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給PGY孩⼦子們的
前⽛牙樹脂秘⾟辛…
何偉宏 2012/10/15
基礎篇…for想做到85分的⼈人
現實…
現實…
只是事實的⼀一部分…
before after
before after
before afterpin
before after
before after
before after
before
after
before
after
暫時的美麗?
3 months
just finished 3 months follow-up
表⾯面特徵消失
1 year
just finished 1 year follow-up
染⾊色、易有plaque
7 years
表⾯面磨損凹陷
13 years
1Y
13Y
咬合⾼高度喪失
19 years
19Y咬合喪失、邊緣變⾊色
35 years
樹脂變⾊色,外形喪失
挑戰 or 契機?
讓我們繼續看下去…
前⽛牙OD要點
• 內功:了解resin系統、光線
第⼀一招:bevel
第⼆二招:over filling
第三招:透明度控制
• 外功:外形修正、拋光
前⽛牙OD要點
隱藏邊緣
• 內功:了解resin系統、光線
第⼀一招:bevel
第⼆二招:over filling
第三招:透明度控制
• 外功:外形修正、拋光
前⽛牙OD要點
隱藏邊緣
• 內功:了解resin系統、光線
第⼀一招:bevel
第⼆二招:over filling
第三招:透明度控制
• 外功:外形修正、拋光
前⽛牙OD要點
模仿質感
resin系統
內功…
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
光線
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
室內光
閃燈直打
柔光⽚片
第⼀一招: Bevel
實踐
enamel bevel
dentin bevel
enamel bevel
dentin bevel
primary bevel
D+E
enamel bevel
type 1
for color matching
enamel bevel
type 2
for regular use
不同的bevel⽅方式⽐比較
第⼆二招: Overfilling
bevel margin
bevel margin
resin margin
over filling
cavity
沒bevel,只有overfilling
original
1 year沒bevel,只有overfilling
如果,不要寬的bevel,也不要overfilling…會如何?
7years
overfilling X
enamel long bevel X
7years
很快邊緣就凹了
第三招:
Translucency control
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
看不太出來餅乾在玻璃罐中
除⾮非我們看到罐⼦子的邊緣…
多數情況下,我們不⼀一定要在labial做出enamel layer…
只需在邊緣轉折處強調有透明度即可
狀況1
狀況1 translucent
normal
狀況2
狀況2
狀況2
opaque
狀況2
opaque
狀況2
opaque
translucent
normal
狀況3... 失誤
opaque
過⽩白區透出
translucent
case 13
過⽩白區透出
過⽩白區透出
正⾯面觀
back shell
opaque
normal
translucent
有時,隨便補補就有透明度…Why???
在關⼩小⽛牙縫時,不必分層
外形修正
外功…
⿈黃⾦金⽐比例適合⽛牙科嗎?
⾃自然 Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
⿈黃⾦金⽐比例是正⾯面接近觀察的⽐比例,
⼀一般距離看起來⾨門⽛牙太⼤大
不太⾃自然 Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
⿈黃⾦金⽐比例也不是拿來計算⽛牙⿒齒
“真正”的寬度的
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
⼤大於4mm,請不要勉強⽤用補的了啦...
除了⽐比例,要有線⾓角
及不同⽛牙形的觀念
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
不注意線⾓角,可能會補成⽅方的= =
M-D線⾓角拉近,
⽛牙⿒齒看起來較不⽅方
M-D線⾓角拉遠,
⽛牙⿒齒看起來較⽅方
M-D線⾓角更近,
⽛牙⿒齒看起來更不⽅方…
但已不⾃自然了
拋光
Bonded Porcelain Restorations In The Anterior Dentition – A
Biomimetic Approach
Pascal Magne & Urs Belser
拋光的各種⼯工具,通常是⽤用Low Speed
要拋光到很亮是ok的,尤其是enamel,
但沒必要,只會讓樹脂更明顯@@
填補的⼩小輔助…
palatal backing
banding
mock-up 可以很精細也可以很混,圖
中都很混…視case⽽而定
但重點是,palatal的咬合先做出
來,印inedex可省很多事!
實例
其實有些步驟…沒拍到XD
依顏⾊色及咬合做好mock-up
壓index,注意palatal要貼好,index buccal part可以切
掉,此法可配合Rubber dam,但要修整好index
完成~偷懶之作…⽛牙齦還不⼩小⼼心卡到XD
Thanks for your
attention! ...zzZZ

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前牙複合樹脂 85分之卷