一种美观的牙体缺损修复方法--IPS EmpressⅡ铸造陶瓷高嵌体的临床应用

目的探讨采用IPS EmpressⅡ铸造玻璃陶瓷制作高嵌体修复牙冠（牙合）龈距较短的牙体大面积缺损患牙,并评价其修复效果.方法对37例41颗牙体缺损的患牙,分为实验组和对照组,实验组采用IPS EmpressⅡ铸造玻璃陶瓷制作高嵌体,光固化多功能树脂粘结剂粘结,对照组常规制作金属高嵌体,并进行修复后6、12个月的临床追踪观察,综合美国加州牙科协会制定的全瓷修复临床评定标准,以及刘亦洪对玻璃陶瓷修复体的评价内容并加以补充改进,制定评价标准,做临床评价.结果IPDSEmpressⅡ铸造玻璃陶瓷材料强度高,具有优异的美学特性,高嵌体具有良好的边缘密合性,固位效果良好,能很好地恢复患牙的（牙合）面解剖形态和邻接关系,牙龈组织无红肿炎症.结论IPS EmpressⅡ铸造玻璃陶瓷高嵌体修复牙体缺损可取得较好的修复效果.     

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。     

IPS-Empress瓷贴面进行前牙美容修复的临床疗效观察

目的：通过对前牙采用IPS Empress全瓷贴面美容修复后的临床疗效观察,分析其修复效果。方法：32例患者制作IPS Empress全瓷贴面82个,修复后半年、1年、2年用改良-瑞格（Ryge）标准评价方法,对瓷贴面的各项临床指标：颜色匹配、边缘适合性、牙龈反应、术后敏感、瓷贴面完整度进行观察分析。结果：临床观察结果表明,95%左右的患者具有优良的边缘适合性,瓷贴面损坏脱落率低于4%,接近95%的患者具有良好的颜色匹配。不到2%的瓷贴面龈缘有轻度充血,7%左右患者在备牙后1周以内出现不同程度冷热刺激敏感,粘接后绝大部分敏感消失;约3%的瓷贴面切端边缘有小的缺损。结论：研究表明IPS Empress全瓷贴面系统是一种可靠的,美观效果很好的理想的前牙修复方法。     

表面粗糙度对烤瓷上釉效果的影响

目的 观察上釉前陶瓷不同的表面粗糙度对其上釉后最终表面光洁度的影响.方法 将5组（n=12）烤瓷试件在注水条件下用碳化硅砂纸分别逐级打磨至220^#、320^#、600^#、800^#和1200^#,常规上釉.上釉前、后分别测量表面粗糙度Ra,扫描电子显微镜定性分析表面形貌.结果 1200^#砂纸打磨后上釉获得的表面最光滑（Ra=0.19μm）,220^#砂纸打磨后上釉的试件表面最粗糙（Ra=0.55μm）,各组陶瓷上釉前后的表面粗糙度差异具有统计学意义（P〈0.05）;扫描电子显微镜分析结果 与粗糙度仪测试结果 一致.结论 上釉前应对烤瓷表面进行细磨、抛光,以便在上釉后获得尽量光滑的表面.     

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.     

不同粗化处理后瓷表面微观结构的电镜研究

目的：观察不同瓷表面粗化处理方式对瓷微观结构改变的影响。方法：分别对瓷片进行6种不同的表面粗化处理，喷金后扫描电镜观察瓷表面结构。结果：磷酸处理对瓷表面形态未见有明显改变；氢氟酸及喷砂处理对瓷表面形态改变明显。结论：氢氟酸及喷砂处理对瓷表面形态的改变较磷酸处理明显，为临床陶瓷的粘结应用提供参考。     

Evaluation of the topographical surface changes and roughness of zirconia after different surface treatments

