瓷嵌体和Ceramage聚合瓷嵌体边缘微渗漏的对比研究

目的:通过对比Ceramage聚合瓷嵌体和铸瓷嵌体边缘微渗漏大小,为临床嵌体材料的选择提供参考。方法:20颗离体牙按嵌体备洞原则制备近中邻Ⅱ类洞,随机分为2组,每组10颗。分别用Ceramage和IPS EmpressⅡ制作嵌体后使用Rely X ARC进行粘结。经冷热循环500次品红染色后,金刚砂片平行于牙体长轴沿近远中方向将修复体纵向剖开2次,在体式显微镜下测量染料渗入轴壁、龈壁的深度。结果:2组嵌体材料轴壁和龈壁均出现微渗漏。采用成组设计的两样本均数比较t检验处理数据,两组之间微渗漏差异有统计学意义(轴壁:t=5.604,龈壁:t=6.718,P<0.01),同组间龈壁微渗漏程度均显著高于轴壁,配对t检验显示差异有统计学意义(IPS EmpressⅡ:t=5.766,Ceramage:t=4.392,P<0.01)。结论:Ceramage聚合瓷是制作树脂嵌体较理想的材料。     

选择性激光熔覆技术与失蜡铸造法制作的金属嵌体边缘微渗漏的对比研究

目的:对比研究选择性激光熔覆技术(selective laser melting,SLM)制作的钴铬合金、钛合金嵌体与失蜡铸造法制作的钴铬合金、钛合金嵌体的边缘微渗漏情况。方法:40颗离体前磨牙制备长方形邻颌洞,随机分为四组,每组10颗。分别用选择性激光熔覆技术制作钴铬合金、钛合金嵌体与失蜡铸造法制作钴铬合金、钛合金嵌体后,使用Single Bond2粘结。试件经冷热循环品红染色后,金刚砂片平行于牙体长轴近远中方向纵向剖开试件2次,体式显微镜下观察记录染料渗入试件牙轴壁、龈壁的深度。结果:四种嵌体的轴壁和龈壁均出现不同程度的微渗漏,经单因素方差分析有统计学意义(轴壁:F=38.33,龈壁:F=90.95,P0.05);SLM钴铬合金、SLM钛合金嵌体微渗漏程度小于失蜡法铸造钴铬合金、钛合金嵌体,差异有统计学意义(P0.05),SLM钴铬合金嵌体与SLM钛合金嵌体微渗漏差异无统计学意义(P0.05);同种材料龈壁微渗漏明显高于轴壁,经配对t检验显示差异有统计学意义(P0.01)。结论:选择性激光熔覆技术制作的金属嵌体抗边缘微渗漏能力好于失蜡铸造法制作的金属嵌体。     

不同桩核和粘结材料与牙体微渗漏关系的研究

目的:比较两种桩核常用粘结材料复合树脂、玻璃离子粘结后的根向微渗漏的大小,并进行分析和评价。方法:采用40颗离体上颌前磨牙作桩核制备,随机分为4组,每组10颗牙。A组:纤维树脂桩核复合树脂粘结组;B组:纤维树脂桩核玻璃离子粘结组;C组:铸造镍铬合金桩核复合树脂粘结组;D组:铸造镍铬合金桩核玻璃离子粘结组。采用微渗漏染料渗入法,印度墨汁作染料染色1周后透明技术处理,观察样本染色深度。结果:纤维桩核与两种粘结剂出现微渗漏的现象少于铸造镍铬合金桩核与两种粘结剂。结论:树脂粘结剂与牙体组织面以及粘结剂与桩核组织界面有较强的化学结合,封闭效果更好。     

