其低廉的价格、良好的美观效果、较高的强度、稳定的化学性能和较好的生物相容性,已广泛应用于临床冠桥修复中,并被广大患者所接受。其中,镍铬合金因其价格低廉,机械性能良好及结合强度高等优点,成为目前国内最常用的烤瓷金属基底材料,但其耐腐蚀性和生物相容性稍差,临床有龈染、黏膜过敏等问题,有待进一步解决。为此,近年来不断有新的烤瓷基底材料研制开发并应用于临床,如纯钛、钛合金、含钛合金等。而烤瓷熔附金属修复体成功的关键是金瓷间有良好的结合力,故本实验对临床常用的五种非贵金属基底材料与不同瓷粉的结合强度进行测试比较,以期为临床工作提供实验依据。　实验选择临床上常用的纯钛、钛合金、含钛合金、Ni-Cr合金五种非贵金属作为研究对象,制作金属试件108个,随机分成9组、每组12个,按临床制作常规,分别熔附Noritake Ti22瓷粉、HeraCeram瓷粉及Vita瓷粉,共获得烤瓷熔附金属试件9组,即:A1组:Ni-Cr(H)熔附HeraCeram瓷粉,A2组:Ni-Cr(H)熔附Vita瓷粉,B1组:Ni-Cr(西北)熔附HeraCeram瓷粉,B2组:Ni-Cr(西北)熔附Vita瓷粉,C组:纯钛熔附Noritake Ti22瓷粉,D组:Ti6Al4V熔附Noritake Ti22瓷粉,E组:Ti6Al7Nb熔附Noritake Ti22瓷粉,F1组:含钛合金熔附HeraCeram瓷粉、F2组:含钛合金熔附Vita瓷粉。采用三点弯曲实验的方法对烧结好的金瓷试件的金-瓷结合情况进行测试,将得到的每组数据进行统计学分析,比较各组金-瓷结合强度。再随机从各组金瓷试件中选择2个、共18个试件,用自凝树脂包埋,用SiC水砂纸进行打磨直至显露金瓷结合界面后利用扫描电镜分别观察各组金属与相熔附的瓷粉结合界面的形貌特征。实验结果显示:1.Ni-Cr合金组结合情况:A1组试件的结合强度为46.05±3.16,A2组的结合强度为42.05±3.26,B1组的结合强度为44.04±3.69,B2组的结合强度为47.47±2.92。统计学结果显示: A1﹥B1,B2﹥B1(P>0.05);A1﹥A2(P<0.05)。电镜显示:4组试件的瓷层均与金属基体相互交错.结合紧密.无明显气泡.也无明显中间层出现。2.纯钛及钛合金组结合情况:C组纯钛-Noritake Ti22结合强度:36.49±2.98 MPa,D组Ti6Al4V-Noritake Ti22结合强度:39.93±2.96 MPa, E组Ti6Al7Nb-Noritake Ti22结合强度:39.35±2.88 MPa。统计学结果显示:D组、E组结合强度均大于C组(P<0.05),D>E(P>0.05)。电镜显示各组瓷粉均与金属基体相互交错.结合紧密.无明显气泡.也无明显中间层出现。3.含钛合金组结合情况:F1组含钛合金-HeraCeram结合强度:41.08±2.98 MPa,F2组含钛合金-Vita结合强度:42.29±3.38 MPa,统计学结果显示:F2大于F1组(P>0.05)。电镜显示:各组瓷粉均与金属基体相互交错.结合紧密.无明显气泡.也无明显中间层出现。4.将Ni-Cr组(A1、A2、B1、B2),纯钛组(C),钛合金组(D、E)及含钛合金组(F1、F2)的金-瓷结合强度进行比较,统计学结果显示有显著差异,且Ni-Cr>含钛合金>钛合金(2种)>纯钛。结论:1.本实验各组金属的金-瓷结合强度均大于1SO所要求的基本值25 MPa,符合临床应用要求。2.Ni-Cr(H)- HeraCeram瓷大于Ni-Cr(H)-Vita瓷的结合强度(P<0.05),说明同厂家的金属与瓷粉金-瓷结合强度较好;Ni-Cr(西)-Vita的结合强度大于Ni-Cr(西)- HeraCeram瓷的结合强度但无显著性意义(P>0.05),即Ni-Cr(西)金属与Vita瓷和HeraCeram瓷之间均可以相互匹配使用,为临床工作提供更多的选择。3.Ti-6Al-4V及Ti-6Al-7Nb与Noritake Ti22瓷的结合强度均大于钛-Noritake Ti22的结合强度(P<0.05),而两种钛合金与瓷的结合强度无显著性意义(P>0.05),这就提示我们钛合金可能比纯钛有更好的临床应用前景。4.含钛合金-Vita瓷的结合强度大于含钛合金-HeraCeram瓷的结合强度但无显著性差异(P>0.05),即含钛合金与Vita瓷和HeraCeram瓷均可以相互匹配使用。5.临床常用非贵金属的金-瓷结合强度为Ni-Cr>含钛合金>钛合金(2种)>纯钛,统计学分析它们之间有显著性差异,综合有关研究资料分析说明:Ni-Cr合金与瓷的结合强度最高,适于临床应用,但其耐腐蚀性和生物相容性有待改进和提高;纯钛及钛合金虽然生物相容性和耐腐蚀性相对较好,但其结合强度较Ni-Cr和含钛合金低有待进一步提高;含钛合金具有良好的生物化学性能、较好的结合强度,但由于是新型材料其临床远期效果还有待证实。更多还原

【Abstract】 Since non-precious porcelain-fused-to-metal restoration has such advantages as cheep cost、good qualities in the aspects of good-looking、high bonding strength、good biocompatibility and good mechanical function, they have been widely used for dental prosthesis production, and it has been used more and more commonly in clinic. However, Ni-Cr alloy its low cost and good biocompatibility and good mechanical function, it become domestic Ni-Cr alloy as metal substrates have been widely used in clinic , but the long-time clinical practices and experimental investigations demonstrate that the Ni-Cr alloy have lots of adverse effects like stomatitis, rash or gum coloring, etc, clinic have lots of adverse effects like stomatitis, rash or gum coloring, So they also must be replaced by other materials. Pure Ti and Ti alloys and little-Ti-containing alloy, etc, What’s more, the favorable bonding strength between metal and porcelain ensures the adherence of porcelain to the metal base under the motivation of different direction forces during the usual tooth movement. we have employed the three-point bending test to investigate many materials including Ti, Ti-alloy, little-Ti-containing alloy, Ni-Cr alloy, and used the electron microscope to observe their interfaces.We choose Ti, Ti-alloy, little-Ti-containing alloy, Ni-Cr alloy as subjects. 