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【陶瓷貼片+全瓷冠】知名部落客Nancy-終於能露齒拍照了。-雅偲牙科診所

【陶瓷貼片+全瓷冠】知名部落客Nancy-終於能露齒拍照了。

 



常看我照片的人一定有注意到我幾乎很少露齒笑,
就算有也都是有一定的角度, 其實是因為我對我的牙齒很自卑.
小的時候沒有好好照顧所以有蛀牙, 還曾經摔斷過好幾個牙齒, 所以我的牙齒排列不是很正常.

最讓我在意的就是這2個牙齒特別黃!
這就是為什麼我很少露齒笑了, 因為真的不好看阿!



犬齒的部分本來就會比其他牙齒黃一點, 但是我個人覺的顏色落差很多,
笑起來特別明顯, 所以我都會特別避開.

犬齒後面那個則是因為原本就有蛀牙, 補牙的時間已經年代久遠,
造成牙齒表面有裂縫. 所以看起來有一點灰灰黃黃的



我之前去過雅偲專業牙科中心找 鄭聖達醫師做冷光美白,
當時就跟醫師諮詢過這兩個牙齒要做美白貼片跟全瓷冠.






雅偲鄭聖達醫師 也非常專業也非常仔細喔!
我詢問 每一個問題她都非常仔細的回答我,
直接先給大家看前後比較圖!

左邊是before, 犬齒跟後面那個牙齒顏色很黃
右邊是after, 犬齒做了美白貼片, 後面那個做了全瓷冠.

牙齒的顏色跟上排其他牙齒完全一樣呢!




讓我來跟大家分享一下過程,
一開始要先拍X光看牙齒本身的狀況,
如果牙齒本身是健康的, 只要改變牙齒的顏色就只要把牙齒磨小一點, 貼上美白貼片就好了~
如果牙齒本身就有蛀牙, 視蛀牙的情況而定就要做全瓷冠




醫師非常仔細的幫我檢查中~



接下來因為要把牙齒磨小, 所以需要打麻藥,
麻藥要打在牙齦上所以先在表面上麻藥



打麻藥中, 這個針筒看起來超可怕的, 其實不痛, 因為表面已經麻醉了,
但是打裡面牙齦的時候我還是全身緊繃阿~這支好大支阿!






之後就開始磨牙,
我的犬齒部分牙齒算健康, 所以只要磨小貼上貼片就好了~
後面那個因為補牙的部分範圍比較大, 所以如果只做貼片沒辦法支撐, 所以需要做全瓷冠



牙齒磨小後就要準備做齒模了







上面的齒模做好, 下面也要壓模, 這樣才能確認做出來的牙齒咬合正常



因為全瓷冠跟貼片都需要一個禮拜的時間去製作,
所以醫師也幫我做了暫時的牙套.



雖然是暫時的, 醫師還是很仔細的幫我拋光修形狀~



這個就是暫時的牙套喔!
其實顏色已經比我原本的顏色白很多了, 醫師幫我用最白的顏色做
暫時的牙套因為材質不同, 所以比較容易卡色素~這一個禮拜內吃東西要特別小心~




一個禮拜後我回去迎接我的新牙齒!


在這裡呢!



首先要先把暫時的牙套拆到,
這個過程比較不舒服, 因為暫時的牙套黏得很緊,
敲敲打打了半天才拿下來,
我都好害怕我真得牙齒會斷掉之類了~

醫師一直都會問我有沒有什麼不舒服~真得很細心喔!



試戴我得貼片跟全瓷冠!!
顏色真得很完美!

醫師要我再三的確認顏色是否是我要的,
如果不是都可以送回去重作.



確定好顏色之後就要黏了!

這個步驟真得很仔細, 他們連黏膠都有7個顏色,能夠在牙套固定的時候做最後的微調.
而且還有7個沒有黏性的讓你先試戴, 確定好了顏色再用相對應的黏膠做固定!!

真個很仔細呢! 就是要做到最完美!



醫師在幫我挑選最適合的黏劑顏色





完成了喔!!!
我終於擺脫那2個黃板牙了!!!



謝謝醫師讓我終於可以露齒拍照了!!!
我愛你!!! ((終於讓我表白了~))





牙齒的美觀真得很重要喔! 一口美麗的笑容會讓你整個人更有自信~
如果你的牙齒不整齊,正在猶豫要不要矯正, 我建議你不要猶豫喔!
我身邊每一個有矯正的朋友都說這是他們最好的決定,
因為矯正後臉型會變的更美, 而且一口整齊的牙齒真得很重要喔!

