• 作者： 張標能; 陳瑞松; 謝季全
• 作者服務機構： 私立中國醫藥學院附設醫院牙科; 國立臺灣大學牙醫學系暨國立臺灣大學醫學院附設醫院牙科
• 中文摘要： 數十年來金屬陶瓷冠（Porcelain-fused-to-metal crown）一直都是牙科臨床上最被廣泛使用的修復（Restorative）材料，但由於其內在具有的脆性，儘管是在製作過程中非常小心，陶瓷冠的缺損、破裂仍是常常見到。為了讓牙醫師及患者免除需破壞再重做的痛楚，尤其是少量的缺損，諸多學者都主張寧用修補的方式以取代重做，於是乎瓷材修補系列不斷的被研究發展。迄今，複合樹脂材料仍是唯一能在口內修補破損瓷材的材料，但瓷材(Porcelain)與修補材間的鍵結力仍無法達到我們的要求。本實驗的目的即在評估複合樹脂修復材與瓷材不同的三層(opaque porcelain, body porcelain andenamel porcelain)間的鍵結力。結果顯示opaque porcelain與修復材間有最強的鍵結力，body porcelain次之，enamelporcelain則最弱。 基於陶瓷本身的硬度及脆性，我們建議後牙咬合面的修復最好少用陶瓷冠。如一旦破裂發生，若要探用複合樹脂修復，除了使用酸蝕及粗糙瓷材表面之外，合併使用偶合劑（coupling agent)及特殊的黏著劑(bonding agent)是目前最被建議使用的修補方法。再者，根據本實驗之結果，我們建議，雖然破裂處只到enamel porcelain但修補時可將之至少磨至dentin porcelain，如此將會有更好的修補效果。
• 英文摘要： The tensile bonding strength between repair materials and porcelain is not as good as would hope.For the present study we tested the tensile bonding strength between layers of porcelain (i.e, enamel, bodyand opaque) and repair materials, and compared strengths between the bonding materials. We found thatthe opaque layer had the strongest tensile bond with the repair material (43．9±9.8 MPa), while the bodylayer came next (34.3±11.8 MPa), and enamel was the weakest (22.7士6.4 MPa). The bonding strengthsof three different layers of porcelain also showed significant differences (p＜0.05.） Owing to the inherent brittleness of porcelain, we suggest that when restoring posterior teeth, thearea of veneered porcelain on a porcelain-fused-to metal (PFM) crown should be as small as possible,-especially on the occlusal surface. Besides performing acid etching and surface roughening a fracture, com-bining the composite resin with a silane coupling agent plus a special bonding agent is the best method forrepair. Also based on this study, in order to increase bonding strength, preparation of the fractured sur-face with a coarse rotating instrument to produce a rougher and deeper surface is also strongly suggested,even if the fracture only involves the enamel layer.
• 中文關鍵字： porcelain repair; tensile bonding strength.
• 英文關鍵字： --