复合树脂预热的研究现状和临床应用

复合树脂作为临床常用牙科充填材料存在耐磨性差、聚合收缩大和牙本质边缘适应性不佳等问题。近年有研究发现预热可以改善复合树脂的性能,本文就预热复合树脂对其单体转化率、边缘微渗漏、机械性能以及牙髓的影响等方面进行探讨,以供临床参考。     

四种复合树脂材料与牙体间边缘密合度的研究

目的:对Poss复合树脂及其余3种临床常用复合树脂材料与牙体间边缘密合度比较分析,为临床上更好地选择充填材料提供依据。方法:将40颗离体牙随机分成4组,每组10颗牙,按照国际标准备V类洞,分别用Poss复合树脂,3M Z350复合树脂,Durafill复合树脂,Charisma复合树脂充填牙体,恒温保存,品红染色后,近远中方向剖开牙体,扫描电镜下测量每组充填体与牙体间的边缘密合度。结果:Poss复合树脂与牙体间边缘密合度最小,其次为3MZ350复合树脂,Durafill复合树脂,Charisma复合树脂。结论:Poss复合树脂这种新型材料可以作为临床充填材料,目前临床常用树脂Z350复合树脂与牙体间边缘密合度最小。     

牙齿漂白对复合树脂充填体影响的研究进展

复合树脂在临床上的应用日益广泛,无论漂白前后进行复合树脂充填,都可能会对复合树脂充填体造成一定的影响,包括:颜色,半透明度,微硬度,复合树脂与釉质、牙本质的粘结强度及复合树脂充填体边缘微渗漏等。制定治疗计划必须将漂白剂对复合树脂的影响考虑在内,才能保证良好的漂白效果及预后。本文就牙齿漂白对复合树脂充填体影响的研究进展进行综述。     

复合树脂的分层充填固化技术

复合树脂是临床广泛应用的一种牙体缺损充填修复材料.复合树脂固化过程中伴随的体积收缩最终使充填修复体边缘密合性下降,出现微裂隙,产生微渗漏现象,进而导致修复体边缘变色等一系列不良后果.     

3种窝洞修复方法之间微渗漏的比较

目的:探讨用复合树脂修复Ⅴ类洞时,3种不同修复方法之间微渗漏的差异。方法:挑选36颗3个月内拔除的完整磨牙,制备颊面Ⅴ类洞,将牙随机平均分为3组(n=12),分别使用直接充填法、预热充填法和间接嵌体法完成3M Z350复合树脂修复体,经过500次冷热水循环试验后用品红染色。将牙体纵切成厚度为0.9 mm的薄片,用体视显微镜观测染料渗透深度。结果:预热树脂组和嵌体组之间微渗漏差别无显著性,均显著小于直接充填组(P≤0.05)。结论:使用预热树脂充填和嵌体修复均可减小Ⅴ类洞龈壁边缘微渗漏。     

全瓷嵌体修复后牙牙体缺损166例疗效分析

目的:全瓷嵌体修复后牙牙体缺损166例,分析其临床疗效.方法:全瓷嵌体应用于后牙牙体缺损修复,并与复合树脂嵌体作对照,从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂、颜色匹配等方面进行比较.结果:经过3年的临床观察,全瓷嵌体在边缘着色、基牙继发龋、解剖形态、颜色匹配等方面的临床疗效优于复合树脂嵌体.结论:全瓷嵌体是一种较好的新型牙体缺损修复体.     