108 sheets were divided into 9 groups, each group included 12 sheets. HeraCeram JC porcelain cement was fused and adhered to the group A1:Ni-Cr(H)、B1:Ni-Cr(northwest)and F1:little-Ti-containing alloy; Vita porcelain cement was fused and adhered to the group A2:Ni-Cr(H)、group B2:Ni-Cr(northwest) and group F2: little-Ti-containing alloy; Noritake Ti22 porcelain cement was fused and adhered to the group C:pure Ti、group D:Ti6Al4V and group E: Ti6Al7Nb. By three-point bending test was employed to detect the metal-ceramic bonding test. To make test specimens by the same method, each group included 2 sheets. There were 18 sheets altogether. Test specimens were invested with selfcuring resin, finished with SiC, cleaned and goldblasted. Than metal-ceramic combinational interface were observed and analyzed by SEM.Result:1.The bonding of Ni-Cr:A1:46.05±3.16, A2:42.05±3.26, B1:44.04±3.69, B2:47.47±2.92, A1﹥B1, B2﹥B1 (P>0.05); A1﹥ A2 (P<0.05). The electron microscopy revealed the bonding was tight between the cement and the metal base and no obvious air bubble or interlayer was found in each group.2.The bonding of pure Ti and titanium alloys:C:36.49±2.98 MPa, D:39.93±2.96 MPa, E:39.35±2.88 MPa, D and E>C(P<0.05), D>E(P>0.05). The electron microscopy revealed the bonding was tight between the cement and the metal base and no obvious air bubble or interlayer was found in each group.3.The bonding of little-Ti-containing alloy: F1:41.08±2.98 MPa, F2:42.29±3.38 MPa, F2>F1(P>0.05). The electron microscopy revealed the bonding was tight between the cement and the metal base and no obvious air bubble or interlayer was found in each group.4.Their bonding strengths stepped up in the order of pure titanium, titanium alloys, little-titanium-containing alloy, Ni-Cr alloy.Conclusion:1. The experiment drew a conclusion that the bonding strengths of the four kinds of base metal-ceramic alloys was all beyond 25 MPa, the baseline of ISO.2. The bonding strength of Ni-Cr(H)- HeraCeram is higher than Ni-Cr(H)-Vita(P<0.05); and the bonding strength of Ni-Cr(northwest)-Vita is higher than Ni-Cr(northwest)- HeraCeram,(P>0.05); Ni-Cr(northwest) alloy can fused with Vita porcelain or HeraCeram porcelain.3. The bonding strength of Ti-6Al-4V-Noritake Ti22 or Ti-6Al-7Nb-Noritake Ti22 is higher than Ti-Noritake Ti22 respectively(P<0.05), but there has no significance between Ti-6Al-4V and Ti-6Al-7Nb, may be Ti-alloy is better than Ti in clinical use.4. The bonding strength of little-Ti-containing alloy-Vita is higher than little-Ti-containing alloy-HeraCeram(P>0.05), so little-Ti-containing alloy may be fused with Vita porcelain or HeraCeram porcelain.5. The bonding strength of Ni-Cr alloy-porcelain is the highest,but the anti-causticity and the biocompatibility should be improved; the anti-causticity and the biocompatibility of pure Ti and Ti-alloy is good, but the bonding strength should be improved; the little-Ti-containing alloy is a type of new material, its long-term effect remains to be confirmed.更多还原