CAD/CAM与常规印模制作二硅酸锂陶瓷高嵌体修复无髓后牙缺损的效果及对咀嚼功能的影响

doi:10.3969/j.issn.1006-5725.2025.20.010

摘要/Abstract

摘要：

目的比较CAD/CAM技术与常规印模制作的二硅酸锂陶瓷高嵌体修复无髓后牙缺损的临床效果及对咀嚼功能的影响。方法本项前瞻性随机对照试验于2021年2月至2023年2月，共纳入104例需要后牙二硅酸锂陶瓷高嵌体修复的患者。随机数字表法将患者分为两组，52例采用CAD/CAM技术制作二硅酸锂陶瓷高嵌体（研究组），52例采用常规印模制作二硅酸锂陶瓷高嵌体（对照组）。比较两组患者的牙龈指数、牙齿松动度、菌斑指数、咀嚼效率、患者美观满意度及不良反应发生情况。结果修复后，研究组患者的牙齿松动、牙龈及菌斑指数均低于对照组（P < 0.05）。修复1年后，研究组咀嚼效率高于对照组（P < 0.05）。研究组高嵌体修复后不良反应发生率5.77%，低于对照组的25.00%（P < 0.05）。研究组高嵌体修复后美观满意度为94.23%，较对照组高，差异有统计学意义（P < 0.05）。结论 CAD/CAM技术在修复无髓后牙缺损时，相较于常规印模制作，能够提供更好的修复体适合度和咀嚼效率，且更能提高患者满意度。这表明CAD/CAM技术在后牙高嵌体修复中具有明显优势，值得临床推广使用。

关键词: CAD/CAM技术, 二硅酸锂陶瓷, 高嵌体, 咀嚼功能, 无髓后牙修复

Abstract:

Objective This study aimed to compare the clinical efficacy and impact on masticatory function of lithium disilicate ceramic onlays fabricated using CAD/CAM technology versus conventional impression techniques for restoring pulpless posterior tooth defects. Methods A prospective randomized controlled trial was conducted from February 2021 to February 2023， enrolling 104 patients requiring lithium disilicate ceramic onlay restoration for posterior teeth. Patients were randomized into two groups using a random number table： 52 patients in the study group received lithium disilicate ceramic onlays fabricated with CAD/CAM technology， and 52 patients in the control group received onlays fabricated via conventional impression. The two groups were compared in terms of gingival index， tooth mobility， plaque index， masticatory efficiency， patient satisfaction with aesthetics， and incidence of adverse reactions. Results After restoration， the study group showed lower scores of tooth mobility， gingival index， and plaque index than the control group （P < 0.05）. One year after restoration， the masticatory efficiency of the study group was higher than that of the control group （P < 0.05）. The incidence of adverse reactions in the study group was 5.77%， which was significantly lower than 25.00% in the control group （P < 0.05）. The aesthetic satisfaction rate in the study group was 94.23%， which was significantly higher than that in the control group （P < 0.05）. Conclusions Compared with conventional impression techniques， CAD/CAM technology provides better restoration fit and masticatory efficiency， and improves patient satisfaction when restoring pulpless posterior tooth defects. These findings indicate that CAD/CAM technology has significant advantages in posterior tooth onlay restoration and is worthy of clinical promotion.

Key words: CAD/CAM technology, lithium disilicate ceramic, high inlay, chewing function, endodontically treated posterior teeth restoration

中图分类号:

R783.4

孟亚军,李莉,郜珍燕. CAD/CAM与常规印模制作二硅酸锂陶瓷高嵌体修复无髓后牙缺损的效果及对咀嚼功能的影响[J]. 实用医学杂志, 2025, 41(20): 3214-3219.

Yajun MENG,Li LI,Zhenyan. GAO. Comparison of the effects of CAD/CAM and conventional impression‑making of lithium disilicate ceramic high inlay restorations on molar endodontically treated teeth and chewing function[J]. The Journal of Practical Medicine, 2025, 41(20): 3214-3219.

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组别	例数	年龄/岁	性别（男/女）/例	缺牙部位/例		病程/月
组别	例数	年龄/岁	性别（男/女）/例	前磨牙	磨牙	病程/月
研究组	52	42.69 ± 5.93	29/23	27	25	3.79 ± 1.23
对照组	52	43.98 ± 6.34	25/27	24	28	3.43 ± 1.08
t/χ²值		1.072	0.616	0.346		1.586
P值		0.286	0.432	0.556		0.116

组别	例数	牙龈指数		牙齿松动度		菌斑指数
组别	例数	修复前	修复后	修复前	修复后	修复前	修复后
研究组	52	2.46 ± 0.38	1.35 ± 0.19	20.56 ± 3.88	2.97 ± 0.58	2.30 ± 0.31	1.53 ± 0.15
对照组	52	2.41 ± 0.33	1.47 ± 0.17	20.10 ± 3.51	3.50 ± 1.06	2.20 ± 0.25	1.63 ± 0.16
t值		0.716	3.394	0.634	3.163	1.822	3.288
P值		0.475	0.001	0.528	0.002	0.071	0.001

组别	例数	修复前	修复6个月	修复1年
研究组	52	55.92 ± 6.11	60.32 ± 5.26	71.14 ± 6.08
对照组	52	54.73 ± 6.20	58.70 ± 4.49	68.53 ± 6.23
t值		0.986	1.689	2.146
P值		0.327	0.094	0.034

组别	例数	食物嵌塞	疼痛	过敏	牙龈发炎	总发生
研究组	52	1	2	0	0	3（5.77）
对照组	52	5	4	0	4	13（25.00）
χ² 值						7.386
P值						0.007

组别	例数	非常满意	满意	不满意	总满意
研究组	52	40	9	3	49（94.23）
对照组	52	32	10	10	42（80.77）
χ² 值					4.308
P值					0.038