大块充填复合树脂后牙窝洞充填效果的回顾性研究

目的 分析高粘型大块充填复合树脂Filtek Bulk Fill、粘度可变型大块充填复合树脂SonicFill和分层复合树脂Filtek Z350用于后牙深龋窝洞充填的临床效果。方法 回顾分析2019年3月至2019年6月期间于南京大学医学院附属口腔医院牙体牙髓病科行后牙深龋窝洞充填的91例病例,根据治疗时使用的充填材料分为Filtek Bulk Fill(FB)组（n=31）、SonicFill(SF)组（n=27）、Filtek Z350(Z350)组（n=33）。比较三组的充填体术后超过1年的成功率,以及边缘着色、边缘适应性、继发龋、术后敏感等边缘密合性相关指标。结果 大块充填复合树脂在充填体成功率以及边缘密合性方面存在着优于分层复合树脂的趋势,但无统计学意义(均P>0.05)。结论 大块充填复合树脂可用于后牙深龋窝洞充填,且可获得略优于分层复合树脂的治疗效果。     

银汞合金和复合树脂充填物边缘失败的研究

临床上充填物边缘失败的现象比较常见,造成失败的原因很多,如继发龋、材料变性等。为评估临床上银汞和复合树脂充填物边缘失败时继发龋的情况,作者作了如下研究。 材料和方法 550名临床医生,收到调查表后,按要求记录各自工作中前5例银汞合金和前5例复合树脂充填物边缘失败的病例。记录内容包括:①充填物边缘失败原因的术前诊断、充填材料、充填物形态,②小心去除充填物,根据术后所见,评价继发龋的发生情况。然后收集、整理资料,进行分析。 结果 对158例Ⅱ类洞银汞合金及172例Ⅲ,Ⅳ,Ⅴ类洞复合树脂充填物边缘失败的病例进行分析,表     

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1962年Bowen开发出第一个牙色材料复合树脂,随着无机填料的不断改进,复合树脂的性能日趋完善,在临床上应用越来越广泛.复合树脂与牙体间的密合度是影响修复效果的重要因素之一,密合度低则易形成边缘微渗漏,进而导致复合树脂充填后的继发龋、充填物松动、脱落等不良后果.     

SR－Isosit复合树脂嵌体的临床应用

ＳＲ－Ｉｓｏｓｉｔ复合树脂嵌体的临床应用首都医科大学附属北京口腔医院张华，韩慕随着技术进步，光固化复合树脂在耐磨性、硬度等方面越来越接近合金材料，而边缘密贴情况则明显优于银汞合金等充填材料［１］。但是光固化复合树脂在口腔特定的环境下磨损率还是很高的［...     

排龈联合流动树脂衬层技术修复楔状缺损临床疗效观察

目的：评估采用排龈联合流动树脂衬层技术修复楔状缺损的临床疗效。方法选择65例楔状缺损患者,每个患者的双侧上颌前磨牙均存在齐龈的4个楔状缺损（共260颗牙）,将每个患者的4颗楔状缺损牙随机分为Ⅰ、Ⅱ、Ⅲ、Ⅳ4组,分别用光固化复合树脂直接充填,排龈+光固化复合树脂直接充填,光固化流动树脂衬层+复合树脂充填,排龈+光固化流动树脂衬层+复合树脂充填4种方式进行修复,于修复后1年进行观察对比。以改良的美国公共卫生署的直接临床评价系统（USPHS）评估疗效,数据进行卡方检验。结果1年复查结果显示,色泽协调性、边缘着色、边缘密合性、表面形态4个方面,4组间A、B分级间差异均无统计学意义（P>0.05）。成功率方面Ⅰ组和Ⅳ组间差异有统计学意义（P<0.05）,Ⅳ组排龈+光固化流动树脂衬层+复合树脂充填临床疗效最好。结论排龈联合光固化流动树脂衬层技术,然后再行复合树脂充填是比较好的楔状缺损修复方式。     