如果你跟我一樣也想要改變牙齒的顏色, 可以先去諮詢是否做冷光美白就足夠,
或是要做美白貼片~雅偲牙醫 醫生會給你很好的建議喔!!!

<牙齒>一次見效! 絕對值得的冷光牙齒美白!


文章引用:http://www.wretch.cc/blog/ksnancy/13542711

雅偲牙醫 全瓷冠 陶瓷貼片推薦醫師

 

院長 鄭聖達醫師 

http://www.arsclinic-dental.com/doctor.php?id=1

蔡昀蓉醫師

http://www.arsclinic-dental.com/doctor.php?id=3

 

全瓷牙冠介紹既然身為贋復牙科醫師, 這篇就來談談全瓷冠, 這也是患者常常心中的疑問, 尤其是假牙材質的選擇與價位為何差異這麼大, 請耐心仔細看到!


Q: 什麼是全瓷冠?
A:全瓷冠泛指內冠為二氧化鋯或二矽酸鋰的材質, 外層如同一般金屬陶瓷假牙一樣燒上陶瓷. 跟傳統金屬陶瓷假牙的差別只在於內冠的製作, 傳統的金屬陶瓷假牙內冠為鈦合金, 鈀銀合金, 金鈀合金等等.

Q: 全瓷冠與金屬陶瓷冠有何差異?
A: 最早期在牙科陶瓷還沒發展之前, 能用的只有金屬牙冠, 也就是口內常常見到銀色的假牙. 大約50年來牙科陶瓷發展, 已經可以將金屬表面燒上陶瓷, 演變為接近牙齒顏色的金屬陶瓷假牙.
現今主流已經從金屬陶瓷假牙轉變為全瓷冠, 不過仍然有很多醫師仍然製作傳統的金屬牙冠居多, 當然受限於牙科醫師訓練背景, 與患者口內咬合狀況, 以及患者常常因為價位便宜就選擇金屬假牙.

Q: 全瓷冠可以應用在那些假牙?
A: 現今牙科材料進步, 氧化鋯內冠之抗破裂強度(Fracture resistance)早已與鈀銀合金金屬內冠差不多, 所以可應用在 單顆假牙, 3顆牙橋, 植牙支台齒與假牙, 薄瓷貼片, 目前算是可以完全取代舊式金屬內冠的製作.

Q: 全瓷冠的優點
A: 美觀自然, 質地透明感類似真正的牙齒感覺(想像一下法藍瓷或是琉璃工坊的作品), 所以漸漸成為牙科市場的主流. 傳統金屬陶瓷假牙久了之後, 常常見到黑黑的假牙邊緣透出來, 若是在前牙則相當的不美觀. 而全瓷冠則不會有這樣情形發生.

Q: 氧化鋯內冠如何製作?
A: 現今大致上有兩種方法製作:


  1. 一種是電腦輔助設計與製作(CAD-CAM)以電腦掃描石膏模型, 設計內冠型態之後, 再另外電腦輔助車床方式完成內冠製作. 這邊有範例可供閱覽, 大家一看就明白氧化鋯內冠的作法http://www.youtube.com/watch?v=TJAh95-_QTQ
  2. 另一種做法是熱壓鑄式, 一樣以刻蠟之後, 以熱壓鑄方式製作, 這需要較有經驗的技工師傅製作成功率較高. 而這種製作方式較常用在薄瓷貼片(e-max).

Q: 氧化鋯內冠製作好之後的步驟
A: 與傳統金屬瓷牙一樣, 需要由技師在外層燒上陶瓷, 每家廠牌的瓷塊都研發相對應的瓷粉, 若是有牙齒層次特殊, 則另外會用外染的方式進行外部的染色, 讓全瓷冠更接近自然牙的感覺.

Q: 全瓷冠的缺點?
A: 不管是全瓷冠或一般金屬瓷牙冠, 既然是瓷牙就會發生瓷裂的情形, 瓷裂原因大抵上可分為四類: 


  1. 技工所製作瑕疵: 在高溫(約攝氏1100度)燒瓷的過程中, 不可避免的高溫燒製的過程只有稍稍一點點氣泡或是溫度控制不當就會造成內部微瓷裂, 裝戴至患者口內, 受到較大的咬合大就會瓷裂.
  2. 患者有夜間磨牙或咬合空間不足: 夜間磨牙患者常常有大於3~5倍的咬合力, 因此容易造成瓷裂. 另外預留瓷的厚度與空間太厚或太薄都容易發生瓷裂, 這與患者牙齒上下咬合空間有關係.
  3. 牙科醫師的錯誤: 正確的支台齒修磨與取模都是關鍵步驟, 以及裝戴之後的細部咬合調整都是極為重要. 回歸一句話耐心,耐心,還是耐心.
  4. 不明原因的瓷裂: 即便是都按照標準程序製作, 依然會發生瓷裂, 所以當瓷裂發生不需要太過驚嚇, 因為有的時候根本不知道問題出在哪.

