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前牙複合樹脂 85分之卷

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兩年前的教材,簡單把前牙做到85分~
95分的部分,將來有機會再說吧@@
許多圖是從
"Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach
by Pascal Magne & Urs Belser"這本書引用的
而case有一例13年追蹤是廖峰聘老師提供的,感謝他們:)

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前牙複合樹脂 85分之卷

  1. 1. 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
  2. 2. 現實…
  3. 3. 現實… 只是事實的⼀一部分…
  4. 4. before after
  5. 5. before after
  6. 6. before afterpin
  7. 7. before after
  8. 8. before after
  9. 9. before after
  10. 10. before after
  11. 11. before after
  12. 12. 暫時的美麗?
  13. 13. 3 months
  14. 14. just finished 3 months follow-up 表⾯面特徵消失
  15. 15. 1 year
  16. 16. just finished 1 year follow-up 染⾊色、易有plaque
  17. 17. 7 years
  18. 18. 表⾯面磨損凹陷
  19. 19. 13 years
  20. 20. 1Y 13Y 咬合⾼高度喪失
  21. 21. 19 years
  22. 22. 19Y咬合喪失、邊緣變⾊色
  23. 23. 35 years
  24. 24. 樹脂變⾊色,外形喪失
  25. 25. 挑戰 or 契機?
  26. 26. 讓我們繼續看下去…
  27. 27. 前⽛牙OD要點
  28. 28. • 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
  29. 29. 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
  30. 30. 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
  31. 31. resin系統 內功…
  32. 32. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  33. 33. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  34. 34. 光線
  35. 35. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  36. 36. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  37. 37. 室內光
  38. 38. 閃燈直打
  39. 39. 柔光⽚片
  40. 40. 第⼀一招: Bevel 實踐
  41. 41. enamel bevel dentin bevel
  42. 42. enamel bevel dentin bevel
  43. 43. primary bevel D+E
  44. 44. enamel bevel type 1 for color matching
  45. 45. enamel bevel type 2 for regular use
  46. 46. 不同的bevel⽅方式⽐比較
  47. 47. 第⼆二招: Overfilling
  48. 48. bevel margin
  49. 49. bevel margin resin margin
  50. 50. over filling cavity 沒bevel,只有overfilling
  51. 51. original
  52. 52. 1 year沒bevel,只有overfilling
  53. 53. 如果,不要寬的bevel,也不要overfilling…會如何?
  54. 54. 7years
  55. 55. overfilling X enamel long bevel X 7years 很快邊緣就凹了
  56. 56. 第三招: Translucency control
  57. 57. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  58. 58. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  59. 59. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  60. 60. 看不太出來餅乾在玻璃罐中
  61. 61. 除⾮非我們看到罐⼦子的邊緣…
  62. 62. 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
  63. 63. 狀況1
  64. 64. 狀況1 translucent normal
  65. 65. 狀況2
  66. 66. 狀況2
  67. 67. 狀況2 opaque
  68. 68. 狀況2 opaque
  69. 69. 狀況2 opaque translucent normal
  70. 70. 狀況3... 失誤 opaque 過⽩白區透出 translucent
  71. 71. case 13 過⽩白區透出
  72. 72. 過⽩白區透出
  73. 73. 正⾯面觀
  74. 74. back shell
  75. 75. opaque
  76. 76. normal
  77. 77. translucent
  78. 78. 有時,隨便補補就有透明度…Why???
  79. 79. 在關⼩小⽛牙縫時,不必分層
  80. 80. 外形修正 外功…
  81. 81. ⿈黃⾦金⽐比例適合⽛牙科嗎?
  82. 82. ⾃自然 Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  83. 83. 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
  84. 84. 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
  85. 85. ⼤大於4mm,請不要勉強⽤用補的了啦...
  86. 86. 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
  87. 87. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  88. 88. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  89. 89. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  90. 90. 不注意線⾓角,可能會補成⽅方的= =
  91. 91. M-D線⾓角拉近, ⽛牙⿒齒看起來較不⽅方
  92. 92. M-D線⾓角拉遠, ⽛牙⿒齒看起來較⽅方
  93. 93. 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
  94. 94. 拋光
  95. 95. Bonded Porcelain Restorations In The Anterior Dentition – A Biomimetic Approach Pascal Magne & Urs Belser
  96. 96. 拋光的各種⼯工具,通常是⽤用Low Speed
  97. 97. 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@@
  98. 98. 填補的⼩小輔助…
  99. 99. palatal backing
  100. 100. banding
  101. 101. 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!
  102. 102. 實例 其實有些步驟…沒拍到XD
  103. 103. 依顏⾊色及咬合做好mock-up
  104. 104. 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
  105. 105. 完成~偷懶之作…⽛牙齦還不⼩小⼼心卡到XD
  106. 106. Thanks for your attention! ...zzZZ

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