Ii-Inlays zeCeramic zosuku olunye: Kutheni iMisebenzi Engakumbi Isiya Kwi-CAD/CAM Ecaleni Kwesihlalo

Asikuko ukwenza ulungiso ngokukhawuleza, kodwa kukucwangcisa ngokutsha indlela umzi-mveliso ovelisa ngayo izinyo elinye.

Isigulana sihlala phantsi. Isiqwenga esikhulu se-composite kwi-molar yaso siphinde sangasebenzi. Into abafuna ukuyazi ilula: "Singasindisa izinyo lendalo kangangoko kunokwenzeka? Kwaye oku kungenziwa namhlanje?"

Kwindlela yokusebenza yesiqhelo, impendulo idla ngokuba hayi. Iimpawu, ukubuyiselwa okwethutyana, kunye nokuqokelelwa okwesibini emva kweeveki ezimbini zezona zinto ziqhelekileyo. Kodwa ngeskena sangaphakathi komlomo, uyilo lweCAD, kunye nomatshini wokugaya ecaleni kwesitulo, yonke inkqubo - ukulungiswa, ukuskena, uyilo, umatshini wokugaya, kunye nokufakwa kwesamente - inokwenzeka kutyelelo olunye. Isigulana siphuma ngaloo mini inye nokulungiswa okusisigxina kweseramikhi.

Nantsi indlela ebonakala ngayo ecaleni kwelinye:

Ngomatshini wokugaya osecaleni kwesitulo, loo ngxaki ingaqhelekanga yeeveki ezimbini enokulungiswa okwethutyana isuswa ngokupheleleyo. Isigulana akufuneki siphile nentlungu yexeshana enokuphela nangaliphi na ixesha - kwaye akufuneki sibuye ukuze sibuye okwesibini.

Oku akupheleli nje ekucwangciseni ixesha. Kutshintsha amava esigulana, kutshintsha indlela ugqirha wamazinyo alawula ngayo umgangatho wokulungiswa, kwaye kutshintsha indlela indawo yokunyanga ecwangcisa ngayo ishishini layo lokulungisa.

Xa ubungqina bezonyango bexesha elide, ukuvela kwezinto eziphathekayo, kunye noqoqosho olusebenzayo zonke zikhomba kwicala elinye, izinto ezifakelweyo zeseramikhi zaloo mini ziyeka ukuba yiteknoloji "entle ukuba nayo" kwaye zibe nobuchule bezonyango obufanele ukwakhiwa.

Ukusuka Kukulinda Kweeveki Ezimbini Ukuya Kwisihlalo Sosuku Olunye: Indlela Esebenza Ngayo Ukuhamba Kwesihlalo Esisecaleni

Ukulungiswa kwesihlalo ngaloo mini nye kuphazamisa indlela yokusebenza eyayisahlulwa kwiindawo ezininzi, ukunikezelwa kwemisebenzi emininzi, kunye nokuqeshwa okuninzi ngosuku olunye:

Ukulungiswa kwamazinyo → Ukwahlukaniswa kunye nokuhlolwa komda → I-Intraoral scan → Uyilo lwe-CAD → Ukugaya i-CAM → Ukwenziwa kwekristale/ukutshiza okanye unyango lomphezulu njengoko kufuneka → Ukuzama → Ukuqinisekiswa kwesamente kunye nokuqinisekiswa kwe-occlusal.

Isigulana asiyi kubuya size siphephe ukungaqiniseki kwemibono kunye nokulungiswa okwethutyana. Ugqirha wamazinyo ugcina ulawulo oluqhubekayo kwimida, uqhagamshelwano olukufutshane, i-contour, kunye nokuvaleka ngelixa isigulana sisesesitulweni. Ukuba kukho into efuna ukulungiswa, sinokubuyela kwinqanaba loyilo okanye lokusila ngoko nangoko.