The purpose of this study was to investigate the surface morphology and roughness of zirconia after different surface treatments. Eighty sintered zirconia specimens were divided into four groups (n = 20) according to the surface treatments received: no treatment, erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation (400 mJ, 10 Hz, 4 W, 100 MPS, distance: 1 mm), tribochemical silica coating with 30 μm aluminum oxide (Al(2)O(3)) modified by silica, and air abrasion with 110 μm Al(2)O(3) particles. After the surface treatments, the surface roughness (Ra in μm) of the specimens was evaluated using a surface texture measuring instrument. Surface morphology of a specimen from each group was evaluated with atomic force microscope (AFM) and scanning electron microscope (SEM) analyses. The surface roughness values were statistically analyzed by the Kruskal-Wallis and Mann-Whitney U tests (p = 0.05). All of the surface treatments produced rougher surfaces than the control group (p < 0.005). While there were no significant differences between the surface roughness of laser and silica groups (p > 0.05). SEM and AFM analyses revealed changes in surface topography after surface treatments, especially in the laser group with the formation of rare pits and in the silica and air abrasion groups with the formation of microretentive grooves. According to the results of the statistical and microscopic analyses, all of the surface treatments can be used for roughening zirconia prior to cementation; however, air abrasion is the most effective surface treatment to obtain micromechanical retention.     

Effect of feldspathic ceramic surface treatments on bond strength to resin cement

OBJECTIVE: The objective of this study was to evaluate the shear bond strength of resin cement to feldspathic ceramic with various surface treatments. BACKGROUND DATA: Application of adhesive techniques is well established in restorative dentistry, yet the influence of surface treatments on the bond strength of resin cement to ceramic materials prior to luting or repair procedures remains unclear. METHODS: One hundred samples made of a feldspathic ceramic were divided into 10 groups (n = 10): (1) control (no treatment); (2) 10% hydrofluoric acid (HF); (3) 37% phosphoric acid (H(3)PO(4)); (4) 1.23% acidulated phosphate fluoride acid (APF); (5) diamond bur; (6) air abrasion with Al(2)O(3); (7) Al(2)O(3) + HF; (8) CoJet-Sand; (9) Er:YAG laser, and (10) Al(2)O(3) + Er:YAG laser. Afterwards, silane was applied and a resin cement cylinder was built. After 24 hours at 37 degrees C, the prepared specimens were submitted to a shear bond strength test and stereoscopic evaluation to determine the type of failure after rupture. RESULTS: Bond strength means were statistically different for the different surface treatments. The highest bond strengths were obtained with HF, CoJet-Sand, and Al(2)O(3). The groups treated with Al(2)O(3) + Er:YAG laser, diamond bur, and Al(2)O(3) + HF had moderate bond strengths. The lowest bond strengths were obtained with H(3)PO(4), APF, Er:YAG laser, and the control group. CONCLUSIONS: The HF, CoJet-Sand, and Al(2)O(3) techniques were the most effective surface treatments. The null surface treatment proposed with the Er:YAG laser showed low bond strength, and seems to be inadequate for clinical use with the parameters tested.     

Bond strength of resin cement to zirconia ceramic with different surface treatments

Zirconia-based ceramics offer strong restorations in dentistry, but the adhesive bond strength of resin cements to such ceramics is not optimal. This study evaluated the influence of surface treatments on the bond strength of resin cement to yttrium-stabilized tetragonal zirconia (Y-TZP) ceramic. Seventy-five plates of Y-TZP ceramic were randomly assigned to five groups (n?=?15) according to the surface treatments [airborne particle abrasion, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiation (Fidelis Plus 3, Fotona; 2 W, 200 mJ, 10 Hz, with two different pulse durations 180 or 320 μs), glaze applied, and then 9.5 % hydrofluoric acid gel conditioned, control]. One specimen from each group was randomly selected, and specimens were evaluated with x-ray diffraction and SEM analysis. The resin cement (Clearfil Esthetic Cement, Kuraray) was adhered onto the zirconia surfaces with its corresponding adhesive components. Shear bond strength of each sample was measured using a universal testing machine at a crosshead speed of 1 mm/min. Bond strengths were analyzed through one-way ANOVA/Tukey tests. Surface treatments significantly modified the topography of the Y-TZP ceramic. The Nd:YAG laser-irradiated specimens resulted in both increased surface roughness and bond strength of the resin cement. The highest surface roughness and bond strength values were achieved with short pulse duration. Nd:YAG laser irradiation increased both surface roughness of Y-TZP surfaces and bond strength of resin cement to the zirconia surface.     

