树脂水门汀颜色稳定性及其对全瓷修复效果影响的研究进展

树脂水门汀广泛用于粘接全瓷修复体,其颜色稳定性与修复体的长期效果有直接关系。树脂水门汀变色的内源性因素通常与材料构成及聚合反应的引发机制相关,树脂水门汀变色的外源性因素主要与口腔局部环境相关。树脂水门汀的颜色稳定性与全瓷修复体长期美学效果关系密切。本综述系统介绍目前临床常用树脂水门汀的颜色稳定性及影响因素,以及其对全瓷修复效果的影响,以期为临床提供参考。     

两种粘接剂对氧化锆全瓷冠粘接效果的比较

目的 比较树脂加强型玻璃离子和自粘接树脂型水门汀粘接剂对氧化锆全瓷冠的临床粘接效果.方法 选取66例患者100颗需要进行氧化锆全瓷冠修复的患牙,随机分为两组(n=50),分别采用3M RelyXTMLuting树脂加强型玻璃离子粘固剂(RelyX L组)和3M RelyXTM U200通用自粘接树脂水门汀(RelyX U组)粘接.两年后复查,检查修复体的固位情况及边缘密合性,比较两组修复的成功率.结果 RelyX L组修复成功率98.0％;RelyX U组修复成功率100.0％,两组间差异无统计学意义.结论 在进行氧化锆全瓷冠修复时,采用树脂加强型玻璃离子和自粘接树脂型水门汀粘接剂均能取得良好的临床粘接效果.     

文献综述 自粘接树脂水门汀

目的：根据PubMed所纳入的专业学术期刊中检出的原创性科学研究论文全文,对有关自粘接水门汀的研究以及该类材料的性能进行总结。材料和方法：用关键词”self—adhesive cement（自粘接水门汀）或产品的商品名称”进行检索。结果：在所调查的众多体外研究中,迄今为止仅见到两类商品化的自粘接水门汀。本文将结果按以下类别进行总结：与牙体组织（釉质、冠部牙本质、根面牙本质）的粘接,与修复材料（根管桩、瓷、钛基台）的粘接、边缘适合性、微渗漏、机械性能,生物相容性、化学粘接性和氟释放,以及临床应用评价。结论：可供临床使用的自粘接水门汀有多种,本文中大多数文献数据是基于其中的一种材料所作的研究。体外研究结果显示,与其他多步法树脂水门汀相比,自粘接水门汀与牙本质和修复材料之间的粘接效果令人满意：但自粘接水门汀与牙釉质的粘接性能较弱。在推荐该类材料广泛应用以前,还需对其临床表现进行长期评估。     

瓷贴面粘接技术

瓷贴面是一项较成熟的修复技术,但临床并未开展,其主要原因是担心贴面脱落!贴面的脱落与临床设计、牙体预备、粘接技术、咬合习惯等均有关系,其中粘接技术是一个很重要的环节。本文从以下几方面对瓷贴面的粘接技术和要点给以详细的阐述。(1)瓷贴面的粘接类型:牙体预备为釉质(>80%),适用于改变颜色的氟斑牙、四环素牙、变色牙等;以及改变牙齿形态的修复。牙体预备中大量牙本质暴露,适用于牙体大面积缺损如冠折,龋坏等,以及不同牙位的多种瓷修复体联合修复(贴面、嵌体、部分冠、全冠等)。随着粘接材料和粘接技术的发展,釉质粘接的传统瓷贴面在减少,混合粘接的新型瓷贴面逐渐增加。(2)瓷贴面的粘接机制:牙齿和贴面的表面处理;硅烷偶联剂的应用。(3)粘接系统的选择:酸蚀-冲洗型树脂水门汀与自酸蚀型树脂水门汀;光固化型树脂水门汀与双重固化型树脂水门汀。(4)临床操作步骤和要点:修复体和牙齿粘接面的表面处理;硅烷偶联剂的应用和操作要点。     

2种纤维桩核修复方案的临床效果比较

目的比较在纤维桩修复中,自酸蚀粘接系统和自粘接桩核树脂水门汀临床修复效果。方法选取100例患者220颗需要桩核冠修复的前磨牙或前牙,随机分为2组,分别采用玻璃纤维桩+自粘接桩核树脂水门汀修复方案和玻璃纤维桩+自酸蚀粘接系统+桩核树脂修复方案,2组患牙均用烤瓷熔附金属全冠或全瓷冠修复牙体外形。36个月后复查,统计2组修复的成功率,并用χ2检验。结果自粘接组有103颗牙(46例)得到评价,无桩核脱落,无纤维桩折断、牙根折裂,桩核修复成功率100%;自酸蚀粘接组有98颗牙(48例)得到评价,桩核脱落1颗,未发生纤维桩折断、牙根折裂,桩核修复成功率98.99%,两者差别无统计学意义。结论在玻璃纤维桩桩核修复中,采用自粘接桩核树脂水门汀和自酸蚀粘接系统+桩核树脂均能取得良好的临床效果。     

