種植基臺幾何形狀對氧化鋯冠軸向固位力的影響

[中圖分類號]R783.4[文獻標志碼]A [doi] 10.7518/gjkq.2025082

Effect of implant abutment geometry on the axial retaining force of zirconia crown

ZhangHong，Yu Qing

Deptofroidoicllnitloil

calHospital，titteofomtology，NnjingUiversity，Nnjing8ina

Supported by：NanjingScienceand TechnologyProgram （202205051）

Correspondence：YuQing，Email：kqmike@163.com

[Abstract]ObjectiveThisstudyinvestigatedtheeffctsofocclusalgingivalheight，convergenceangle，andabutment diameteron theaxial tensile force of zirconiacrowns and explores the interactions among these threefactors.Methods Using Solidworks software，twelve types of abutments with varying convergence angles （ 12^° and 6^° ），occlusal gingival heights （3 and 5mm ），anddiameters（3.5，5，and 6mm ）were designed，which resulted ina total of72 samples （six of each type）.Theseabutments were manufactured via selective laser melting （SLM） three-dimensional printing.Corresponding zirconia crowns （72 total） were produced via computer aided designand computer aided manufacturing （CAD/ CAM） and bonded for 48h .Axial tensile tests were then conducted using a universal testing machine，followed by statisticalanalysis.ResultsInaxial tensile tests，theretention force increased withtheabutmentdiameter in theorderof 3.5lt; 5lt;6mm groups （Plt;0.05） .Inaddition，retentionforcewashigher inthe 6^° convergence angle group compared with the12^° group （Plt;0.05） andgreater inthe 5mm occlusal gingival height group compared with the 3mm group （Plt;0.05） .No interactionwasobservedamong the three factors.However， interactions were noted between occlusal gingival height and diameter and between convergence angle and diameter.Notably，when the occlusal gingival height was 3mm ，no significant difference was detected in theretention forcebetween the3.5and 5mm diametergroups （Pgt;0.05） .Similarly，ata 12^° convergence angle，no significant differencewasobserved intheretention forcebetweenthe5and 6mm diameter groups （Pgt;0.05） ）.Conclusion The retentionforceofzirconiacrownsincreaseswithalargeabutmentdiameter，smallconvergenceangle，andgreatocclusal gingival height.Reducing theconvergenceangle ismore critical thanincreasing theabutment diameter whentheocclusal gingival height is low.Incases with minimal restorative space，the selection ofa smalldiameterabutment while ensuring a small convergence angle can also achieve satisfactory retention.

[Key words] implantabutment；height；convergenceangle；diameter；crown；retaining force；retention strength

隨著種植修復技術的發展，種植義齒因其優越的舒適感和良好的咀嚼功能等優點越來越受患者歡迎，已成為牙列缺損患者首選的修復治療方法。種植義齒冠修復最常用的固位方法是螺絲固位和粘接固位，這2種固位方法各有其優缺點。螺絲固位的優點在于，當修復體出現損壞或軟組織發生炎癥時，可以方便地拆卸進行修補或定期清潔；不足的是制作工藝復雜、費用高，長期應力作用下會出現螺絲松動或折斷1-2]，尤其是在后牙區進行種植義齒修復時，因視野及操作空間有限，螺絲固位往往會增加操作難度[。粘接固位的優點是成本較低，具有優良的美觀性，并且粘接層可以緩沖部分應力；不足的是粘接劑的殘留會引起種植體周圍炎或修復體的脫粘[1-2]。已有研究]表明，代型法、橡皮障法、凡士林法等技術可以有效減少種植修復體周圍粘接劑的殘留，降低不良反應。因此，粘接固位不僅能滿足患者對美觀的需求，還能為醫生提供便利的修復體試戴，值得進一步研究與優化。

在種植義齒修復中，常用的材料包括氧化鋯和二硅酸鋰等，其中氧化鋯憑借其優越的強度而被廣泛應用于臨床。然而，氧化鋯陶瓷冠的脆性高、耐酸性差，且粘接性弱4，易出現牙冠脫位等問題。Alfadhli等的研究發現：牙齒支持氧化鋯冠3年的存活率為 90.9% ，其中固位喪失是 7.8% 。Pitta等發現：臨床種植修復時，氧化鋯冠極易脫粘。由此可見，提高全冠固位力并改善牙冠與基臺間的粘接性能，已成為當前種植修復領域亟待解決的問題。……