正畸托槽粘接过程中的四手操作评价

目的:评价四手操作对正畸托槽粘接的效果.方法:将门诊正畸初诊患者随机分为实验组和对照组各10例,两组分别共需粘接托槽182个和184个.分别记录实验组和对照组托槽粘接所用全部时间及24 h后复诊托槽粘接位置和脱落情况,进行统计分析.结果:实验组粘接每个托槽所需时间平均1.63 min,对照组为2.69 min,两者间有显著性差异(p<0.01).24 h后复诊实验组和对照组分别有7个和23个托槽位置粘接不够准确,需重新粘接.两个组的托槽粘接正确率分别为96.15%和87.50%,有统计学差异(p<0.01).实验组和对照组分别有3个和9个托槽脱落,两者的托槽脱落率4.89%和1.65%,无统计学的差异(p>0.05).结论:通过"四手操作",医生临床操作时间缩短,托槽位置粘接不当个数减少,工作效率明显提高.而相同医生采用同样材料器械粘接托槽,无论是否有护士协助,24 h后托槽脱落率无统计学差别.     

两种正畸粘接剂托槽生存率的比较研究

目的：比较自酸蚀粘接剂和全酸蚀粘接剂粘接托槽的临床效果。方法：选择42名固定正畸患者,采用自身对照研究,分别使用一步法自酸蚀粘接剂和两步法全酸蚀粘接剂粘接726个托槽,计算12个月内托槽的脱落率,卡方检验比较4种因素（粘接剂、牙弓、牙位和性别）对托槽脱落率的影响;Kaplan-Meier法绘制托槽生存率曲线,log-rank检验分析上述4种因素对托槽生存率的影响,同时评价牙釉质表面的剩余粘接剂指数。结果：两种粘接剂的托槽脱落率无统计学差异;生存分析表明粘接剂类型和牙弓位置对托槽生存率的影响无统计学差异,但前磨牙托槽的生存率比切牙和尖牙低,女性患者的托槽生存率高于男性;自酸蚀粘接剂的剩余粘接剂指数与全酸蚀粘接剂无统计学差异。结论：自酸蚀粘接剂与两步法全酸蚀粘接剂都具有较高的托槽生存率,均能满足正畸临床粘接的要求。     

两种托槽粘接剂的比较实验和研究

目的：测定树脂和化学固化型玻璃离子托槽粘接剂的抗剪切粘接强度。方法：100颗离体双尖牙被随机分成两组，每组又按照测试时间的不同分成3个亚组。组1、组2分别用京津釉质粘合剂(树脂)、Ketac—Bond(化学固化型玻璃离子粘接结剂)粘接托槽，对所有实验样本进行了抗剪切粘接强度的测试。结果：①树脂和化学固化型玻璃离子的抗剪切粘接强度随时间的增加而增强。②树脂粘接剂的断裂主要发生在釉质—树脂界面，而化学固化型玻璃离子粘接剂的断裂则主要发生在自身内部。结论：树脂型托槽粘接剂固化后24h以内达到临床应用标准，而化学固化型玻璃离子粘接剂在固化后24h以内达不到该标准，不适合于临床应用。     

2种粘接剂粘接托槽首次脱落率的临床评价

目的比较树脂类Grengloo粘接剂和玻璃离子类GC Fuji LC粘接剂粘接托槽的首次脱落率。方法固定正畸病例96例,采用自身对照法在口内左右侧随机使用Grengloo和GC粘接剂粘接托槽,记录托槽首次脱落情况。结果两种粘接剂托槽的总体首次脱落率Grengloo组高于GC组,差异有统计学意义（χ2=11.269,P=0.001）。组内比较：Grengloo组（χ2=76.816,P〈0.001）和GC组（χ2=48.538,P〈0.001）上颌、下颌颊面管脱落率的差异均有统计学意义,下颌均高于上颌;Grengloo组（χ2=11.045,P=0.010）、GC组（χ2=4.485,P=0.034）下颌前磨牙脱落率均高于上颌前磨牙,差异有统计学意义。组间比较：下颌颊面管脱落率GC组低于Grengloo组,差异有统计学意义（χ2=9.757,P=0.002）。其他组内组间比较差异均无统计学意义。结论下牙托槽的粘接脱落率较上牙高,尤其在磨牙区;GC与Grengloo粘接剂都能够满足临床粘接需要,GC粘接剂尤其适合后牙区托槽粘接。     

两种非调和型正畸粘接剂的临床效果分析

正畸托槽直接粘接技术己成为固定矫治器正畸治疗中必不可少的手段.粘接材料对正畸托槽的粘接效果起着重要作用.本文对两种非调和型正畸粘接剂粘贴托槽的临床效果进行了观察,结果报道如下.     