超瓷材嵌体边缘微漏的研究

目的　研究超瓷材 (targis)嵌体边缘微漏情况。方法　将 10颗离体牙制备成两个邻牙合面的Ⅱ类洞 [近中邻牙合面洞 (MO)、远中邻牙合面洞 (DO) ],一侧颈壁位于釉牙骨质界上方 1mm(即颈壁位于牙釉质上 ) ,另一侧位于釉牙骨质界下方 1mm(即颈壁位于牙骨质上 ) ,均采用超瓷材嵌体修复 ,经 0～5 6℃冷热循环 2 0 0次后 ,用金刚砂片沿牙合面中部近远中方向将实验牙切成两半 ,在扫描电镜下观察微漏并拍照 ,扫描电镜图片经透扫仪输入电脑 ,在电脑屏幕上测量微漏情况。结果　超瓷材嵌体牙合壁均未见微漏现象 ;颈壁位于牙釉质处的超瓷材嵌体微漏发生率 (10 % )少于颈壁位于牙骨质处的超瓷材嵌体(30 % ) (P 0 .0 5 ) ;微漏程度与颈壁位置无关 (P 0 .0 5 ) ,颈壁位于牙釉质处的超瓷材嵌体的颈壁微漏平均值是 (0 .6 0± 0 .2 1) μm ,颈壁位于牙骨质处的超瓷材嵌体的颈壁微漏平均值是 (0 .6 7± 0 .19) μm。 结论　超瓷材嵌体具有较好的临床应用价值。     

自酸蚀粘结剂对树脂充填体边缘封闭后微渗漏变化的体外实验研究

目的：探讨自酸蚀粘结剂对树脂充填体边缘封闭后微渗漏的影响。方法：将40颗完整无龋坏、无隐裂的新鲜离体磨牙随机分为4组，备洞并用3M Z350树脂充填。第1、2组使用3M Adper Easy One自酸蚀粘结剂，第3、4组使用Dentsply Xeno IV自酸蚀粘结剂。备洞充填抛光后，第1组和第3组为实验组，分别使用3M Adper Easy One 和 Dentsply Xeno IV自酸蚀粘结剂对充填体边缘涂布20s。第2组和第4组为对照组，不进行这项操作。然后，对1～4组充填体均进行光照，经温度循环后涂隔水剂，亚甲基蓝溶液染色，对牙齿长轴切片，在体视显微镜下观察修复体边缘染料渗漏情况。结果：3M Adper Easy One 和Dentsply Xeno IV自酸蚀粘结剂对树脂充填边缘处理后微渗漏均明显变小（P＜0.05），且染料渗入窝洞均明显减轻。结论：3M Adper Easy One和 Dentsply Xeno IV自酸蚀粘结剂对充填体边缘进一步处理后均起到明显边缘封闭作用。     

空气喷砂技术制洞对树脂粘结界面微渗漏的研究

目的：观察空气喷砂技术制洞对树脂粘结界面微渗漏的影响。方法：分别运用空气喷砂和传统涡轮机制洞、两种粘结体系进行牙本质粘结,采用染料渗入法观察粘结界面的微渗漏情况。结果：自酸蚀组微渗漏程度低于全酸蚀组,空气喷砂制洞组微渗漏程度低于涡轮机制洞组,酸蚀组微渗漏程度均低于未酸蚀组。结论：空气喷砂技术制洞树脂粘结界面微渗漏情况优于传统涡轮机制洞。     

四种牙体充填材料牙冠微渗漏的比较

目的：本实验旨在评价4种牙体充填材料在冠部暂时性封闭窝洞能力。方法：选用4℃保存100颗新鲜离体前牙颈部截断并保证牙根长度不小于10mm。糊剂加牙胶尖侧压充填后,根管口处统一制备成2mm×2mm×3mm的洞形。随机分为5组,每组20颗牙,分别为松风玻璃离子组、磷酸锌水门汀组、聚羧酸水门汀组、国产玻璃离子组、空白组,并经温度循环。每组选15颗牙用细菌渗透法观察细菌渗透后无菌培养液的浑浊情况。每组另外5颗,除空白组外用日立S-570型扫描电子显微镜观察根管冠方充填材料与根管壁间的微缝隙。结果：①细菌渗透法：1个月后松风玻璃离子仅发生2例冠部细菌渗漏,其余充填材料均发生大量细菌渗漏,4种材料间均有显著性差异（P〈0.01）;②扫描电镜：磷酸锌水门汀和聚羧酸水门汀均颗粒较粗大,有较大微缝隙夹杂有空气泡;国产玻璃离子表面粗糙内部有许多裂隙;松风玻璃离子与牙本质小管完全密合粘结紧密,无微缝隙存在,4种材料间均有显著性差异（P〈0.05）。结论：①松风玻璃离子在暂时性窝洞充填过程中冠方抗渗透能力优于国产玻璃离子粘固剂,磷酸锌水门汀,聚羧酸锌水门汀;②本实验中细菌渗透法,扫描电镜所检测结果基本相一致。     