含长链烷基季铵盐纳米抗菌无机填料的复合树脂对人牙菌斑生物膜的影响

目的 合成含长链烷基季铵盐纳米抗菌无机填料的复合树脂,探讨其对人牙菌斑生物膜的影响。方法 制备含长链烷基季铵盐的纳米抗菌二氧化硅填料,经表面偶联处理后,分别以0%、5%、10%、15%及20%的质量分数添加到复合树脂中,以0%组作为对照组,用三点弯曲试验来检测其力学性能。建立人牙菌斑生物膜体外模型,通过菌落计数、乳酸代谢分析及活/死细菌染色等手段来评价复合树脂对人牙菌斑生物膜的影响。结果 与对照组相比,当复合树脂纳米抗菌无机填料的质量分数小于15%时,其力学性能没有明显改变（P>0.05）;当纳米抗菌无机填料的质量分数达到5%及以上时,复合树脂对人牙菌斑生物膜的代谢产生明显的抑制作用,显示出良好的抗菌性能（P<0.05）。结论 当抗菌无机填料的质量分数达到5%时,复合树脂具有较强的抗菌防龋功能。     

抗菌剂对复合树脂综合性能影响的研究进展

复合树脂是目前临床上应用最多的口腔科修复材料,但其仍存在强度低、耐磨性差、易出现微渗漏和继发龋等缺点,因此有关提高复合树脂性能的研究从未停止。与其他修复材料相比,复合树脂表面细菌更容易黏附、聚集,进而形成菌斑生物膜。在复合树脂中添加抗菌剂已成为重要的手段,但抗菌剂的添加对复合树脂的力学、理化性能以及细胞毒性的影响需要进一步研究,文章就抗菌剂对复合树脂综合性能影响的研究进展做一综述。     

New restoration and direct pulp capping systems using adhesive composite resin.

There have been many arguments on the irritating mechanisms of the composite resin on the dental pulp. While the direct irritative effect of the resin has been preferred, some authors considered that the marginal microleakage and the resulting bacterial infection play a more important role in inducing the complicating pulp irritation. We developed a new filling technique, called the direct inlay restoration method, which could prevent the marginal leakage associated with the polymerization shrinkage of the adhesive composite resin. In this study, we tried to apply our method clinically. None of the 440 cases which were filled with the adhesive composite resin and 60 cases out of 64 cases in which the pulps were directly capped with the adhesive composite resin developed any signs and symptoms of pulp irritation. The other 4 cases developed signs of pulp irritation. Two of those 4 cases were pulpectomized due to spontaneous pain and the other 2 cases turned out to be well after re-restoration. With the informed consent of the patients, the direct pulp capping using the adhesive composite resin was experimentally performed on 6 caries-free 3rd molars and the histopathological examination of these capped molars revealed that neither significant degenerative nor inflammatory changes were brought about in the dental pulp. These clinical and histopathological observation suggest that the dental pulp irritation after resin filling is not induced by the composite resin itself.     

Comparative in vitro evaluation of two provisional restorative materials

STATEMENT OF PROBLEM: Provisional crowns traditionally have been associated with problems such as poor occlusion, contour, fit, and finish. Fabrication procedures should be uncomplicated and predictable within a realistic time frame. PURPOSE: The purpose of this study was to compare the quality of provisional restorations fabricated by dental students from 2 different materials (bis-acryl composite resin and PMMA) and identify the advantages and disadvantages associated with each material. MATERIAL AND METHODS: This study evaluated the occlusion, contour, marginal adaptation, and finish of 222 provisional crowns fabricated by 2 groups (A and B) of dental students. One bis-acryl composite resin material (Integrity) and 2 PMMA resins (C&B Resin and Snap) were evaluated. RESULTS: For group A, Integrity was statistically superior (P<.05) to C&B Resin in all 4 categories for anterior provisional crowns. For posterior provisional crowns, Integrity proved superior in the categories of contour and marginal adaptation, but no significant differences were established for occlusion and finish. For group B, Integrity was statistically superior to Snap in the categories of occlusion, contour, and marginal adaptation, whereas there was no statistical difference in finish. When all 4 categories were analyzed, Integrity was found to be statistically superior. CONCLUSION: Bis-acryl composite resin (Integrity) was significantly superior to PMMA (C&B Resin and Snap) as a provisional restorative material.     

Amalgam--Resurrection and redemption. Part 1: the clinical and legal mythology of anti-amalgam.

