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標題: | 樹脂加壓及注射成形方式與數位切削列印方式製作之上顎無牙義齒基底應變分布之評估 - 體外實驗 Evaluation the strain distribution of maxillary denture base fabricated by compression molded, injection molded, CAD/CAM milled and 3D printed techniques - An In Vitro Study |
作者: | Po-Ju Huang 黃柏儒 |
指導教授: | 楊宗傑(Tsung-Chieh Yang) |
關鍵字: | CAD/CAM切削,3D列印,熱聚合樹脂,上顎活動義齒,應變,老化加工測試, CAD/CAM milled,3D printing,Heat-polymerized resin,Maxillary denture,strain distribution,artificial aging, |
出版年 : | 2020 |
學位: | 碩士 |
摘要: | 實驗目的:本研究目的在檢測樹脂熱聚合加壓及注射方式與數位化技術電腦設計切削及3D列印所製作之上顎活動義齒基底,在受力後的應變分布及材料老化加工後對應變分布的影響。
材料與方法:基於本研究團隊先前研究[1]製作出的上顎鈷鉻合金 ( cobalt-chrome alloy ) 金屬參考模,以透明壓克力樹脂翻製成測試模型,並以2 mm 厚之矽膠印模材製作出軟組織墊片置於測試模型上,用以模擬上顎無牙嵴之黏膜構造。而後,依據金屬參考模之組織面,分別採用下列三種製程、各二種材料(共計六種組合)製備出上顎全口義齒基底板:(1) 樹脂熱聚合製程 [注射成型 (injection molding, IM group)、壓縮成型 (compression molding, CM group)] ;(2) CAD/CAM切削製程 ( CCM-P group、CCM-Y group );(3) 3D列印製程 ( 3DP-B group、3DP-N group),每種材料各包含五個樣品 (共計30個) 上顎全口義齒基底板以供測試。義齒基底完成後,於拋光面黏貼應變規 (strain gauge ),以測得CH1:唇繫帶切跡 (labial notch)、CH2:橫向義齒基底中線前緣( anterior middle base plate – transverse )、CH3:上顎後障 (post dam)、CH4:縱向義齒基底中線前緣 ( anterior middle base plate – axial)、CH5:左側頰繫帶切跡 (left buccal notch)、CH6 CH7:左側齒槽脊前緣及後緣 (left anterior and posterior ridge crest ) 等七處不同走向或位置之受力應變。就義齒基底受力後之應變分布,本研究所採取之測試方式為:將測試模型固定於萬能試驗機 (universal testing machine)上,並將待測試之義齒基底放置於測試模型上,施以5公斤重垂直定力後,記錄應變數值,完成初始測量;而在材料老化加工後之受力應變測試方法為:以彈性防水漆覆蓋於應變規上,將義齒基底置於37度恆溫蒸餾水中浸泡 14 天,移出恆溫水浴槽後按照前述義齒基底受力應變之測試方法,完成浸泡14天之應變測量;接續前一步驟,再次將義齒基底置入37度恆溫蒸餾水中浸泡 14 天並測量其應變,完成浸泡28天之受力應變測試。本研究之統計方式則使用Mann-Whitney U test進行樹脂熱聚合、CAD/CAM milled與3D printing三種製程中兩種不同材料的比較,另以Kruskal -Wallis test 進行三種製程間的比較,同時採Dunn’s test進行事後檢定 (post-hoc test) ,最後以Wilcoxon signed rank sum test來評估IM group, CM group, CCM-P group, CCM-Y group, 3DP-B及3DP-N各組老化加工前後應變值是否有差異,有意義水準設於p小於0.05。 實驗結果:初始進行義齒基底受力應變測量時,同種製程之兩種材料大多呈現同為拉伸應變 (Tensile strain, 簡稱拉應變) 或是壓縮應變 (compressive strain, 簡稱壓應變) 等相類似的應變傾向,且三種製程均分別由大至小於上顎後障 ( CH3 )、左側齒槽脊後緣 ( CH7 )、唇繫帶切跡 ( CH1 )呈現明顯的應變。又CAD/CAM切削及列印兩種數位製程的應變趨勢亦相近,但CAD/CAM切削製程之應變小於3D 列印製程,且標準差顯示出3D 列印製程有較大的應變分布。而材料經28天老化加工後,樹脂熱聚合製程及CAD/CAM切削製程的兩種材料在浸泡過後還是各自呈現相似的應變變化,但是在3D列印製程中的兩種不同材料則顯示出較大的應變變化趨勢差異。再者,在將義齒基底浸泡14天之後,幾乎所有製程都有應變增加,而增加浸泡時間到28天後,應變則均有下降的趨勢,但除了3D printing製程之外,老化測試前後的應變大小沒有統計上的顯著差異。另外,各製程間的差異也隨著浸泡時間增加而逐漸縮小,而且從各位置觀察應變變化率,可以發現CAD/CAM 切削有最小的變化率,乃三種製程中較為穩定,樹脂熱聚合次之,3D printing 製程則有最大變化。 結論:樹脂熱聚合、CAD/CAM切削與3D 列印製程都可以觀察到在唇繫帶切跡 ( CH1 )、上顎後障 ( CH3 ) 以及左側齒槽脊後緣 ( CH7 )有較大的應變。在上顎後障(CH3 )處,3D printing組呈現較CAD/CAM 切削組大的壓應變;樹脂熱聚合製程則為應變值大於CAD/CAM milled與3D printing的拉應變。三種製程製作之義齒基底在老化加工之後,皆會出現受力後應變下降的趨勢。其中CAD/CAM milled製程的變化最小,熱聚合製程次之,3D printing group則是有最大的變化。 Purpose: The purpose of this in vitro study was evaluation of strain distribution between maxillary denture base which were fabricated by CAD/CAM milled, 3D printed and conventional heat polymerized resin ( compression/injection molding ) method after the static force loading and material aging process. Materials and methods: Based on the research by our research team [1], the metal cobalt-chrome alloy reference model was converted into a test model which made with transparent acrylic resin. A 2mm artificial gingiva made with silicon impression material was placed on the test model to simulate the structure of the maxillary edentulous mucosa. According to the intaglio surface of the metal reference model, the following three different process method containing 2 materials each ( six materials in total ) were used to fabricated the base plate of the maxillary denture base : (1) conventional heat-polymerized resin process [ injection molding group, IM group), compression molding, CM group ]; (2) CAD / CAM milled process (CCM-P group, CCM-Y group); (3) 3D printing process (3DP-B group, 3DP-N group ), five denture bases were fabricated for each material (total sample size = 30). Since the denture base were completed, seven