不同脱敏剂对楔状缺损充填后微渗漏的影响

目的:比较不同脱敏剂对楔状缺损充填后的微渗漏的影响。方法:选取30颗前磨牙随机分成3组并制作楔状缺损洞型,分别用MEdental,Gluma脱敏剂对牙本质进行表面处理,流动树脂充填,对照组牙本质表面不做任何处理,经牙合力循环、热循环后,用2%亚甲基蓝染色,24h后将每个离体牙由颊舌向沿牙长轴连续切下3片。在体视显微镜下放大40倍观察充填体边缘染液微渗漏情况,然后在SEM下观察流动树脂与牙体组织之间的粘结情况。结果:3组间充填体微渗率差异均有统计学意义(P0.05),以MEdental材料的边缘微渗率最低(P0.01);扫描电镜下观察可见:Medental组树脂与牙体组织结合良好,Gluma组树脂与牙体组织结合处部分位置出现裂隙,对照组树脂与牙体组织结合处存在裂隙且较Gluma组明显。结论:MEdental脱敏剂和Gluma脱敏剂均能降低楔状缺损充填后的微渗率,MEdental脱敏剂影响较大,使用Gluma脱敏剂和MEdental脱敏剂可以获得较好的边缘封闭性。     

两种树脂填充方法对微渗漏影响的实验研究

目的：通过两种树脂充填方式微渗漏的比较，为临床找到一种能有效防止微渗漏且操作简便的充填方式。方法：选择新近拔除的60颗人恒牙在唇、颊侧备V类洞。随机分为两组，每组30颗牙。用3M自酸蚀粘结剂及3M树脂分别按分层及分割增量两种方式充填，经恒温保存、染色、纵剖牙体，在体视显微镜下观测充填物边缘微渗漏的情况。结果：分层充填的微渗漏大于分割增量充填。结论：两种充填方式微渗漏之间有显著性差异，分层充填的微渗漏大于分割增量充填。     

树脂改良型玻璃离子联合自酸蚀粘结剂修复Ⅴ类洞对微渗漏的影响研究

目的:研究树脂改良型玻璃离子联合自酸蚀粘结剂修复Ⅴ类洞时对充填体边缘微渗漏的影响。方法:选取20颗成人新鲜拔除完整无龋前磨牙,清洁后于所有离体牙牙颈部制备标准Ⅴ类洞型,随机分为A组与B组。A组:洞壁使用自酸蚀粘结剂贺利氏ibond进行处理;B组:不做处理,所有窝洞使用树脂改良型玻璃离子FujiⅡLC进行充填,光固化后常规修形抛光。利用流动树脂封闭离体牙根尖孔后按照要求涂布指甲油,彻底干燥后置于37℃浓度为1g/L的罗丹明B溶液中侵泡24h进行荧光染色。染色成功后取出冲洗干净并利用慢速金刚砂切片制作成符合观察标准的薄切片,激光共聚焦显微镜下观察牙体界面与充填体之间染料渗入情况并摄取图像,图像使用LEICA TCS SP8分析软件测量并记录深度。结果:A组与B组的微渗漏深度值分别为(8.63±0.56)μm、(21.64±1.10)μm,两组间数据比较有显著差异(P0.05),具有统计学意义。结论:利用树脂改良型玻璃离子充填牙颈部Ⅴ类洞时结合自酸蚀粘结剂可以明显减小充填体边缘微渗漏。     

Microleakage of Er:YAG laser and dental bur prepared cavities in primary teeth restored with different adhesive restorative materials