不同磨抛方法对烤瓷表面粗糙度的影响

目的:观察不同的磨抛程序和自上釉的陶瓷表面的粗糙度,为临床陶瓷修复体抛光提供可参考的依据.方法:按照不同的抛光程序进行分组,以自上釉组作为对照组.在抛光过程中以粗糙度测试仪测试抛光过程中陶瓷表面粗糙度变化并进行统计学分析.结果:经由粗到细的磨抛工具进行抛光后,陶瓷表面粗糙度均稳步下降,各组在使用ceramaster抛光头后表面粗糙度值趋于稳定,与其后使用抛光膏抛光后已无显著性差异(P＞0.05),凡是经Ceramaster及抛光膏抛光后的实验组陶瓷表面粗糙度与对照(上釉)组无显著差异(P＞0.05).结论:陶瓷使用由粗到细的抛光工具逐步抛光,可以使陶瓷表面粗糙度稳步下降,选用合适的抛光工具和合理的抛光程序可以简化抛光过程并使陶瓷表面达到上釉陶瓷表面的粗糙度.     

前牙美容修复中IPS Empress 2新型铸瓷系统应用的可行性及安全性

目的:探讨前牙美容修复中IPS Empress 2新型铸瓷系统应用的可行性及安全性。方法:选取2011年5月~2014年5月四川省广安市人民医院口腔科收治的46例(118颗牙)需要接受前牙全瓷冠修复的患者,依据随机数字表法将这些患者分为两组,即观察组23例(59颗)和对照组23例(59颗)。给予对照组患者传统钴铬合金的烤瓷冠修复,给予观察组患者IPS Empress 2新型铸瓷贴面修复。结果:观察组患者对修复体颜色、修复体外形、修复体舒适度的满意度100%(23/23)、100%(23/23)、95.6%(22/23)均明显比对照组78.3%(18/23)、82.6%(19/23)、73.9%(22/23)高(P0.05);治疗后0.5年观察组患者的边缘适合度、牙敏感症状、颜色匹配均明显比对照组好(P0.05),治疗后3年观察组患者的边缘适合度、牙龈健康状况、颜色匹配均明显比对照组好(P0.05)。结论:前牙美容修复中应用IPS Empress 2新型铸瓷系统安全可行。     

Effect of different surface treatments on tensile bond strength of silicone-based soft denture liner

Failure of the bond between the acrylic resin and resilient liner material is commonly encountered in clinical practice. The purpose of this study was to investigate the effect of different surface treatments (sandblasting, Er:YAG, Nd:YAG, and KTP lasers) on tensile bond strength of silicone-based soft denture liner. Polymethyl methacrylate test specimens were fabricated and each received one of eight surface treatments: untreated (control), sandblasted, Er:YAG laser irradiated, sandblasted + Er:YAG laser irradiated, Nd:YAG laser irradiated, sandblasted + Nd:YAG laser irradiated, KTP laser irradiated, and sandblasted + KTP laser irradiated. The resilient liner specimens (n = 15) were processed between two polymethyl methacrylate (PMMA) blocks. Bonding strength of the liners to PMMA were compared by tensile test with the use of a universal testing machine at a crosshead speed of 5 mm/min. Kruskal–Wallis and Wilcoxon tests were used to analyze the data (α = 0.05). Altering the polymethyl methacrylate surface by Er:YAG laser significantly increased the bond strengths in polymethyl methacrylate/silicone specimens, however, sandblasting before applying a lining material had a weakening effect on the bond. In addition, Nd:YAG and KTP lasers were found to be ineffective for increasing the strength of the bond.     

Effects of Er:YAG laser treatments on surface roughness of base metal alloys

We investigated the effects of different Er:YAG laser treatments on the surface roughness of base metal alloys. A total of 36 specimens were prepared of two base metal alloys (Wiron 99, Bellabond plus). The surfaces of the specimens were standardized by gradual wet grinding with 320-, 600-, 800- and 1,000-grit silicon carbide paper for 10 s each on a grinding machine at 300 rpm. Specimens of each alloy were randomly divided into six groups (n = 6) comprising a control group (group C), a group sandblasted with Al₂O₃ powder at 60 psi for 10 s through a nozzle at a distance of 10 mm (group S), and four Er:YAG laser (Fotona AT) treatment groups. The laser treatment groups were as follows: 500 mJ, 10 Hz, 100 μs (group 500MSP); 500 mJ, 10 Hz, 300 μs (group 500SP); 400 mJ, 10 Hz, 100 μs (group 400MSP); and 400 mJ, 10 Hz, 300 μs (group 400SP). Surface roughness measurements (Ra) were performed using a profilometer. The data were analysed by two-way ANOVA, and mean values were compared using Tukey’s HSD test (α = 0.05). According to the two-way ANOVA results, the base metal alloys and interaction between base metal alloy and surface treatment were not statistically significant different (p > 0.05), the surface treatments were significantly different (p < 0.0001). For the two base metal alloy groups, no significant differences were observed among the control, 400MSP, and 400SP groups (p = 0.912), and these groups demonstrated the lowest Ra values. The highest Ra value was observed in group S (p < 0.05). Er:YAG laser treatment at 400 and 500 mJ/10 Hz is not an alternative method for surface roughening of base metal alloys.     

