期刊导航

论文摘要

边缘区预备体边缘、修复体边缘、粘固(粘接)层及龈缘的几何位置关系——边缘位置的新分类与新方案

Geometric position relationship between gingival, preparation, restoration margins and the cementation (adhesive) layer in the marginal area: new classification and scheme for margin position

作者:于海洋, 罗天

Author:Yu Haiyang, Luo Tian

收稿日期:2024-10-18          年卷(期)页码:2025,43(2):163-163-174

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:龈缘(线),预备体边缘,修复体边缘,目标修复空间,龈沟生理作用,显微修复与制作,生物学宽度,生物导向性预备技术,

Key words:gingival margin (line),preparation margin,restoration margin,target restorative space,physiophysiologic function of gingival sulcus,micro-prosthodontics and fabrication,biological width,biologically orien-ted preparation technique,

基金项目:四川省卫生健康委员会研究者发起的临床研究项目(230LCYJ017)

中文摘要

当前固定修复边缘的低质量现状与边缘相关并发症高发生率高度关联,并与龈缘(G)、预备体边缘(P)、修复体边缘(R)三个边缘(简称“三缘”)的共识性定义及时空几何位置关系不明确相关。本文从现有术语“龈缘”作为表面解剖标志存在的问题展开讨论,提出了符合几何学和测量学并更具表面解剖标志意义的术语“龈缘线”,明确了边缘区有预备体边缘、修复体边缘、龈缘、粘固(粘接)层、龈沟等参与方,通过对预备体边缘、修复体边缘、粘固(粘接)层等进入龈沟可能诱发各种医源性损害风险的讨论,强调了保持龈沟各种正常生理作用的重要性。进一步论证了“三缘”间及其与粘固(粘接)层间的适宜时空几何位置关系,根据边缘区“三缘”与粘固(粘接)层的空间位置关系提出了边缘位置的9型分类法(龈剖面上)、243型分类法(近远中向),克服了以往边缘位置分类纳入对象单一不全、风险因素失控等问题,具有实用性强、风控点明确、主控几何量效能好等优势。进一步定义的“RPG间距”代表牙体预备临床程序中先后出现并可以实测的预备体边缘完成线或修复体边缘完成线与龈缘线之间龈剖面上的间距,通过对龈下设计、生物导向性预备技术等不足的讨论,“龈沟/龈沟液+生物学宽度=牙周第一道保护屏障”的生理与临床意义的解析,结合现有临床循证证据提出龈上RPG200方案,即预备体边缘与修复体边缘均位于龈缘线上且与其间距小于200 μm,该推荐设计方案具有裸眼隐身的美观效果,也对龈缘、龈沟等无损伤,并方便医生与患者进行清洁维护等优势。本文提出的边缘区边缘位置的新分类法以及推荐的RPG200龈上新设计方案为边缘区的修复设计与各种并发症的防控提供了新思路。

英文摘要

The current low quality of fixed restoration margins is highly correlated with the high incidence of margin-related complications. It is also related to the unclear spatiotemporal geometric position relationship among the consensus definitions of the gingival margin (G), preparation margin (P), and restoration margin (R). This paper discusses the existing problem of the existing term “gingival margin” as a surface anatomical landmark; proposes the term “free gingival margin line” that conforms to geometry and measurement and has importance as a surface anatomical landmark; and clarifies the participants that exist in the marginal area. These participants include the P, R, and G; cementation (adhesive) layer; and gingival sulcus. Moreover, this paper discusses the various iatrogenic damages induced by entering the gingival sulcus via the P, R, and cementing (adhesive) layer. Through the discussion of the design deficiencies of the subgingival and biologically oriented preparation technique, the physiological and clinical importance of the concept of gingival sulcus/gingival sulcus fluid + supercrestal tissue attachment (biological width) = first periodontal protective barrier was analyzed. The value of preserving the physiological role of the gingival sulcus is emphasized. Furthermore, the newly defined RPG distance represents the distance between the successive P or R line and free G line and can be measured in the clinical procedure of tooth preparation. The optimal solution is 0-200 µm, that is, RPG200: the P and R are located on the free G line and the distance between these margins is less than 200 µm. This distance not only has the aesthetic effect of invisibility to the naked eye, it also has a minimal effect on the G and gingival sulcus and is convenient for doctors and patients to clean. Furthermore, in accordance with the positional relationship between the three margins and cementation (adhesive) layer, a new classification of marginal positions is proposed. This classification overcomes the problems of incomplete inclusion objects and uncontrolled risk factors in the previous classification. It also has the advantages of strong practicability, good efficiency of main control geometric quantity, and clear risk control points. The new design scheme and classification of the margi-nal position of RPG200 proposed in this paper provide a new understanding for margin design and complication prevention in the future.

上一条:基于数字化美学设计的流动树脂注射充填修复技术

关闭

Copyright © 2020四川大学期刊社 版权所有.

地址:成都市一环路南一段24号

邮编:610065