The purpose of this study was to evaluate and compare the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation and conventional dental bur cavity preparation on in vitro microleakage of class V cavities restored with different adhesive restorative materials and two types of self-etching adhesives in primary teeth. Standard class V cavities were prepared on 80 extracted primary, and the teeth were randomly divided into eight subgroups prepared either by dental bur or Er:YAG laser irradiation and then restored with self-cured glass ionomer (GI), resin-modified glass ionomer (RMGI), resin composite and Clearfil SE Bond (two-step self-etching adhesive), and resin composite and Clearfil S3 Bond (one-step self-etching adhesive). Restorations were finished and stored in distilled water at 37 °C for 24 h and then subjected to thermocycling. All the teeth were sealed with nail varnish, placed in a silver nitrate solution, and then vertically cut in a buccolingually direction. Subsequently, the specimens were evaluated for gingival and occlusal microleakage using a stereomicroscope. Data were analyzed using Kruskal–Wallis test followed by Mann–Whitney test. Wilcoxon test was used for comparing occlusal microleakage with gingival microleakage at p?<?0.05. A higher degree of occlusal and gingival microleakage values for the teeth restored with GI or RMGI was obtained by both preparation methods compared with that of resin composites and the two self-etching primers. Er:YAG laser irradiation resulted in a significantly higher degree of microleakage only at the gingival margins for teeth restored with GI or RMGI, or composite and Clearfil S3 Bond compared with the bur preparation. The Er:YAG laser-prepared teeth restored with composite and Clearfil SE Bond demonstrated a better marginal seal on occlusal and gingival margins compared with that of bur-prepared cavities. The degree of microleakage in class V cavities was affected by the type of adhesive restorative materials, type of self-etching adhesive, cavity margin location, and tooth preparation method either by Er:YAG laser or dental bur.     

自酸蚀粘结剂Adper Easy One修复牙体颈部楔状缺损的临床观察

目的:观察自酸蚀粘结剂Adper Easy One和全酸蚀粘结剂PrimeBond NT在修复牙体颈部楔状缺损的临床效果。方法:选取75例患者需要行牙体颈部楔状缺损树脂修复的共93颗活髓患牙随机分为2组,实验组使用自酸蚀粘结剂结合树脂充填修复,对照组使用全酸蚀粘结剂结合树脂充填修复。于充填术后1年对患者进行临床复查,根据Ryge的改良USPHS评分系统评估充填体情况。结果:两组充填修复1年后临床效果比较无显著性差异(P0.05),自酸蚀粘结剂充填修复术后敏感率小于全酸蚀粘结剂差异显著(P0.05)。结论:自酸蚀粘结剂用于牙体颈部楔状缺损粘结修复治疗后牙髓敏感率低可达到较好的临床效果。     

Effect of saliva contamination on microleakage around class-5 cavities restored with three different types of adhesive materials

The recent improvement of adhesive materials should decrease the risk related to saliva contamination. The aim of this study was to evaluate the effect of saliva contamination on the microleakage within class V cavities restored with three different types of materials: conventional glass ionomer cement, composite resin and compomer. 30 human extracted teeth were randomly divided in 3 equal groups. In each group, class V cavities were prepared on both facial and lingual surfaces (but joint for glass ionomer cement and bevelled incisal margin for composite resin and compomer). The lingual cavities were contaminated with saliva prior to restoration, while the facial cavities were not contaminated, serving as control. After water storage for 24 hours, teeth were immersed in 1% methylene blue solution for 24 hours. The axial sections were viewed under an optical microscope and the extent of dye penetration along cervical, axial and incisal margins was measured in millimetres. Statistic analysis showed that under salivary contamination, microleakage increased along the cervical margin of restoration for all three tested materials. Saliva contamination resulted in microleakage within the axial wall of the cavity only for the conventional glass ionomer cement. These data indicate that composite resin and compomer used together with new adhesives seem to be less sensitive to saliva contamination compared to conventional materials. However, under saliva contamination, cervical microleakage cannot be completely prevented and proper isolation should still be mandatory.     