不同方法治疗急性大脑中动脉M2段闭塞效果

目的对比常规治疗、经静脉溶栓和血管内治疗对急性大脑中动脉M2段(MCA-M2)闭塞的临床疗效。方法76例急性MCA-M2闭塞患者分别接受常规治疗(常规组,n=31)、静脉溶栓治疗(溶栓组,n=27)和血管内治疗(血管内组,n=18),比较3组疗效相关指标。结果治疗后24 h,血管内组美国国立卫生研究院卒中量表(NIHSS)评分较基线下降≥4分者占比(83.33%)显著高于常规组(48.15%,校正前及校正后P均<0.01)。随访90天,相比常规组,溶栓组和血管内组良好预后率均提高、死亡率均降低,非症状性颅内出血发病率增加(校正前P均<0.05);经年龄、基线NIHSS评分、发病至入院时间校正后差异均无统计学意义(P均>0.05)。溶栓组1例出现症状性颅内出血。血管内组血管再通率94.44%。结论对于MCA-M2闭塞性急性脑梗死患者,急诊血管内治疗安全、有效,可早期快速改善神经功能。     

Effect of different mechanical and chemical surface treatments on the repaired bond strength of an indirect composite resin

Lasers in Medical Science - This study compared the effects of two mechanical surface preparation techniques, air abrasion and Nd:YAG laser, with the use of two adhesive systems, self-etch and etch...     

不同真空度烧结对瓷颜色的影响

目的：探讨瓷粉烧烤时真空度的设制对瓷颜色的影响，为技师制备烤瓷冠选择正确的真空度值提供理论依据。方法：用Vita A3色体瓷粉制作厚度为2．5mm的圆盘状瓷块15个，按不同真空度分为三纽，每组5个．在烤瓷炉中分别在30hPa、50hPa、96hPa真空度下进行烧烤后，应用Minolta CR-221色度计采用CIE L*a*b*色度系统，进行颜色测定。结果：在不同真空度中烧结出瓷的色相和彩度变化不大，并与比色板中A3的色相与彩度一致：但明度值有一定的差异。随着真空度的升高，瓷的明度值相应增加，30hPa真空中烧结出的瓷的明度值与比色板中A3的明度值较为一致。结论：需使用Multimat touch烤瓷炉的最大真空值来完成瓷的烧结过程，以控制过多气泡的产生而影响瓷的明度。     

The effect of different enamel surface treatments on the microleakage of fissure sealants

The aim of this study was to evaluate the effects of different techniques of surface treatment on the microleakage of a fissure sealant in molar teeth. A total of 50 freshly extracted noncarious human third molars were randomly assigned to one of five groups. Occlusal fissures were treated with one of the following: acid etching with 35% orthophosphoric acid (group 1); fissurotomy with a Fissurotomy Micro NTF metal bur (group 2); laser etching with an Er,Cr:YSGG laser at 2 W and 20 Hz (group 3); laser etching with an Er,Cr:YSGG laser at 2 W and 40 Hz (group 4); and air abrasion for 20 s with 30-μm Al₂O₃ particles via a CoJet Prep device (group 5). After surface pretreatment, a resin-based sealant was applied to the fissures. The sample teeth were subjected to thermocycling and stored in distilled water at 37°C for 1 month. Following immersion in 0.5% basic fuchsin solution for 24 h, three buccolingual slices of each sample tooth were scored under a stereomicroscope, and the morphological appearance of the area between the enamel surface and fissure sealant was examined under a scanning electron microscope. The Kruskal-Wallis test and one-way ANOVA revealed significant differences in marginal leakage, as follows: group 1 showed significantly lower scores than groups 2 and 5, the scores of groups 1, 3 and 4 were not significantly different, and group 2 showed significantly higher scores than groups 3 and 4. Laser irradiation, the metal bur, and the CoJet Prep device did not eliminate the need for acid etching of the enamel prior to placement of a fissure sealant. Laser etching at 2 W (20 Hz or 40 Hz) may be an alternative to conventional acid-etching.