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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,牙体缺损修复,嵌体,金属全冠,部分冠,桩核,烤瓷冠,固定桥,牙体缺损修复,部 分 冠,Partial veneer crown,(partial-coverage restoration),部分冠,一,:,定义,二,:,区别,三,:,分类,四,:,优点,五,:,缺点,六,:,适应证,七,:,禁忌症,八,:,设计,(,邻间沟预备,),九,.:,牙体预备,部分冠是覆盖于,部分,牙冠表面的,金属,固定修复体。,一、部分冠的定义,：,An,extracoronal,metal restoration,that covers only part of the clinical crown,An,extracoronal,metal restoration,that covers only,part,of the clinical crown,Partial veneer crown,An,extracoronal,metal restoration,that covers,only,part,of the,clinical crown,二,.,部分冠与其它修复体的区别,1.,嵌体,inlay,高嵌体,onlay,2,.,铸造金属全冠,complete cast crown,区别,嵌体,inlay:,An fixed,intra,coronal,restoration,部分冠,Patial,Veneer Crown:,An,extra,coronal,metal restoration,嵌体,部分冠,铸造金属全冠,complete,cast crown,部 分 冠,partial,veneer,crowns,区别,部分冠,部分冠的分类与命名,7/8,冠,3/4,冠,7/8,冠,邻面半冠,部分冠的分类与命名,3/4,冠,7/8,冠,邻面半冠,部分冠的历史,7/8 Crown,History and Development,1950,Dr. Don Smith,USC Preparation Handbook,1964,Dr. Rex,Ingraham,Atlas of Cast Gold Procedures,1972,Drs.,Shillingburg,and Fisher,A partial veneer restoration,(,Aust,Dent J.),1974,Drs.,Shillingburg, Hobo, and Fisher,Preparations for Cast Gold Restorations,部分冠的应用,Partial Veneer Utilization,According to insurance company claim forms, the,Full Gold Crown,is used 14 times more often than Partial Veneer Gold Crown restorations.,部分冠,一,:,定义,二,:,区别,三,:,分类,四,:,优点,五,:,缺点,六,:,适应证,七,:,禁忌症,八,:,邻间沟预备,九,.:,牙体预备,四、部分冠的优点,1.,比金属全冠美观。,2.,与全冠相比磨牙少，更符合保存修复原则。,3.,与牙龈接触的龈边缘短，对牙龈刺激小。,优 点,4.,试戴时易检查边缘,5.,粘接时易就位,6.,粘接后易测活力,优 点,五、部分冠的缺点,3119,1366,1.,固位力小于全冠,2.,操作复杂,3.,美观,？,缺 点,Partial Veneers,advantages,Conservation of tooth structure,Accessible margins,Less gingival irritation,More easily seated into place,Able to electric pulp test in future,Partial Veneers,disadvantages,Less resistance and retention than full gold crowns,Preparations more technically demanding,Potential esthetic issues compared to ceramic restorations,牙体缺损修复,六、部分冠的适应证,适应症,中等程度牙体缺损，至少一个壁是完整的,。,后牙,适应症,固定义齿的固位体,后牙,适应症,恢复咬合或合面改形,后牙,适应症,恢复前牙切道,适应症,恢复前牙切道,适应症,牙周夹板,中等程度牙体缺损，至少一个壁是完整的。,作为固定义齿的固位体,恢复咬合或合面改形,适应症,后牙,3/4,冠,作为固定义齿的固位体,恢复前牙切道,牙周夹板,适应症,前牙,3/4,冠,七、部分冠的禁忌症,3119,1366,1.,临床冠过短,2.,跨度过大的固定义齿的固位体,3 .,无髓前牙,没有足够的支持,4.,牙体缺损面积大,累及颊尖的后牙,禁忌症,Question1:What are the indications and contraindications for partial veneer crowns?,Question2:What are the advantages and disadvantages of partial veneer crowns,部分冠,一,:,定义,二,:,区别,三,:,分类,四,:,优点,五,:,缺点,六,:,适应证,七,:,禁忌症,八,:,设计,(,邻轴沟,),九,:,牙体预备,八、部分冠设计与制备要点,邻轴沟设计,位置,方向,形态,深度,轴沟的位置,轴沟方向,轴沟方向,前牙 后牙示意图,轴沟的形态,轴沟的形态,169L-009,形态,Remove point to make flareinto one plane,形态,深度,深度,深度,“Triangle of Success”,轴沟的舌壁抵抗脱位,轴沟深度,预备常见错误,90 degrees,邻轴沟设计,位置,-,近唇颊轴线角,颊侧接触点内,方向,-,前牙平行切,2/3,后牙平行就位道,形态,-,轴沟舌壁与邻面轴壁,垂直,颊壁形成竖斜面,(flare),深度,-1mm,（长度,-4mm,）,Grooves,Lingual walls taper toward lingual of prep,Lingual walls provide resistance to lingual displacement of the restoration,0.5 mm axial depth,Gingival ends 0.5 mm occlusal to finish line,Placed with tapered fissure bur-169L,Size of 170L bur,请小结,1.,前后牙,3/4,冠的邻轴沟的位置、方向,2.,邻轴沟的作用？,ANY QUESTIONS?,Occlusal Offset,Facial cusp of maxillary 3/4 preparations,Provides bulk of gold near finish line,Not,for occlusal clearance,Parallels facial margin of preparation,0.5 mm deep (pulpal),1.5 mm from facial finish line,169L-009,部分冠,一,:,定义,二,:,区别,三,:,分类,四,:,优点,五,:,缺点,六,:,适应证,七,:,禁忌症,八,:,邻轴沟设计,九,:,牙体预备,
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