联合偶联剂表面处理对金属托槽与不同瓷修复体黏结强度影响的研究

目的:研究四种表面处理方法对三种陶瓷修复体表面处理后与金属托槽间黏结强度的影响。方法:三种不同的瓷粉制作试件并随机分成四个处理组:①酸蚀;②喷砂;③喷砂+偶联剂;④酸蚀+偶联剂。在各组试件表面处理后黏结金属托槽并测量其黏结剪切强度。结果:①经统计学分析,无论对于喷砂还是酸蚀,结合硅烷偶联剂处理后都能显著地提高托槽与瓷修复体表面的黏结强度(P<0.05);而且这种经偶联剂辅助处理后黏结强度提高的特点,是不因为瓷修复体的材料的不同而有显著的差异性的(P>0.05);②酸蚀不同于喷砂,单独处理时达不到临床托槽黏结强度要求,而结合硅烷偶联剂后,其黏结强度有显著的提高(P<0.05);③同一处理方法对不同的陶瓷修复体其黏结剪切强度无统计学差异(P>0.05)。结论:偶联剂作为一种辅助处理措施,可以提高喷砂或酸蚀处理后托槽与瓷修复体表面的黏结强度;联合硅烷偶联剂处理,可使单独应用达不到临床托槽黏结要求的酸蚀表面处理方法,达到临床应用要求。     

瓷表面处理方式对瓷修复体缺损美容修复影响的研究

目的：研究不同瓷表面粗化处理对Vita VMK95瓷粘结强度的影响。方法：瓷片按表面粗化方式分为6组，每组分别与树脂粘结，测剪切强度，统计分析所得数据。结果：喷砂后氢氟酸处理组粘结强度最高，喷砂后磷酸酸蚀组与不喷砂氢氟酸蚀组次之，单纯偶联剂处理组最低。结论：综合临床安全性考虑，喷砂后用磷酸处理是瓷修复体缺损后较好的瓷表面处理方法。     

自酸蚀封闭剂与玻璃离子联合用于托槽粘结的临床观察

目的：评价自酸蚀粘结剂与树脂加强型玻璃离子联合用于正畸托槽粘结的临床使用效果。方法：随机选择50名患者，采用自身对照的方法进行为期12个月的临床观察。385个托槽用自酸蚀封闭剂（3MESEP）和光固化树脂加强型玻璃离子水门汀（FUJI ORTHO LC）粘结，390个托槽用京津釉质粘结剂粘结。观察托槽脱落的时间和脱落后粘结剂在牙面上的残留量，计算托槽脱落率和粘结材料残留指教。结果：光固化树脂加强型玻璃离子水门汀和自酸蚀封闭剂粘结的托槽脱落率为10．1％；京津釉质粘结剂粘结的托槽脱落率为9．0％，两者差异没有统计学意义（P〉0．05）。两种材料粘结的托槽脱落后，牙釉质上的粘结材料残留指教差异无显著统计学意义（P〉0．05）。结论：自酸蚀封闭剂和树脂加强型玻璃离子所构成的粘结技术粘结正畸托槽的粘结强度，可以满足正畸治疗的需要，在临床上有广阔的应用前景。     

Er：YAG激光照射对牙釉质与VITA MarkⅡ瓷块间粘结强度的影响

目的：用Er：YAG激光照射和酸蚀剂分别处理牙釉质表面,观察其表面的形态学变化,评价Er：YAG激光照射和酸蚀剂处理对牙釉质与VITA MarkⅡ瓷块间粘结强度的影响。方法：收集因正畸拔除的无龋坏、无隐裂的完整人类前磨牙40颗,在牙体的近远中面制备出3mm×3mm的牙釉质面样本,共40个。将所有样本随机分为4组,每组10个样本按以下分组进行表面处理：①Er：YAG激光组（60mJ,2Hz）;②酸蚀纽（35％磷酸）;③Er：YAG激光＋酸蚀组;④酸蚀＋Er：YAG激光组。每组随机抽取2个样本通过扫描电子显微镜观察其表面形态,其余8个样本通过3M ESPE RelyX Unicem光固化树脂粘结剂与VITA MarkII瓷块粘结,经粘结强度测试检测牙釉质与VITA MarkII瓷块间的粘结强度,用SPSSl7．0统计软件进行分析,采用单因素方差分析将各组数据两两比较,P〈0．05差异有统计学意义。结果：酸蚀＋Er：YAG激光组与其他各组比较,粘结强度值显示最高值,差异显著（P〈0．05）;Er：YAG激光＋酸蚀组粘结强度值呈最低值,差异显著（P〈0．05）;酸蚀组和Er：YAG激光组粘结强度值居中,二者之间无统计学差异（P〉0．05）。结论：酸蚀联合Er：YAG激光照射能够增强牙釉质与VITA MarkII瓷块问的粘结强度,是牙体组织粘结前有效的轰面处理方式．     