strain gauges were then attached on the polishing surface in different position and direction as following order : CH1: labial notch, CH2: transvers anterior middle base plate, CH3: maxillary Post-dam, CH4: axial anterior middle base plate, CH5: left buccal notch, CH6 CH7 : left anterior and posterior ridge crest. Strain distribution data with static loaded denture base were collected by following method: fixed the test model on the universal testing machine, place the denture base to be tested on the model, apply an axial static load of 5 kg and record the strain value, complete the initial measurement. Test method of strain distribution after material aging processing: covered the strain gauge with waterproof varnish, then stored the denture base in 37 degrees constant temperature distilled water for 14 days. After removed the denture base from the constant temperature water bath, using the same method of initial measurement, collecting the strain distribution data of the denture bases went through 14 days artificial aging and static loaded. Following the previous step, the denture bases were placed in 37 degree constant temperature distilled water again for another 14 days, and the strain of 28 days aging was measured. Statistically, we use Mann-Whitney U test to compare two materials in the same process method. Kruskal-Wallis test were used to compare the three process methods, with Dunn's test method for post-hoc test. Last, Wilcoxon signed rank sum test were used to evaluated IM group, CM group, CCM-P group, CCM-Y group, 3DP-B and 3DP-N the difference between initial and after aging. The significant difference level is set at p <0.05. Results: During the initial strain measurement, two materials of the same process method showed similar strain tendency mostly, and the most significant strains present in the following three spots with descending sequence: Maxillary post dam (CH3), left posterior ridge crest (CH7) and labial notch (CH1). The strain distribution trend of the two digital method are similar and the CAD/CAM milling process present lesser strain than 3D printing, and the standard deviation of 3D printing shows largest data deviation. After the material is artificial aged for 28 days, the two materials of the conventional heat polymerized and CAD/CAM milled still exhibit similar strain changes after immersion, but the trend of the 3D printing process is quite different. Moreover, almost all process methods present increased strain after immersion for 14 days. While increasing the soaking time to 28 days, the strain tends to decrease, and the difference between the various process method becomes smaller, but no statically significant difference except for 3D printing process. Somehow, the difference between process method decreased after artificial aging, CAD/CAM milled with the lowest changing rate, followed by heat polymerized, the 3D printing has the greatest change. Conclusion: Significant strain could be observed in labial notch (CH1 ), post dam (CH3) and left posterior ridge crest (CH7) of denture base which were fabricated by heat polymerized, CAD/CAM milled and 3D printing process. In the Post dam (CH3), 3D printing group exhibits larger compressive strain than the CAD/CAM milled group. Meanwhile, the heat polymerized process has greater tensile strain value than the CAD/CAM milled and 3D printing. After the denture bases made by the three processes were aged, the strain tends to decrease after loading. Among them, the CAD/CAM milled process has the smallest changes, followed by the heat polymerized process, and the 3D printing group has the largest changes. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/18476 |
DOI: | 10.6342/NTU202003088 |
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顯示於系所單位: | 臨床牙醫學研究所 |
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