不同正畸粘接系统在托槽再粘接中的应用评价

目的：检测使用不同正畸粘接系统再粘接托槽对其剪切粘接强度的影响,以探讨提高临床再粘接效率的方法。方法：选择60颗正畸减数的恒双尖牙,依据不同粘接系统随机分为3组：津京釉质粘接剂（A组）、TransbondXT光固化粘接系统（B组）及Transbond自酸蚀粘接系统（C组）。所有样本均先用津京釉质粘接剂粘接托槽,24h后去除托槽重新粘接新托槽,测量3组托槽再粘接的剪切强度及粘接剂残留指数（AdhesiveRemnantIndex,ARI）。结果：3组托槽再粘接剪切强度分别为（8．615±2．460）MPa、（8．807±1．801）MPa及（8．144±3．023）MPa,组间剪切强度差异无显著性;ARI评分表明：C组牙面上残留的粘接剂明显少于其他两组。结论：采用自酸蚀粘接系统再粘接托槽的剪切强度与其它两种粘接系统相当,并且去除托槽后牙面残留粘接剂较少。     

不同方法去除不同材质正畸托槽及粘接剂的对比实验研究

目的 研究不同方法去除不同材质正畸托槽及残余粘接剂对釉质表面的影响,评价一种适宜高效的去粘接方法,为正畸临床工作提供指导.方法 取因正畸原因拔除的人上颌前磨牙56颗,分别粘接金属或陶瓷托槽,使用2种方法去除正畸托槽后再使用3种不同方法去除残余粘接剂并对牙面抛光.分别检测粘接剂残留指数(ARI),操作时间及牙面粗糙度指数,并使用扫描电镜观察釉质表面微观结构.结果 托槽去除钳及釉质凿组去除托槽后的ARI无显著性差异(P>0.05).金刚砂车针+矽粒子组去除粘接效率最高,Super-Snap抛光碟组次之,矽粒子组最低.矽粒子组处理后釉质表面形貌及粗糙度与天然釉质最接近,Super-Snap抛光碟组次之,金刚砂车针+矽粒子组最差.使用相同方法去除金属托槽和陶瓷托槽无显著性差异(P>0.05).结论 托槽去除钳较釉质凿去除托槽更安全,矽粒子去粘接效果最好但效率最低,Super-Snap抛光碟去粘接效果及效率均处可接受范围,金刚砂车针不适于去粘接.采用相同方法去除不同材质托槽及粘接剂对牙面的影响类似.     

正畸托槽粘接剂对细菌粘附影响的临床试验研究

目的：评价不同正畸托槽粘接剂对口腔细菌粘附的差异。方法：采用临床实验的方法。观察三种常用正畸托槽，粘接剂在口内戴用二个月后的细菌粘附情况及种类。结果：三种粘接材料的细菌粘附能力有显著性差异。结论：从粘附口腔细菌的数量来看，所选三种常用粘接材料存在差异。光固化玻璃离子粘固剂为最少，其次为高粘度聚羧酸粘固剂和复合树脂釉质粘接剂。     

不同底板托槽拆除后底板残余粘接剂分析

目的    比较激光和铸造2种底板托槽的粘接强度,分析托槽底板残余物,探讨拆除托槽对釉质表面的影响。方法    选取2014年6月于哈尔滨医科大学口腔颌面外科因正畸拔除的上颌前磨牙40颗,其中选择激光底板和铸造底板托槽各20颗,粘接于离体上颌前磨牙后进行剪切、拉伸实验。再选取正畸结束患者拆除的前磨牙激光底板、铸造底板托槽各71个,对所有托槽底板粘接剂残余指数（ARI）进行计分,并随机抽取托槽进行底板粘接剂电镜观察。结果    激光底板托槽抗剪切强度（SBS）和ARI高于铸造底板托槽,抗拉伸强度（TBS）低于铸造底板托槽（P < 0.05）;托槽底板残余粘接剂中均可检测到钙元素。结论    激光和铸造两种底板托槽的粘接强度均能达到临床要求,拆除托槽对釉质表面有损伤。     