二氧化锆烤瓷牙与蓝宝石单晶体托槽的粘结实验研究

目的:为临床上选择蓝宝石单晶体托槽与二氧化锆烤瓷牙粘结剂提供理论依据。方法:选择72颗二氧化锆烤瓷前牙在两种瓷面处理方式下分别用3M光固化树脂、3M化学固化树脂及3M流动纳米树脂粘结蓝宝石单晶体托槽,测试剪切力及粘结剂残留指数(ARI),探讨粘结强度及对烤瓷牙面的影响。结果:1不同瓷面处理方式两两比较,瓷面喷砂组与对照组和瓷面酸蚀组比较均有统计学意义(P0.05);2不同粘结剂两两比较,3M Z350纳米流动树脂与3M光固化型树脂和3M化学固化型树脂粘结剂比较均有统计学意义(P0.05)。结论:二氧化锆烤瓷牙面经磷酸酸蚀结合硅烷偶联剂处理使用流动树脂粘结蓝宝石单晶体托槽,既可获得较好的粘结强度,又对瓷面影响小。     

不同表面处理对氧化锆陶瓷与自粘结树脂粘结强度的影响

目的:研究不同表面处理方法对氧化锆陶瓷与两种自粘结树脂粘结强度的影响,为临床上氧化锆陶瓷修复体粘结选择合适的表面处理方法和粘结树脂提供参考。方法:将80个氧化锆瓷片随机分为A、B、C、D四组。A组采用喷砂+硅涂层法,B组采用Er:YAG激光蚀刻,C组先Er:YAG激光蚀刻后再用喷砂+硅涂层法。D组作为对照组不做处理。每组再分为a、b两个组,分别用Bifix SE自粘结树脂和Clearfil SA自粘结树脂粘结,最后置于万能材料力学测试机测得剪切强度。结果:使用Bifix SE自粘结树脂粘结时,Ca组与Aa组比较,差异无统计学意义(P0.05);但两组均大于Ba组,差异有统计学意义(P0.05),Ba组大于Da组(P0.05),差异有统计学意义。使用Clearfil SA自粘结树脂粘结时(b组),各组粘结强度Cb组Ab组Bb组Db组,各组间差异均有统计学意义(P0.05)。Er:YAG激光蚀刻后再用喷砂+硅涂层法处理后,使用Bifix SE自粘结树脂的粘结强度明显低于使用Clearfil SA自粘结树脂(P0.05)。结论:Er:YAG激光蚀刻单独应用后的粘结效果虽不如喷砂+硅涂层法,但是联合应用后可以获得更高的粘结强度。     

自锁托槽再粘结前处理对托槽脱落率影响的临床观察

目的：观察脱落自锁托槽喷砂处理后再粘结的脱落率。方法：选择使用自锁托槽矫治的正畸患者60例,随机分为两组,复诊时记录托槽初次脱落例数,记录时间为3个月,A组脱落托槽采用喷砂处理后再粘结,B组使用新托槽再粘结,记录3个月的再次脱落例数。结果：A组与B组初次、再次托槽脱落率均无统计学意义（P〉0.05）,再次脱落率明显高于初次粘结脱落率（P〈0.01）。结论：喷砂处理的脱落自锁托槽与新托槽再粘结的脱落率相当,可用于自锁托槽脱落后的再粘结。     