Dental amalgam has come under attack for its allegedly poor physical properties and clinical performance in addition to its poor appearance. It has been claimed that the American Dental Association has a hidden agenda to protect amalgam and that other countries have banned its use. A literature search revealed that the vast majority of amalgam restorations do not cause fractured cusps or have recurrent caries. Most amalgam restorations have been shown to last longer than resin composite restorations. In addition, the materials and techniques involved in amalgam restorations have vastly improved in recent years. Like resin composite restorations, amalgam restorations can often be repaired. The American Dental Association has no vested interest in protecting amalgam. The use of amalgam has not been banned in any country in the European Union. According to the latest scientific information available, dental amalgam is a remarkably durable and long-lasting restorative material. Although its appearance is unesthetic, its clinical performance and effectiveness are unsurpassed by those of resin composite.     

复合树脂嵌体经离体光照固化后修复牙体严重缺损的临床研究

目的：探讨一种适宜的修复牙体严重缺损的方法。方法:复合树脂嵌体经离体光固化后再黏结修复，并与其它传统修复方法比较。结果：1－1．5年临床效果显示：离体光照优于在体光照、银汞合金充填或离子充填。结论：光固化复合树脂嵌体离体固化黏结修复牙体严重缺损是一种值得临床推广的好方法。     

水中浸泡对自修复抗菌复合树脂性能影响的实验研究

目的 合成新型牙科自修复抗菌复合树脂,并探讨水中浸泡对其相关性能的影响。方法 在前期研究的基础上,制备含牙科自修复单体三乙二醇二甲基丙烯酸酯的微胶囊,以7.5%的质量百分比添加到含长链烷基季铵盐修饰的纳米抗菌二氧化硅填料的复合树脂中,生成自修复抗菌复合树脂,并以商品化的Tetric N-Ceram纳米瓷化复合树脂作为对照。复合树脂试件在37 ℃蒸馏水中浸泡处理不同时间,用三点弯曲试验来检测其力学性能;用单刃V形切口梁法来测试其断裂韧性及自修复效率;建立人牙菌斑生物膜体外模型,通过菌落计数、乳酸代谢分析等手段来评价其抗菌性能。结果 浸泡30 d后,对照组和实验组所有复合树脂力学性能及断裂韧性下降明显（P<0.05）,而后随着浸泡时间的延长,下降不明显（P>0.05）;水浸泡处理对自修复效率没有明显影响（P>0.05）,浸泡270 d后仍然可以获得64%的自修复效率;随着浸泡时间的延长,与对照组相比,实验组复合树脂对人牙菌斑生物膜的代谢仍然可以产生明显的抑制作用（P<0.05）,而实验组各时间段之间菌落计数及乳酸产生量则没有明显差异（P>0.05）,显示出良好的抗菌性能。结论 水中浸泡可以明显影响自修复抗菌复合树脂的力学性能,而自修复特性及抗菌性能则没有明显的变化。     

复合树脂嵌体的研究进展及应用现状

复合树脂嵌体也称间接性树脂修复,是由含有双甲基丙烯酸酯基类的复合树脂在体外固化制作而成。体外固化过程释放了复合树脂嵌体的聚合收缩应力,使修复体的聚合收缩局限在粘接层内;同时提高了复合树脂的聚合程度,提升了其机械性能。同样,由于复合树脂嵌体有体外操作过程,因此在解剖形态方面更佳,有着相比直接树脂充填更良好的邻面接触和面形态。相比瓷嵌体,复合树脂嵌体有着修补方便,不磨耗对牙等特点。随着复合树脂材料及树脂粘接材料的更新,复合树脂嵌体的性能如抗折裂强度、边缘微渗漏、硬度及耐磨性等方面得以提高,复合树脂嵌体在临床方面的应用逐渐广泛,不仅限于牙体严重缺损活髓牙的修复,在完成牙髓治疗后的牙齿、隐裂牙、重度磨损牙等疾患中均有应用。本文就近年来复合树脂嵌体的性能研究及临床应用现状作一综述。