瓷贴面粘接技术

瓷贴面是一项较成熟的修复技术,但临床并未开展,其主要原因是担心贴面脱落!贴面的脱落与临床设计、牙体预备、粘接技术、咬合习惯等均有关系,其中粘接技术是一个很重要的环节。本文从以下几方面对瓷贴面的粘接技术和要点给以详细的阐述。(1)瓷贴面的粘接类型:牙体预备为釉质(>80%),适用于改变颜色的氟斑牙、四环素牙、变色牙等;以及改变牙齿形态的修复。牙体预备中大量牙本质暴露,适用于牙体大面积缺损如冠折,龋坏等,以及不同牙位的多种瓷修复体联合修复(贴面、嵌体、部分冠、全冠等)。随着粘接材料和粘接技术的发展,釉质粘接的传统瓷贴面在减少,混合粘接的新型瓷贴面逐渐增加。(2)瓷贴面的粘接机制:牙齿和贴面的表面处理;硅烷偶联剂的应用。(3)粘接系统的选择:酸蚀-冲洗型树脂水门汀与自酸蚀型树脂水门汀;光固化型树脂水门汀与双重固化型树脂水门汀。(4)临床操作步骤和要点:修复体和牙齿粘接面的表面处理;硅烷偶联剂的应用和操作要点。     

2种粘接剂应用于银汞合金粘接修复的临床应用评价

目的:比较2种粘接剂粘接银汞合金修复的粘接效果。方法:选择80颗有后牙龋坏者,其近中及远中均有邻牙存在,充填物在1年内有脱落史者,随机分为A、B组(A组:树脂加强型玻璃离子水门汀组;B组:树脂型银汞粘接剂组)进行充填,随访1年,观察其临床效果。结果:卡方检验2组疗效无显著差异。结论:用2种粘接剂粘接银汞合金修复在1年内达到了同样的效果,而树脂加强型玻璃离子水门汀组较树脂粘接剂组操作简单,为临床治疗提供了新的思路。     

两种不同粘接系统在玻璃纤维桩修复中的临床效果

目的 比较两种不同粘接系统用于玻璃纤维桩核修复的临床效果.方法 选取136颗已行根管治疗的患牙随机分为自酸蚀Multilink N和自粘接RelyX Unicem两组,行玻璃纤维桩+全冠修复.分别在修复后进行随访观察,比较两组患牙的临床修复成功率.结果 修复后6、12、24月,两组成功率均在97%以上,且两组间比较差异无统计学意义(P>0.05).结论 Multilink N自酸蚀树脂水门汀和RelyX Unicem自粘接树脂水门汀用于粘接纤维桩均能获得良好的临床修复效果.     

自粘接型树脂水门汀的研究进展

自粘接型树脂水门汀为近年来新出的一种树脂型水门汀。其有别于全酸蚀和自酸蚀粘接系统。自粘接型树脂水门汀因其卓越的粘接性能,更低的术后敏感及更简便的操作,为现在口腔临床医生所喜爱。本文现将对自粘接型树脂水门汀的粘接机制,粘接性能和机械性能一一作阐述。     

嵌体临床疗效的影响因素

后牙瓷及复合树脂嵌体的5年和10年的临床生存率分别为87.1%~97.6%和51.4%~85.4%。嵌体材料的选择和厚度、基牙的牙位和牙齿情况及水门汀的应用均可影响修复体的临床疗效。临床研究显示：当嵌体厚度达到2 mm时,可有效降低修复体折裂的风险;目前临床上自粘接树脂水门汀的效果已接近自酸蚀树脂水门汀及传统酸蚀-冲洗类树脂水门汀;树脂水门汀的应用以及橡皮障的使用等亦可帮助修复体取得良好的临床疗效。而对于修复体材料、牙位和牙齿情况及水门汀种类对嵌体临床效果的影响,目前尚不能得出较为统一的结论。     

Application of 4-META on adhesive opaque resin. (Part 2) Improvement of adhesive stability (author's transl)]

We had reported 4-META adhesive opaque resin for a metal casting etched with HC1. The bonding strength was as excellent as 260 kg/cm2 after 300 times thermal cycles between 4 degrees C and 60 degrees C but it decreased to 70 kg/cm2 when immersed in water at 37 degrees C for 30 weeks. It was required to improve the stability of bonding against water penetration into the adhesive junction before the clinical application. Preparation of the passive state on the metal casting adhesive stability between this film and the opaque resin were studied in this paper. When the metal casting was dipped in conc. HNO3 for fifteen minutes, adhesive strength was 260 kg/cm2 even after a 30 weeks immersion in water at 37 degrees C or the 10 weeks at 80 degrees C. It could be concluded that the adhesive opaque resin possesses enough adhesive strength and the stability for oral application.     