用酸蚀法提高纯钛与光固化冠桥树脂粘结强度的研究

目的：研究用酸蚀法提高钛与光固化复合树脂剪切粘结强度的可行性，并观察表面粗糙度与剪切粘结强度之间的关系。方法：采用不同浓度的酸蚀剂对钛铸件表面进行酸蚀，并与artglass光固化复合树脂进行粘结，以单纯喷砂组为对照，比较剪切粘结强度的差异。对酸蚀后及剪切试验后的金属表面进行扫描电镜观察，并测定其表面粗糙度。结果：用酸蚀法可以显著提高钛与复合树脂的粘结强度，HF浓度为4％时粘结强度最高。表面粗糙度随酸蚀剂的浓度增高而下降。结论：纯钛铸件用酸蚀法处理后可以获得较高的粘结强度，HF酸浓度以4％为宜。表面粗糙度对粘结强度不起决定性作用。     

瓷修复体与金属托槽粘接强度的实验研究

目的:研究两种不同形状的底板(燕尾状、网状)对正畸金属托槽与瓷修复体粘接强度的影响。方法:根据瓷面处理方式及所粘接托槽的不同,将80个瓷修复体随机平均分为4组:金刚砂车针打磨+燕尾状底板托槽;金刚砂车针打磨+网状底板托槽;9.6%氢氟酸(hydrofl uori c aci d,HF)酸蚀+燕尾状底板托槽;9.6%HF酸蚀+网状底板托槽。将粘接后的每组瓷修复体随机平均分为2组:组1用37℃人工唾液水浴24h;组2不予处理。用硅烷偶联剂、杜拉菲勒光固化复合树脂充填材料进行粘接。检测抗剪切强度及粘结剂残留指数。结果:经人工唾液水浴后,抗剪切强度燕尾状底板托槽组较网状底板托槽组高,且差别有统计学意义(P<0.05);瓷面经打磨处理后,粘结剂残留指数网状底板组高于燕尾状底板组,且差别有统计学意义(P<0.05)。结论:燕尾状底板较网状底板提供更大的抗剪切强度;瓷面经金刚砂车针打磨较用HF酸蚀提供更大的抗剪切强度,且遗留较多粘接剂。     

酸蚀时间对临床托槽粘结效果的影响

目的：比较10s和60s酸蚀后临床托槽脱落率的差异,从而探讨正畸临床适宜的牙釉质酸蚀处理时间.方法：选择年龄为10～18岁的正畸患者30名,随机分为两组,两组患者按不同牙位分别进行两种时间的酸蚀.酸蚀后常规粘结托槽,每次复诊时分别记录两组托槽脱落数,连续记录6个月.结果：10s酸蚀组总脱落率为8.4%,60s酸蚀组总脱落率为3.2%,前牙托槽脱落数明显少于后牙,最易脱落的托槽为第二前磨牙.结论：建议正畸临床上粘结前牙可使用10s的酸蚀时间.第二前磨牙及腭向错位侧切牙宜适当延长酸蚀时间.     

Effects of different surface treatments on shear bond strength in two different ceramic systems

The purpose of this study was to evaluate the influence of different surface treatments (sandblasting, acid etching, and laser irradiation) on the shear bond strength of lithium disilicate-based core (IPS Empress 2) and feldspathic ceramics (VITA VM 9). One hundred ceramic discs were divided into two groups of 50 discs each for two ceramic systems: IPS Empress 2 (group I) and VITA VM 9 (group II). Each of the two groups was further divided into five surface treatment groups (ten each) as follows: group SB, sandblasting with alumina particles (50 μm); group HF, 5 % hydrofluoric acid etching; group L, Er:YAG laser irradiation (distance, 1 mm; 500 mJ; 20 Hz; 10 W; manually, noncontact R14 handpiece); group SB–L, sandblasting + Er:YAG laser; and group HF–L, 5 % hydrofluoric acid + Er:YAG laser. Luting cement (Panavia 2.0) was bonded to the ceramic specimens using Teflon tubes. After 24 h of water storage, a shear bond strength test was performed using a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed with a two-way analysis of variance (ANOVA) and Tukey's honestly significant difference tests (α?=?0.05). The two-way ANOVA indicated that the shear bond strength was significantly affected by the surface treatment methods (p?<?0.05), but there was no significant interaction between the ceramic systems. Group SB–L had the highest mean values for each ceramic system. Sandblasting, followed by Er:YAG laser irradiation, enhanced the bond strength, indicating its potential use as an alternative method. The atomic force microscopic evaluation revealed that group SB had the most distinct sharp peaks among the groups.     