正畸托槽去除时粘接剂残留模式的体外研究

目的：本研究只对金属托槽、树脂托槽分别应用3种不同粘接剂粘接,正畸托槽去除时粘接剂残留的模式进行体外研究。方法：收集因正畸需要而拔除的新鲜双尖牙120颗,随机等分为6组,用国产双尖牙方丝弓树脂托槽和国产方丝弓金属托槽分别应用3种不同粘接剂模拟临床应用的实验条件下粘接,并做组别标记,1KN电液疲劳实验机进行托槽去除。在实体显微镜下观察ARI记分情况,对正畸托槽去除时粘接剂残留模式进行体外研究。结果：树脂托槽组中和金属托槽组中3组粘接剂去粘接后,ARI记分均无显著性差异（P〉0.05）,但同种粘接剂金属托槽与树脂托槽ARI记分有显著性差异（P〈0.05）。结论：去粘接时金属托槽留在牙面的粘接剂少,树脂托槽留在牙面的粘接剂多。说明树脂托槽与粘接剂之间的粘接强度有待进一步加强。     

A comparative assessment of bracket survival and adhesive removal time using flash-free or conventional adhesive for orthodontic bracket bonding: A split-mouth randomized controlled clinical trial

Objectives:To compare bracket survival and adhesive removal time between a flash-free and a conventional adhesive for orthodontic bracket bonding.Materials and Methods:Forty-five consecutive patients had their maxillary incisors, canines, and premolars bonded with ceramic brackets using a flash-free adhesive (APC Flash-Free Adhesive, 3M Unitek, Monrovia, Calif) on one side and a conventional adhesive (APCII Adhesive, 3M Unitek) on the other side. The side allocation was randomized. Bracket failure was recorded at 4-week intervals. The adhesive remnant index (ARI) was scored on debond and adhesive removal timed to the nearest second. The primary outcome was adhesive removal time per quadrant. Secondary outcomes were bracket failure rate, time to first-time failure of a bracket, and ARI score on debond. Paired t-tests were used to compare adhesive removal times and ARI scores between the adhesives with P < .05 considered statistically significant.Results:Bracket failure rates were 4.3% for the flash-free adhesive and 1.9% for the conventional adhesive, with mean times to first-time failure of 31 weeks for the flash-free adhesive and 42 weeks for the conventional adhesive; neither failure rates nor times to first failure were significantly different. Although the flash-free adhesive left significantly more adhesive on the tooth surface after debonding, the adhesive removal times were 22.2% shorter than with the conventional adhesive.Conclusions:Bracket survival with the flash-free adhesive was equivalent to the conventional adhesive when ceramic brackets were bonded. Adhesive removal was significantly faster when using the flash-free adhesive, which may result in time savings of more than 20% compared with the conventional adhesive.     

Measurement and comparison of bracket transfer accuracy of five indirect bonding techniques

Objective:To measure and compare bracket transfer accuracy of five indirect bonding (IDB) techniques.Materials and Methods:Five IDB techniques were studied: double polyvinyl siloxane (double-PVS), double vacuum-form (double-VF), polyvinyl siloxane vacuum-form (PVS-VF), polyvinyl siloxane putty (PVS-putty), and single vacuum-form (single-VF). Brackets were bonded on 25 identical stone working models. IDB trays were fabricated over working models (n  =  5 per technique) to transfer brackets to another 25 identical stone patient models. The mesiodistal (M-D), occlusogingival (O-G), and faciolingual (F-L) positions of each bracket were measured on the working and patient models using digital photography (M-D, O-G) and calipers (F-L). Paired t-tests were used to compare bracket positions between working and patient models, and analysis of variance was used to compare bracket transfer accuracy among the five techniques.Results:Between the working and patient models, double-VF had the most teeth with significant differences (n  =  6) and PVS-VF the fewest (n  =  1; P < .05). With one exception, all significant differences were ≤0.26 mm and most (65%) were ≤0.13 mm. When the techniques were compared, bracket transfer accuracy was similar for double-PVS, PVS-putty, and PVS-VF, whereas double-VF and single-VF showed significantly less accuracy in the O-G direction.Conclusions:Although overall differences in bracket position were relatively small, silicone-based trays had consistently high accuracy in transferring brackets, whereas methods that exclusively used vacuum-formed trays were less consistent.     

