四种正畸粘接剂对金属托槽粘接效果的评价

目的比较4种正畸粘接剂对金属托槽的粘接效果。方法选择正畸临床44例患者,792颗牙,随机分为4组,常规牙面处理,分别按照说明书要求用京津釉质粘接剂、GC树脂改良型玻璃离子粘接剂、3M化学固化型树脂粘接剂和3M光固化树脂粘接剂粘接金属托槽,然后使用MBT矫治技术进行综合性正畸治疗,记录托槽脱落情况。12个月后,评估每组牙的牙釉质脱矿情况,并对所有数据进行统计学分析。结果 3M光固化型树脂粘接剂组托槽的脱落率低于京津釉质粘接剂组,差异有显著性(P<0.05),而其余各组间托槽脱落率的比较差异均无统计学意义(P>0.05)。京津釉质粘接剂组造成釉质脱矿程度在4组中最高,而GC树脂改良型玻璃离子粘接剂的釉质脱矿程度最低,其差异均有统计学意义(P<0.05)。结论京津釉质粘接剂相对远期粘接效果较差;GC树脂改良型玻璃离子粘接剂能够通过释放氟离子有效降低釉质脱矿的发生,是正畸治疗中较为理想的粘接材料,具有良好的临床应用前景。     

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.     

正畸托槽及牙面残余粘接剂的去除方法研究进展

正畸治疗结束后拆除矫治器时，需要完全去除牙面上的残余粘接剂，同时尽可能减少对釉质的损伤，恢复和保护釉质表面的完整形态。矫治过程中托槽及附件脱落需要重新粘接时，也需要完全去除托槽及附件上的残余粘接剂。本文针对托槽和牙面上残余粘接剂的各种去除方法进行综述。     

不同粘接剂去除方式对釉质微观结构及托槽抗剪切粘接强度的影响

目的 对比研究5种不同牙面残留粘接剂去除方式对釉质及托槽抗剪切粘接强度(shear bond strength, SBS)的影响。方法 选取66颗离体前磨牙,随机分为6组。A组：空白组,牙面不做任何处理;B组：金刚砂车针处理组;C组：绿砂石处理组;D组：慢速钨钢钻处理组;E组：慢速钨钢钻+抛光杯处理组;F组：慢速钨钢钻+硅粒子处理组,用上述处理方法对各组等量粘接剂样本进行磨除,记录操作时间,分别用扫描电镜和表面粗糙度仪对釉质表面进行定性和定量评价。各组处理样本粘接金属托槽后,应用万能力学测试仪检测各组托槽SBS,分析牙面粘接剂残留指数(adhesive residual index, ARI)。结果 B、C组去除效率较高,E组效率最低;扫描电镜显示F组处理后的釉质形态最接近正常牙釉质;F组表面粗糙度最低((0.48±0.13)μm),与A组无统计学差异(P>0.05);D组托槽再粘接强度最高((16.61±1.99)MPa),明显高于A组(P<0.05);各组托槽去除后的ARI指数无显著性差异(P>0.05)。结论 金刚砂车针及绿砂石去除效率较高,但对釉质损伤较大;慢...     

预置粘接剂托槽的抗剪切强度

目的本研究目的是检测预置粘接剂(Adhesive Precoated,APC)托槽粘接后的抗剪切强度,并与传统的正畸托槽粘接后的抗剪切强度进行对比研究。材料与方法研究中使用50个离体前磨牙,随机分为5组,每组10个样本。按照相应的步骤在牙釉质是粘接托槽。组1:先进行釉质酸蚀,然后用光固化树脂粘接剂(Transbond XT)粘接金属托槽;组2:先进行釉质酸蚀,然后粘接 APC 托槽;组3:釉质表面使用自酸蚀偶联剂,然后用光固化树脂粘接剂粘接金属托槽;组4:釉质表面使用自酸蚀偶联剂,然后粘接 APC 托槽;组5:先进行釉质酸蚀,然后用化学固化树脂粘接剂(Unite)粘接金属托槽。用材料力学实验机对托槽施加剪切力,检测每组样本的抗剪切强度和粘接材料残留指数(ARI)。结果每组的平均抗剪切强度分别为组1:11.37±6.62兆帕(MPa);组2:11.08±4.63兆帕;组3:11.62±6.88兆帕;组4:10.96±5.94兆帕;组5:14.41±6.34兆帕。方差分析表明,5组之间的粘接强度的差异没有显著的统计学意义(P>0.05)。结论预置粘接剂托槽可以有足够的粘接强度供临床使用。     

Nd:YAG激光辅助去除陶瓷托槽对托槽的粘接强度及髓腔温度影响的研究

目的　研究国产DL-200型计算机控制脉冲Nd:YAG口腔激光机去除陶瓷托槽的最佳技术参数。方法　观察未使用激光照射组,以及激光功率5 W、照射时间2 s组,功率3 W、照射时间3 s组和功率2 W、照射时间5 s 组,3种参数下激光对陶瓷托槽的粘接强度及髓腔温度的影响。结果　①激光照射后可以显著降低陶瓷托槽的粘接强度,约降低50%,4组间的平均粘接强度差异有统计学意义(P<0·001);②激光照射后各组髓腔温度均升高,各组温度升高有统计学意义(P<0·001),激光功率3 W、照射时间3 s组髓腔温度只升高3·65℃,较其他两组低。结论　国产DL-200型计算机控制脉冲Nd:YAG口腔科激光治疗机激光照射后可以显著降低陶瓷托槽的粘接强度,去除陶瓷托槽的最佳参数是激光功率3 W、照射时间3 s,这一能量不会明显升高牙髓温度。     