Ngoko ke ixabiso elithi "same-day" aliloxesha lokukhawulezisa ngenxa yalo. Liguqula ukuhanjiswa konyango ukusuka kwinkqubo yokunikezelana okuqhekekileyo ukuya kwi-clinical closed loop elawulwa ngugqirha wamazinyo ukususela ekuqaleni ukuya ekupheleni.

Ii-Inlays zeCeramic kunye nee-Onlays: Oko Kuboniswa Bubungqina Bexesha Elide

I-inlay yindlela yokulungisa izinyo engathanga ngqo eyenziwe ngaphandle komlomo ize ifakwe nge-cemented emazinyweni. Xa ii-cusps ezibuthathaka zifuna ukukhuselwa, ulungiso lufikelela kwi-onlay okanye i-overlay. Xa kuthelekiswa nesithsaba esipheleleyo, ezi ndlela zokugubungela izinyo ezingaphelelanga zigcina ulwakhiwo lwamazinyo olusempilweni ngakumbi xa iimeko zivuma.

Zizalisa umsantsa obalulekileyo phakathi kokulungiswa okuhlanganisiweyo ngokuthe ngqo kunye neekorona ezipheleleyo: isiphene sikhulu kakhulu ukuba singazaliswa ngokuthe ngqo ukuze silawule ngokuthembekileyo imo, uqhagamshelwano, okanye umsebenzi, kodwa isakhiwo samazinyo esiseleyo sifanelekile ukugcinwa kwaye asikaqinisekisi ukuba isikrona esigqunywe ngokupheleleyo.

Idatha yexesha elide iyayixhasa le ndlela. uphononongo olucwangcisiweyo kunye nohlalutyo lwe-meta-analysis ye-resin kunye ne-ceramic inlay, onlay, kunye ne-overlay survival Ukugubungela phantse ukubuyiselwa okungu-6,000 kufumanise ukuba ukubuyiselwa kweglasi-ceramic kunye ne-feldspathic porcelain kufikelele kumazinga okusinda kweminyaka emi-5 angama-92–95% kunye nokusinda kweminyaka eli-10 malunga nama-91%. uhlalutyo lwe-meta-analysis lwe-CAD/CAM oluxhaswe ngamazinyo kuphela nge-ceramic uqikelela amazinga okusinda kweminyaka emi-3, emi-5, kunye neli-10 ukuya kuthi ga kwi-94.66%, 91.1%, kunye ne-82.2% ngokwahlukeneyo.

Ezi zifundo aziqinisekisi ukuba yonke into ebuyiselwayo iza kuhlala iminyaka elishumi. Kodwa zenza ingqiqo ecacileyo: xa iimpawu zifanelekile kwaye iprotokholi yeklinikhi ilungile, ii-inlays ze-CAD/CAM ceramic ezisecaleni kwesitulo zibonelela ngeziphumo eziqikelelweyo zexesha eliphakathi ukuya kwelide. Ukukhawuleza akuthethi ukuba kuza kuhlala ixesha elifutshane.

Ukwamkelwa kweCAD/CAM ecaleni kweSihlalo kwihlabathi liphela

Idatha yokwamkelwa komntwana ichaza ibali elifanayo, nangona iindlela zophando kunye neenkcazo zahlukile ngokwamazwe:

Kwindlela yokuziqhelanisa notyalo-mali, into ethethwayo ilula: le ayisiyoteknoloji yovavanyo elinde ukuqinisekiswa. Imizekelo yezonyango neyezorhwebo sele ikhona, kumazwekazi amaninzi nakwiinkqubo zezempilo.

Izinto Ezinokusetyenziswa Emachining for Same Day Restoration

Abavelisi kwihlabathi liphela baye baphuhlisa uluhlu lweebhloko ezisetyenziswayo ngokukodwa ecaleni kwesitulo kunye ne-CAD/CAM ese-lab. Ukuzidibanisa ngokwesayensi yezinto ezibonakalayo kunceda ukucacisa ukuba zeziphi ekufuneka umatshini wokusila wanamhlanje uziphathe:

Abavelisi abahlukeneyo basebenzisa amagama ahlukeneyo — “i-hybrid ceramic,” “i-composite ceramic,” “i-polymer ceramic” — kodwa indlela esetyenziswa ngayo ayiguquguquki: izixhobo ezenzelwe uyilo lwedijithali kunye nokusila ngokukhawuleza, kunye nokulungiswa okulula emva kokusetyenziswa okuxhasa ukuhanjiswa kwangolo suku.