Effect of adhesion boosters on indirect bracket bonding

Objective:To determine the influence of two adhesion boosters on shear bond strength and on the bond failure location of indirectly bonded brackets.Materials and Methods:Sixty bovine incisors were randomly divided into three groups (n  =  20), and their buccal faces were etched using 37% phosphoric acid. In group 1 (control), brackets were indirectly bonded using only Sondhi adhesive. In groups 2 and 3, the adhesion boosters Enhance Adhesion Booster and Assure Universal Bonding Resin, respectively, were applied before bonding with Sondhi. Maximum bond strength was measured with a universal testing machine, and the location of bond failure was evaluated using the Adhesive Remnant Index (ARI). One-way analysis of variance followed by the Tukey test (P < .05) was used to compare the shear bond strength among groups, and the differences in ARI scores were evaluated using the Kruskal-Wallis test (P < .05). The Pearson correlation coefficient was calculated to determine whether there was any correlation between bond strength and ARI scores.Results:The mean shear bond strength in group 3 was significantly higher (P < .01) than in the other groups. Evaluation of the locations of bond failure revealed differences (P < .05) among the three groups. There was a moderate correlation between bond strength and ARI scores within group 3 (r  =  0.5860, P < .01).Conclusion:In vitro shear bond strength was acceptable in all groups. The use of the Assure adhesion booster significantly increased both the shear bond strength of indirectly bonded brackets and the amount of adhesive that remained on the enamel after bracket debonding.     

A clinical comparison of bracket bond failures in association with direct and indirect bonding

Abstract

Objective: To compare bond failure rates between direct and indirect techniques for bonding orthodontic brackets.

Design: A two-centre single blinded prospective randomized controlled clinical trial.

Materials and methods: This study was undertaken at the Birmingham Dental Hospital and Good Hope Hospital, Sutton Coldfield. Thirty-three subjects meeting the inclusion criteria were selected from orthodontic waiting lists and assigned to either of two study groups according to a split-mouth study design. The number and site of bracket failures between tooth types was recorded over 1 year. Statistical analysis was carried out using chi-square tests.

Results: Brackets were lost from 14 of the 553 teeth bonded, giving an overall bond failure rate of 2.5%. There were no significant differences in bond failures between direct and indirect bonding or in the tooth types of the failures.

Conclusions: There was no significant difference in the bond failure rates between direct and indirect bonding.     

Bond strength of a fluoride-releasing bracket adhesive

The aim of the study was to examine a new fluoridereleasing light-cured filling composite for its bonding and debonding qualities when used as a bracket adhesive. The material investigated was a hybrid composite containing a chemically modified fluoride apatite, which is claimed to provide the enamel with phosphate, calcium, and fluoride ions in the presence of an acid pH, recharging its resources of these ions through fluoride-containing toothpastes used in daily oral hygiene.Concurrently suitability as an enamel conditioner was tested in a new self-etching primer, which does not require water rinsing but is gently air dried instead. For comparison a conventional light-cure single-component adhesive was used together with 37% orthophosphoric acid. After application of the respective conditioners, mesh-backed metal brackets were bonded to 20 human premolars in each of the 2 adhesive groups and subjected to a shear test. Bond failure location was evaluated using the Adhesive Remnant Index (ARI).Average bond strength of the experimental bracket adhesive and the conventional etchant was 8.96 MPa. Conditioning with the self-etching primer led to a decrease of mean shear bond strength values to 6.55 MPa. Highest bond strength was determined in the control group (12.19 MPa).The bond strength results obtained in the shear test recommend the new material as a bracket adhesive to be used with orthophosphoric acid for etching.     

Comparison of the transfer accuracy of two digital indirect bonding trays for labial bracket bonding

ObjectivesTo compare the transfer accuracy of two digital transfer trays, the three-dimensional printed (3D printed) tray and the vacuum-formed tray, in the indirect bonding of labial brackets.Materials and MethodsTen digital dental models were constructed by oral scans using an optical scanning system. 3D printed trays and vacuum-formed trays were obtained through the 3Shape indirect bonding system and rapid prototyping technology (10 in each group). Then labial brackets were transferred to 3D printed models, and the models with final bracket positioning were scanned. Linear (mesiodistal, vertical, buccolingual) and angular (angulation, torque, rotation) transfer errors were measured using GOM Inspect software. The mean transfer errors and prevalence of clinically acceptable errors (linear errors of ≤0.5 mm and angular errors of ≤2°) of two digital trays were compared using the Mann-Whitney U-test and the Chi-square test, respectively.ResultsThe 3D printed tray had a lower mean mesiodistal transfer error (P < .01) and a higher prevalence of rotation error within the limit of 2° (P = .03) than did the vacuum-formed tray. Linear errors within 0.5 mm were higher than 90% for both groups, while torque errors within 2° were lowest at 50.9% and 52.9% for the 3D printed tray and vacuum-formed tray, respectively. Both groups had a directional bias toward the occlusal, mesial, and buccal.ConclusionsThe 3D printed tray generally scored better in terms of transfer accuracy than did the vacuum-formed tray. Both types of trays had better linear control than angular control of brackets.     