Selective adhesive luting: A novel technique for improving adhesion achieved by universal resin cements

Objective

We aimed to introduce the concept of “Selective adhesive luting—SAL” which is explained through clinical steps and supported by preliminary laboratory evidence.

Clinical Considerations

Cementation with rubber dam is difficult to perform in case of short abutment teeth and/or subgingival crown margins. By means of universal resin cements/universal adhesive systems, which can be employed in self-adhesive as well as adhesive luting procedures, this paper presents a novel technique allowing clinicians to perform reliable cementation where rubber dam isolation is difficult. The SAL technique entails the application of a universal adhesive system only on easily accessible abutment surfaces, enabling simultaneous adhesive and self-adhesive luting in different portions of the abutment. The SAL clinical workflow is explained through prosthodontic rehabilitation of maxillary right central incisor affected by microdontia and restored with a lithium-disilicate crown. Furthermore, our laboratory microshear bond strength study supports the rationale behind SAL application demonstrating higher bond strength even when the adhesive resin is placed only on one portion of the cementation substrate.

Clinical Significance

This article advocates the application of SAL technique in clinical situations where effective adhesive luting is uncertain, since it can improve the adhesion between the tooth and universal resin cements.     

Direct posterior resin composite restorations: new techniques and clinical possibilities. Case reports.

Direct adhesive resin composite restorations in posterior teeth are now a reality thanks to improvements in these restorative materials and adhesive techniques. However, correct selection and application of materials are vastly important to clinical success. Two restorative techniques are described in detail, in one, a low-viscosity resin composite is placed incrementally, and in the other a condensable resin composite is placed in bulk. The former allows for greater security, because it is more traditional and has already proved to have clinical longevity; the latter has the advantage of being a quicker and simpler procedure. However, both techniques provide restorations that faithfully copy the dental tissues and have all the advantages of adhesive procedures.     

Effects from applying adhesive agents onto silanated porcelain surface on the resin bond durability

This study examined the effects on the bond durability of resins arising from the application of adhesive agent on porcelain surface, silanated by a ceramic primer consisting of gamma-methacryloxypropyltrimethoxysilane (gamma-MPTS), by comparing shear bond strengths before and after thermocycling. When an adhesive agent was applied to a porcelain surface which had been silanated by a ceramic primer for 10 seconds, a significant reduction in resin bonding durability was observed. Extending the silanating period of the ceramic primer to 60 minutes resulted in an increase in resin bonding durability to the porcelain surface. However, the effect on resin bonding durability resulting from the application of adhesive agent was nearly the same as that without adhesive agent application, even though the porcelain surface was silanated for 60 minutes. In other words, positive effects arising from adhesive agent application on resin bonding durability were not observed.     

Influence of a microbrush on bonding fiber post into root canals under clinical conditions

OBJECTIVE: The objective of this clinical report was to evaluate the effectiveness of a microbrush as a carrier of priming-adhesive solution in formation of resin tags, adhesive lateral branches, and resin-dentin interdiffusion zone (RDIZ) when the brush was used to bond fiber posts under clinical conditions. STUDY DESIGN: Twenty endodontically treated teeth, already scheduled for extraction for endodontic or periodontal reasons, were selected for this study. The patients were informed, and their written consent was obtained. The samples were randomly divided into 2 groups of 10 samples each. In group 1, One-Step (Bisco, Schaumburg, Ill) was applied with a brush with Duo-Link resin cement (Bisco). In group 2, One-Step was applied with a microbrush with Duo-Link resin cement (Bisco). Use of the adhesive systems and resin cements was strictly according to manufacturers' instructions. The priming-adhesive solution was light-cured before the dual resin cement and the post were placed. Twenty Aestheti-Plus posts (white quartz fiber posts; RTD, St. Egreve, France) were used. A week after application, the root samples were extracted and processed for SEM observations. RESULTS: Both adhesive systems showed RDIZ and resin tag and adhesive lateral branch formation. In Group 2 samples, RDIZ morphology was easily detectable and uniform along root canals. Also, resin tag formation was well represented in all thirds. In group 1 samples, resin tag formation at the apical third and RDIZ formation was less evident. Statistically significant differences were found among the two groups at the apical third. CONCLUSION: The microbrush permitted a more uniform RDIZ and resin tag formation along the entire length of the canal than did the standard brush. The microbrush can be routinely used for bonding fiber posts into root canal preparations.     