Izisombululo zokusila nezokucoca zeGlobalDentex ezisecaleni kwesitulo zenzelwe ukucubungula zonke ezi ndidi zezinto ezingentla. Umatshini wokugaya omanzi nowomileyo we-DN-H5Z one-axis ezi-5 kwaye i I-DN-W4Z Pro esebenza kakuhle kakhulu kwiglasi-ceramic mill ukuphatha iiseramikhi zeglasi, i-lithium disilicate, izinto ezidityanisiweyo, nokunye. Kwimisebenzi yokusebenza esekelwe kwi-zirconia, Umatshini wokugaya owomileyo we-DN-D5Z one-axis ezi-5 ngababini kunye Isithando somlilo esikhawulezayo nesicothayo se-Q7 , nto leyo egqiba umjikelo opheleleyo wokusila ngemizuzu nje engama-60. Oku kuthetha ukuba nayiphi na indlela yeklinikhi oyikhethayo, izixhobo zakho aziyi kuyithintela indlela onokukhetha kuyo izinto ozisebenzisayo.

Iindawo ezintlanu zokujonga iiklinikhi zokubuyiselwa kwempilo okuqikelelweyo ngosuku olufanayo

Izixhobo ziphucula ukusebenza kakuhle, kodwa azivelisi ngokuzenzekelayo iziphumo ezifanelekileyo. Ukuze ii-inlay ze-ceramic zosuku olufanayo zibe namandla athembekileyo, kufuneka kudlule iindawo zokujonga ezintlanu:

1. Ukukhetha Ityala. Hlola imeko ye-endodontic, impilo ye-periodontal, umngcipheko wokubola kwamazinyo, kunye nokuba isakhiwo samazinyo aseleyo sifanelekile na ukugqunywa inxalenye. Ayizizo zonke iziphene ezinkulu ezifunekayo kumsebenzi wesihlalo.

2. Ukulungiswa kwamazinyo. Shiya indawo eyaneleyo yezinto ezibuyisela izinto kwimeko yazo. Gqiba ukuba ii-cusps ezichaphazelekileyo kufuneka zigqunywe okanye zigcinwe na. Isikhokelo esiqhelekileyo: ubuncinane i-1.5 mm ye-occlusal reduction kwi-lithium disilicate inlays; 2.0 mm xa ugubungela i-cusp nge-onlay. Ubukhulu be-ceramic obungonelanga kumphezulu we-occlusal busesinye sezona zizathu zixhaphakileyo zokungaphumeleli kokubuyiselwa.

3. Uyilo lweDijithali. Isoftware inokubonakalisa ubukhulu, umda, uqhagamshelwano, kunye nemiba yokuvaleka — kodwa iiparameter ezimiselweyo azithathi indawo yokugweba kwezonyango. Ugqirha wamazinyo kufuneka aqinisekise zonke iiparameter ngokuchasene nemeko nganye.

4. Ukwakha i-samente kunye nokwahlukanisa. Amazinyo, umaleko wokubopha, kunye nokubuyiselwa kwabelana ngomthwalo osebenzayo. Ukwahlulwa kwedama lerabha ngumgangatho ogqwesileyo. Iiprotokholi zonyango lomphezulu kufuneka zihambelane nezinto - ukukrola i-hydrofluoric acid kunye ne-silane ye-ceramics yeglasi; iiprotokholi zokubopha ezinamathelayo kwiibhloko ezisekwe kwi-resin.