酸蚀后牙面不同处理方法对托槽粘接效果的影响

目的探讨三种临床常见的不同的酸蚀后牙面处理方法对托槽粘接效果的影响。方法对３０例气水枪冲洗,湿棉球擦拭及酒精棉球擦拭等三种不同酸蚀后牙面处理方法的临床托槽脱落率及粘接剂残留指数ＡＲＩ进行回顾性统计比较。结果气水枪冲洗酸蚀牙面组托槽脱落率最低,ＡＲＩ计分最高;湿棉球擦拭酸蚀牙面组及以酒精棉球擦拭酸蚀牙面组托槽脱落率较高,ＡＲＩ计分较低,后二者与前者相比,托槽脱落率存在着显著差异。结论该结果提示,以气水枪冲洗酸蚀牙面是防止托槽脱落的一个重要方法     

正畸用光固化玻璃离子粘接剂联合麻花丝技术在外伤牙固定中的应用

目的：寻找一种椅旁操作时间短、程序简单、固定效果佳的粘接系统在外伤牙固定治疗中的应用。方法：选择外伤松动牙患者78例共计139颗患牙,随机分为实验组71颗忠牙,采用正畸用光固化玻璃离子粘接剂＋麻花丝固定,对照组68颗患牙采用全酸蚀粘接树脂＋麻花丝固定,固定2-4周时去除固定装置。拆除固定装置6个月后复查,对患牙的疗效进行评价。结果：拆除固定装置6个月后实验组成功率92．9％,对照组成功率91．2％,两组病例差异无统计学意义。结论：正畸用光固化玻璃离子粘接剂＋麻花丝固定外伤松动牙的疗效和稳固性可达到全酸蚀粘接＋麻花丝树脂固定的水平,但前者操作简单,适宜临床应用。     

2种黏结系统与3种牙体硬组织间黏结界面的超微结构研究

目的:比较第7代自酸蚀黏结剂Adper Easy One与两步法全酸蚀黏结剂Adper Singlebond2黏结处理复合树脂充填后的形态学超微结构。方法:在20颗离体人磨牙的颊、舌侧制备盒形单面洞(直径5 mm,洞深3 mm),牙根中1/3处切取表面根片(长5mm,宽3mm),分为2组,每组10个牙冠、10个根片。对2组牙冠的窝洞和根片分别应用黏结剂Adper Singlebond2、Adper Easy One,充填黏结复合树脂后,将其从中间纵向剖开,各得到20个试件。每组随机抽取牙冠部和牙根部各10个试件,进行5000次冷热循环,剩余试件泡于蒸馏水中,常温存放1个月,砂纸打磨抛光,固定脱水,真空干燥、喷金,扫描电镜下观察剖面充填物边缘的黏结情况。结果:扫描电镜显示,全酸蚀Adper Singlebond2黏结处理、常温放置和冷热循环后,牙釉质、牙本质和牙骨质与黏结剂黏结紧密。自酸蚀黏结系统Adper Easy One黏结处理,常温下牙釉质黏结偶见细小裂隙,牙本质和牙骨质与黏结剂结合良好。冷热循环后,牙釉质黏结疏松,可见明显裂缝,牙本质和牙骨质黏结良好。结论:扫描电镜超微观结构观察显示,Adper Singlebond2全酸蚀黏结剂对牙釉质的黏结优于Adper Easy One自酸蚀黏结剂,而对于牙本质和牙骨质效果无明显差别。     

Bond strength and clinical efficiency for two light guide sizes in orthodontic bracket bonding.

Abstract

The purpose of this study was to establish a possible increase in efficiency in bracket bonding with light-cured adhesive by using a larger size on the light transmitting unit. Two light guides were compared, a standard-sized 11-mm light guide and a 19-mm elliptical extra broad light guide, the latter designed to allow simultaneously curing of two adjacent brackets. Fifty extracted human premolars mounted in five phantom maxillary arches were bonded according to a standard procedure with Mini Uni-Twin stainless steel brackets. The two light guides were randomly chosen for each half of the maxillary arch. After bonding, all teeth were tested for tensile bond strength to failure. In the clinical study 30 patients were bonded according to a split mouth technique with the two light guides alternatively used randomly for each side of the jaw. Time for bonding and the occurrence of bracket failures were recorded. The results showed no statistically significant differences between the standard and elliptical light guides regarding tensile bond strength, or bracket failure frequency. However, with the larger light guide size a significantly shorter total bonding time for each patient was required. It is therefore concluded that the elliptical light guide in combination with a light transmitting unit of sufficient quality gave a similar bonding result as the standard light guide, offering the clinician a reduction in chair side time during the bonding procedure.