The elastic moduli across various types of resin/dentin interfaces.

OBJECTIVE: The purpose of this study was to evaluate the elastic moduli of an unfilled adhesive resin (Adper Single Bond) and a filled adhesive resin (Adper Single Bond 2) used with and without a low-viscosity resin (LVR) (Filtek Flow) as an elastic cavity wall in class V composite restorations, restored with a hybrid resin composite (Z250). METHODS: Buccal class V cavities were prepared on extracted premolars and lined with (1) the unfilled adhesive resin, (2) the filled adhesive resin, (3) the unfilled adhesive resin and the flowable composite, and (4) the filled adhesive resin and the flowable composite. All cavities were restored with the hybrid resin composite. The specimens were cut bucco-lingually, embedded in epoxy resin and polished. The polished specimens were evaluated for the elastic modulus with nano-indentation test at the layer of dentin, hybrid layer, adhesive resin, low-viscosity resin and resin composite. RESULTS: The elastic moduli were 25,111 MPa for dentin, 12,243 MPa for hybrid layer of Adper Single Bond, 11,765 MPa for hybrid layer of Adper Single Bond 2, 7595 MPa for Adper Single Bond, 8430 MPa for Adper Single Bond 2, 13,543 MPa for Filtek Flow and 24,494 MPa for Filtek Z250 resin composite. The statistical analysis demonstrated that the elastic moduli were significantly different among layers (p<0.05) except between hybrid layers of unfilled and filled adhesives (p=1.0). CONCLUSION: The application of filled adhesive did not increase the elastic modulus of hybrid layer when compared with the unfilled adhesive resin. The modulus of filled adhesive resin was significantly higher than that of unfilled adhesive resin.     

Effect of adhesive primer developed exclusively for heat-curing resin on adhesive strength between plastic artificial tooth and acrylic denture base resin

Despite progress in the development of denture base resin and artificial tooth materials, dental clinics are still plagued with artificial teeth falling off the denture base--due to poor bond strength--after denture delivery. Against this background, this study sought to examine the effect and durability of an adhesive primer developed exclusively for heat-curing resin on the adhesive strength of heat-curing denture base acrylic resin to plastic artificial tooth. Test specimens were divided into four groups according to the treatment method of the artificial tooth's test bonding surface: air abrasion, adhesive primer application, adhesive primer application after air abrasion, and pretreatment only (control). After heat curing of acrylic resin onto the bonding surface, shear test was performed for two storage periods: 24-hour versus 100-day water storage. From the results obtained, it was revealed that the evaluated adhesive primer was significantly effective in increasing adhesive strength between artificial tooth and acrylic resin, although specimens were stored in water for 100 days.     

Orthodontic bracket bonding without previous adhesive priming: A meta-regression analysis

Objective:To determine the consensus among studies that adhesive resin application improves the bond strength of orthodontic brackets and the association of methodological variables on the influence of bond strength outcome.Materials and Methods:In vitro studies were selected to answer whether adhesive resin application increases the immediate shear bond strength of metal orthodontic brackets bonded with a photo-cured orthodontic adhesive. Studies included were those comparing a group having adhesive resin to a group without adhesive resin with the primary outcome measurement shear bond strength in MPa. A systematic electronic search was performed in PubMed and Scopus databases.Results:Nine studies were included in the analysis. Based on the pooled data and due to a high heterogeneity among studies (I²  =  93.3), a meta-regression analysis was conducted. The analysis demonstrated that five experimental conditions explained 86.1% of heterogeneity and four of them had significantly affected in vitro shear bond testing. The shear bond strength of metal brackets was not significantly affected when bonded with adhesive resin, when compared to those without adhesive resin.Conclusions:The adhesive resin application can be set aside during metal bracket bonding to enamel regardless of the type of orthodontic adhesive used.     

Effect of a hydrophobic bonding resin on the 36-month performance of a universal adhesive—a randomized clinical trial

Clinical Oral Investigations - To evaluate if the addition of a layer of a hydrophobic bonding resin to the recommended application sequence of a universal adhesive improves the respective clinical...