5. Ukuqinisekiswa kwe-Occlusal. Ukuhlalisa umntu oza kulungisa imeko yakhe akuyonto yokugqibela. Iingxaki, ukuphazamiseka okubangelwa kukuphazamiseka, kunye nee-force vectors ezingalunganga kufuneka zichongwe kwaye zilungiswe ngaphambi kokuba isigulane sishiye isitulo. Sebenzisa iphepha elichazayo kwaye uqinisekise ukuba kukho ubudlelwane obuphakathi kunye neentshukumo ezibangelwa kukuphazamiseka.

Iqela elinamava elisecaleni kosihlalo alinyanzelisi ukuba kugqitywe ngemini enye kuzo zonke iimeko. Liyazi ukuba kufuneka liqhubeke nini, nini kufuneka liphinde lisebenze nini, kwaye nini kufuneka lilibazise. Umsebenzi utshintsha isigqi semveliso, hayi umgangatho wezonyango.

Ukwakha iProtokholi yeCAD/CAM ePhindaphindayo yeSihlalo

Inzuzo yokukhuphisana evela kwii-inlays ze-ceramic zangosuku olunye ayizukuba yeyokuqala ukuthenga iskena kunye nomatshini wokugaya. Iya kuba yeyokuqala ukuthenga i-scanner kunye ne-mill. Iya kuba yeyokuqala ukuthenga i-case selection, i-clinical protocol, kunye nokudibanisa iqela libe yinkqubo ephindaphindwayo.

Amanyathelo amathathu okufika apho:

Inyathelo 1: Yenza indawo yokungena kwimeko. Qala ngee-inlays ezithe ngqo zangasemva kunye nee-onlays apho ukwahlulwa kungalawuleka kwaye umngcipheko wokungakhuseleki uphantsi. Chaza iikhrayitheriya ezicacileyo zezinto ezingena emsebenzini wesihlalo kunye noko kuthunyelwa kwilebhu.

Inyathelo lesi-2: Yakha i-SOP epheleleyo. Bhala phantsi imigangatho yokulungiselela, iiprotokholi zokuskena, iiparameter zoyilo, ukukhethwa kwezinto, ukuphathwa emva kokusila, ulandelelwano lwesamente, kunye nokuqinisekiswa kwe-occlusal. Yenze ibe luluhlu lokuhlola lweqela, ingabi ngumkhwa womntu ngamnye.

Inyathelo lesi-3: Yandisa uphononongo lwetyala. Landelela umgangatho we-margin, uqhagamshelwano olukufutshane, ukwenziwa ngokutsha kwe-milling, iziphumo ze-cementation, kunye nokulandelela. Zinzisa indlela yempumelelo kuqala, uze uqhubeke kancinci kancinci uye kwiimeko ezinzima ngakumbi.

Ngolu hlobo, i-CAD/CAM esecaleni kwesitulo ayisayi kuba ngumatshini oqokelela uthuli kwindawo yokusebenza kwaye iba yinkonzo yokulungisa enokuyenza rhoqo indawo yakho yokusebenza.

Into Omele Uyenze: Ukulungiswa Kwemihla Ngayo Kuza Kuhlala Kuyo

Ubungqina bezonyango sele bugubungela amazwekazi amaninzi kunye neenkqubo zonyango. Izifundo zexesha elide ziqinisekisa iziphumo eziqikelelweyo kwiimpawu ezifanelekileyo. Abavelisi bezinto zokwakha bayaqhubeka nokwandisa uluhlu lweemveliso zabo. Indlela icacile.

Kwimisebenzi yamazinyo, umbuzo awusekho "ngaba singakhathali ngee-inlays ze-CAD/CAM ceramic ezisecaleni kwesitulo?" Ngulo: Ngawaphi amatyala oza kuqala ngawo? Ngawaphi amanqanaba eklinikhi oza kubeka? Kwaye kuza kuthatha ixesha elingakanani ukuguqula oku kube yinto ezinzileyo nephindaphindwayo?

Iindlela ezakha olu buchule ngaphambili ziya kuba zezokuqala ukubonelela ngemodeli yokubuyisela imeko kwimeko entle ejongana namava esigulana, unyango lwamazinyo olungenazo izihlunu kangako, kunye nokusebenza kakuhle.