CO2 laser conditioning of porcelain surfaces for bonding metal orthodontic brackets

Bonding to porcelain remains to be a challenge in orthodontic treatments. The objective of this study was to evaluate the effect of CO2 laser conditioning of porcelain surfaces on shear bond strength (SBS) of orthodontic brackets. Eighty feldspathic porcelain specimens were divided into four groups of 20. In each group, half of the porcelain surfaces were deglazed, while the others remained glazed. The specimens in groups 1 to 3 were treated with a fractional CO2 laser for 10 s using 10 mJ of energy, frequency of 200 Hz and powers of 10 W (group 1), 15 W (group 2) and 20 W (group 3). In group 4, a 9.6 % hydrofluoric (HF) acid gel was used for 2 min. A silane coupling agent was applied before bracket bonding, and the SBS was measured with a universal testing machine after 24 h. Deglazing caused significant increase in SBS of laser treated porcelain surfaces (p?<?0.05), but had no significant effect on SBS when HF acid was used for etching (p?=?0.137). ANOVA revealed no significant difference in SBS values of the study groups when glazed surfaces were compared (p?=?0.269). However, a significant between group difference was found among the deglazed specimens (p?<?0.001). Tukey test revealed that the bond strengths of 10 W and 15 W laser groups were significantly higher than that of the HF acid group (p?<?0.05). Laser conditioning with a fractional CO2 laser can be recommended as a suitable alternative to hydrofluoric acid for deglazed feldspathic porcelain.     

Shear bond,wettability and AFM evaluations on CO<Subscript>2</Subscript> laser-irradiated CAD/CAM ceramic surfaces

The purpose of this study is to determine the CO₂ laser irradiation in comparison with sandblasting (Sb), hydrofluoric acid (Hf) and silane coupling agent (Si) on shear bond strength (SBS), roughness (Rg) and wettability (Wt) of resin cement to CAD/CAM ceramics. Sixty (CAD/CAM) ceramic discs were prepared and distributed into six different groups: group A, control lithium disilicate (Li); group B, control zirconia (Zr); group C, Li: CO₂/HF/Si; group D, Li: HF/Si; group E, Zr: CO₂/Sb/Si; group F, Zr: Sb/Si. Result showed significant difference between irradiated and non-irradiated in terms of shear bond strength for zirconia ceramics (p value?=?0.014). Moreover, partial surface wettability for irradiated and non-irradiated ceramics. Irradiated surface demonstrated more rough surface in lithium disilicate than zirconia ceramics. CO₂ irradiation could increase shear bond strength, surface roughness and wettability for both CAD/CAM ceramics.     

树脂加强型玻璃离子粘合剂对牙齿粘结效果及美容满意度的影响

目的:探讨树脂加强型玻璃离子粘合剂对牙齿粘结效果及美容满意度的影响,以寻求粘结效果较好且可以实现微创美容牙科治疗(MiCD)的牙科充填材料。方法:以2010年6月~2013年10月于我院口腔科就诊的142例行正畸治疗的患者为研究对象,并将其随机分为观察组(71例)和对照组(71例),对照组71例患者采用京津釉质粘结剂进行托槽粘结,观察组71例患者采用树脂加强型玻璃离子粘合剂进行托槽粘结。观察并比较两组患者使用粘结剂后的粘结强度、ARI(粘结剂残留指数)评分以及患者对使用不同粘结剂的满意度。结果:两种粘合剂在不同时间的粘结强度比较无显著性差异,但观察组患者ARI评分为0的比例高于对照组患者,且观察组患者满意度显著高于对照组(χ2=14.994,P0.05)。结论:采用树脂加强型玻璃离子粘合剂对牙齿进行粘结时粘结强度高,粘合剂残留少,更符合患者对牙齿美容的需求,值得进一步探究及推广使用。     