Comparison of the effects of Er,Cr:YSGG laser and different cavity disinfection agents on microleakage of current adhesives

The aim of this study was to compare the effect of the Er,Cr:YSGG laser and different cavity disinfection agents on microleakage of an etch-and-rinse and a self-etch adhesive. Class V preparations were completed on the buccal and lingual surfaces of 30 extracted noncarious human molars. The occlusal margin was placed on enamel and the gingival margin on dentin. Preparations were randomly divided into five experimental groups (n = 12); (1) 2% chlorhexidine gluconate (CHX), (2) propolis, (3) ozone, (4) Er,Cr:YSGG laser, and (5) control (no treatment). Each group was divided into two subgroups according to the adhesive system: etch-and-rinse (Adper Single Bond 2), and a self-etch adhesive (All-Bond SE). The preparations were bulk-filled with a resin composite (Arabesk). After storage in distilled water for 24 h the restored teeth were subjected to thermocycling (1,000 cycles; 5-55°C). All specimens were immersed in 0.5% basic fuchsin solution for 24 h and sectioned longitudinally through the centre of the restorations and examined under a stereomicroscope at ×25 magnification. The data were analysed using the Kruskal-Wallis and Mann-Whitney U-tests. No difference was observed between the groups either on enamel or dentin when the etch-and-rinse adhesive was used (p > 0.05). In the self-etch adhesive groups, a significant difference was found only between the laser group and the CHX group on enamel and between the propolis group and the control group on dentin (p < 0.05). Comparing the etch-and-rinse and self-etch adhesives within each group, no differences were found on dentin (p > 0.05). On enamel, a statistically significant difference was found only in the CHX group (p < 0.05). There were no differences in microleakage with the laser and the different cavity disinfectant applications when used with etch-and-rinse adhesive. In the self-etch group there were differences in microleakage depending on the disinfection agent used.     

弹性粘结固定技术治疗外伤松动牙的临床分析

目的:探讨超强纤维带加流动树脂弹性固定夹板在外伤性松动牙复位的效果和相关影响因素。方法:80例(92颗患牙)随机分成实验组40例(48颗),对照组40例(44颗)。实验组使用超强纤维带加流动树脂弹性固定夹板固定患牙,对照组使用牙弓夹板固定法固定患牙。结果:复位固定2～4周后实验组与对照组所有患牙均无松动脱落,但牙周指标牙龈指数(GI)、龈沟出血指数(SBI)、菌斑指数(PLI)经统计学分析,实验组与对照组有显著性差异(P<0.01),牙周指标实验组明显低于对照组;1年后实验组与对照组疗效比较有显著性差异(P<0.01),实验组疗效显著优于对照组。结论:应用超强纤维带加流动树脂粘结固定的患牙,牙周指数变化少,患者异物感小;弹性固定使得牙齿有功能性动度,有利于牙周膜愈合,更符合口腔生理,固定时间更短,又能尽快恢复美观等功能。     

超强纤维带联合流动树脂弹性固定夹板在儿童牙病外伤固定的长期效果

目的:考察超强纤维带联合流动树脂弹性固定夹板在儿童牙病外伤固定的长期效果。方法:收集2010年1月~2010年12月在我院治疗因外伤导致的牙齿Ⅱ~Ⅲ°松动或不完全脱位牙患儿76例,随机分为牙弓夹板固定组40例和超强纤维带联合流动树脂弹性组36例。结果:两组2周复诊后GI、PLI、SBI有显著差异(P0.05);2年随访,牙弓夹板固定组和超强纤维带联合流动树脂弹性组的总有效例有显著差异(P0.05)。结论:超强纤维带联合流动树脂弹性是儿科牙病外伤固定的有效方法。     

Meta分析树脂充填、嵌体修复治疗后牙食物嵌塞的临床疗效

目的：根据国内外2010～2013年公开发表的随机对照性研究结果,评价树脂充填和嵌体治疗治疗后牙食物嵌塞的疗效.方法：检索2010 ～ 2013年国内外公开发表的中英文文献,关键词为“食物嵌塞、充填、嵌体”、“food impaction,fill,inlay”.对树脂充填或嵌体治疗后牙食物嵌塞的患者,进行治疗有效率的Meta分析,评价疗效.结果：共检索出的相关文献117篇,经筛选36篇文献符合本次Meta分析的纳入标准.共3607例研究对象被纳入治疗有效率评价,各研究方差齐性检验差异无统计学意义,采用Meta分析固定效应模型,评价树脂充填组和嵌体治疗组有效率0R值,合并均值及95％可信区间为3.60（2.91～ 4.47）.结论：树脂充填治疗后牙食物嵌塞较嵌体治疗的疗效好.