Q: 是瓷裂不是內冠斷裂
A: 常常有患者抱怨, 做什麼全瓷冠這麼爛, 還會裂掉.....這裡要說明是, 只要是燒瓷的假牙就有可能發生瓷裂, 但是裂掉的通常是外層因為高溫燒製的陶瓷, 而不是內側的氧化鋯的內冠. 我們所能做的是儘量避免瓷裂的情形發生的方式就是1. 請有經驗的技工師傅製作 2.控制精準的燒瓷空間以及咬合調整而已. 至於患者拿全瓷冠去啃雞骨頭, 或是吃很硬很硬的螃蟹殼, 發生瓷裂的機率就會增加. 

Q: 遇到瓷裂的後續處理方式
A: 因為全瓷冠或金屬陶瓷假牙均為固定黏著, 沒有破壞假牙是拆不下來的. 遇到瓷裂小範圍一點點的話, 則在口內拋光打亮即可. 遇到大範圍的瓷裂則建議重新製作!

Q: 全瓷冠的價位
A: 氧化鋯內冠依照國外大廠瓷塊的不同而衍伸出市場的價位區隔, 因為國外大廠的瓷塊與瓷粉進價不一樣, 所以相對的成本也不一樣, 所以市場的價位也不一致. 一般常見的市售瓷塊為 LAVA, Ceremill, Cercon. 而瓷塊也有相對應的廠牌的機器使用, 這些昂貴的器材與技工師傅再加上牙科醫師精巧的手藝, 才能造就出客製化擬真的假牙.

Q: 大台北地區全瓷冠價位
A: 全瓷冠價格因為技工所瓷塊進價高, 並且需要電腦輔助設計與製作儀器(CAD-CAM),再加上技師與醫師專業的製作與調整, 大約在 20000~45000元/顆. 若經濟情況允許全瓷冠是目前最佳的選擇!

Q: 為什麼全瓷冠這麼貴?
A: 這個也是非常多人經常問的問題, 其實多數的患者都只問假牙是什麼 "材質", 以材質來決定假牙的價位, 這個觀念是錯誤的!!!
一個好的醫師, 除了要花時間, 技術, 精準的修磨支台齒, 精準的咬模灌模, 再加上技工師傅的巧手,才能造就出一個質感較佳且精準的假牙. 而一個贋復牙科醫師的養成除了學識經驗技術要花很長很長的時間, 慢慢才能從每一次的錯誤中學習到課堂中學不到的醫病關係與臨床經驗, 各位民眾們別只看到 "材質" 這兩個字好嗎?



Q: 為什麼要選擇全瓷冠而不選擇傳統的金屬陶瓷牙冠?
A: 傳統金屬陶瓷牙冠缺點為牙齦與假牙交界的邊緣容易因為金屬邊緣關係產生黑黑的顏色, 尤其在前牙區不甚美觀. 有時劣質金屬合金內冠容易造成牙齦發炎紅腫, 臨床表現就是牙齦紅腫, 假牙邊緣黑.
全瓷冠可以改善傳統金屬陶瓷牙冠,  氧化鋯內冠是一種"白色金屬", 也是金屬合金的一種, 但是顏色是白色可以完全改善早期金屬陶瓷牙冠所造成的缺點. 此外, 氧化鋯具有極佳的生物相容性, 不會對牙齦造成發炎反應, 所以建議還是選擇全瓷冠吧!


Q: 什麼是全鋯牙冠?
A: 利用氧化鋯瓷塊製作, 外層不燒上陶瓷, 稱為全鋯牙冠.

Q: 何時會使用全鋯牙冠?
咬合空間不足, 或是特別某些案例, 因上下咬合空間不足夠, 造成外層陶瓷空間不足, 特別是上下顎第二大臼齒, 或是深咬患者, 特別容易發生類似情形. 但也可以製作"全鋯牙冠", 意思就是整顆假牙都用氧化鋯製作完成, 硬度足夠, 但是受限於瓷塊色澤選擇, 沒辦法做得像陶瓷一樣美觀, 不過這是另一種變通方式.


Q: 那我該選擇甚麼假牙才好? 全瓷冠或金屬瓷牙冠?
A: 依照國外整體牙科整體趨勢來說, 若是經醫師評估可以製作全瓷冠, 則建議口內的假牙以全瓷冠為優先考量與選擇!