Porcelain conditioning with Nd:YAG and Er:YAG laser for bracket bonding in orthodontics

In this study, shear bond strength (SBS) of metal orthodontic brackets to porcelain following conditioning by Er:YAG (erbium-doped yttrium aluminum garnet) and Nd:YAG (neodymium-doped yttrium aluminum garnet) laser in comparison to conventional methods was evaluated. One hundred glazed porcelain discs with an upper central shape were prepared and randomly assigned to five equal groups of 20. In the first group, samples were only deglazed and roughened by diamond burs. In the second group, after roughening and deglazing of porcelain samples, the samples were etched by 9.6% hydrofluoric acid for 4 min. Groups, 3, 4, and 5 were prepared by 0.8-W Nd:YAG laser, 2-W Er:YAG laser, 3-W Er:YAG laser for 10 s, respectively. Then, metal, mesh-based brackets were bonded to porcelain samples, and after being stored in distilled water for 24 h, debonding was carried out by a Zwick testing machine. ANOVA and Tukey tests were used to compare SBS in five groups. Mean SBS in groups 1 to 5 were 3.3 ± 1.6, 7.0 ± 2.1, 6.9 ± 2.7, 2.3 ± 1.1, and 3.7 ± 2.3 MPa, respectively. ANOVA test revealed a significant difference between five groups (p < 0.05). Although Tukey’s test showed SBS in groups 2 and 3 were significantly higher than the other groups, they did not differ with each other significantly (p > 0.05). The results revealed that SBS of 9.6% hydroflouric acid and Nd:YAG Laser was in an acceptable range for orthodontic treatment. Nd:YAG laser was shown to be an acceptable substitute for hydrofluoric acid while Er:YAG laser with the mentioned power and duration was not a suitable option.     

3种黏结材料对中、重度氟斑牙正畸托槽脱落率的影响

目的观察氟斑牙患者应用不同黏结剂对托槽脱落率的影响,探讨有效的正畸治疗措施。方法 18例氟斑牙患者随机分为3组,A组采用京津釉质黏结剂,B组采用光固化复合树脂黏结剂,C组将氟斑牙表面釉质少量磨除直接贴面黏结,观察各组治疗1个月后的托槽脱落率及不同临床因素的作用。结果 C组氟斑牙患者将氟斑牙表面釉质少量磨除直接贴面黏结的托槽率最低,明显低于A组和B组托槽脱落率,且B组的托槽脱落率明显低于A组,各组间比较,差异均有统计学意义（P〈0.05）。各组托槽脱落率男性明显高于女性,差异均有统计学意义（P〈0.05或0.01）。儿童和青少年的托槽脱落率明显高于成人,差异均有统计学意义（P〈0.05或0.01）。但各组不同牙位间托槽脱落率比较,差异无统计学意义（P〉0.05）。结论托槽的黏结是口腔正畸治疗中的重要步骤,将氟斑牙表面釉质少量磨除直接贴面黏结的托槽率效果好,但具有一定的适应证,临床医生应根据患者的不同情况选择合适的黏结剂,以降低托槽的脱落率。     

不同瓷表面处理方式对烤瓷-光固化树脂粘接作用的对比研究

目的：比较几种不同瓷表面处理方法对烤瓷－光固化复合树脂粘接强度的影响。评价硅烷偶联剂对粘接强度的影响。方法：烤瓷试件分为四组，分别以8％HF，陶瓷酸蚀剂，1．23％APF凝胶，Nd:YAG激光器作瓷表面处理，每组一半应用偶联剂，一半不用偶联剂，与光固化复合树脂粘接后，经冷热水温差循环试验后测定剪切粘接强度。结果：以上四种手段单独应用时，8％HP睡陶瓷酸蚀剂组高于1．23％APF凝胶和激光组。应用硅烷联剂后每组的剪切粘接强度均有显著提高，但四组之间无显著差异。结论：经瓷表面经硅烷偶联剂处理后有利于提高瓷与树脂间的粘接强度。在适当条件下，1．23％APF的Nd:YAG激光可以代替HF进行瓷表面的处理。