三种非金属托槽抗剪切强度比较

目的 比较京津釉质粘接剂粘接三种非金属托糟的抗剪切强度，评估托槽去除后牙面残留粘接剂指数（adhesive remnant indexes，ARI），为临床合理选择非金属托槽提供指导。方法 60颗人类前磨牙随机均分为三组，用京津釉质粘接剂分别粘接陶瓷托槽、有机玻璃托槽和聚碳酸酯托槽，测定并记录其抗剪切强度和托槽去除后牙面残留粘接剂指数。结果 三种托槽的抗剪切强度和ARI记分情况均不全相同（P〈0.05），组间比较发现陶瓷托槽组与另两组间差别显著（P〈0．01），而有机玻璃组与聚碳酸酯组间无显著差别（P〉0．05）。结论 在应用京津釉质粘接剂粘接托槽时，陶瓷托槽的粘接强度足可以满足正畸临床矫治要求，而有机玻璃托槽和聚碳酸酯托槽的粘接强度较低以至不能满足正畸临床矫治要求，应谨慎使用。     

Nd:YAG激光对水门汀与牙本质剪切强度的影响

目的:评价脉冲Nd:YAG激光对水门汀与牙本质间剪切强度的影响,并观察激光照射前后的牙本质表面结构变化。方法:取人前磨牙30个,暴露牙本质粘接面形成60个测试样本,随机分为激光组和对照组。激光组以0.8W、10Hz脉冲Nd:YAG激光照射牙本质表面25sec,联合3种水门汀充填;对照组直接使用3种水门汀充填于牙本质表面,置于37℃生理盐水24h后,测试剪切强度,并进行统计学分析,在根管显微镜下观察断裂模式并分类。扫描电镜观察激光照射前后的牙本质表面形态。结果:聚羧酸锌组、玻璃离子组和树脂加强玻璃离子组在Nd:YAG激光照射前(后)的剪切强度分别为4.63±1.39(4.77±0.97)MPa、5.15±0.67(5.26±1.21)MPa和0.92±0.46(0.99±0.35)MPa,激光照射前后的差别均无统计学意义(P>0.05)。扫描电镜观察,0.8W、10Hz的Nd:YAG激光照射会使牙本质表面熔融,玷污层基本去除,大部分牙本质小管封闭,且在局部会出现裂纹。结论:Nd:YAG激光(0.8W、10Hz)处理牙本质,对聚羧酸锌和玻璃离子水门汀与牙本质间的粘接强度无影响。     

Safety evaluation of debonding domestic ceramic brackets with bracket-removal plier in vitro

目的 使用去托槽钳去除两种底板设计的国产多晶体氧化铝陶瓷托槽,评价对牙齿安全性的影响.方法 选择离体上、下颌各15颗双尖牙,随机分为3组.实验组为国产沟槽底板(3条横沟)和网格底板(3×3网格)陶瓷托槽,对照组为临床常用多晶体氧化铝陶瓷托槽(Crystaline IV).使用37%液体磷酸和京津釉质粘接剂分别粘接上述3种托槽,在0.9%生理盐水中室温保存24h.使用去托槽钳及WDW3050型微机控制电子万能试验机龈向施加剪切力,检测去除强度、粘接剂残留指数(ARI)及托槽断裂个数,并以立体显微镜评价釉质表面损伤情况.结果 国产沟槽底板、网格底板陶瓷托槽及Crystaline IV的去除强度分别为18.49±4.00MPa、17.89±4.13MPa和17.62±4.51MPa,三者间无显著性差异.主要去除部位均在粘接剂内部,托槽断裂个数分别为7个、7个和6个.各有一颗使用国产沟槽底板陶瓷托槽和Crystaline IV的牙齿在立体显微镜下发现明显的釉质缺损.结论 对于唇面呈弧形的牙体,使用去托槽钳龈向施加剪切力去除国产多晶体氧化铝陶瓷托槽时,去除强度大,易发生托槽断裂,且可能并发釉质剥脱,并不是理想方法.     

MBT托槽光固化粘接与化学固化粘接的临床应用比较

目的比较光固化复合树脂与京津釉质粘接剂临床粘接MBT托槽的效果。方法选择牙列完整的20例非拔牙固定正畸矫治患者的患牙400颗,将2种粘接剂分别用于同一患者的左上颌和右下颌区以及右上颌和左下颌区,比较正畸治疗期间MBT托槽脱落情况。结果使用光固化复合树脂和京津釉质粘接剂粘接MBT托槽的脱落率无统计学意义。结论光固化复合树脂与京津釉质粘接剂粘接强度基本相同,但光固化复合树脂具有临床操作可控性强、MBT托槽粘接准确率高等优点,值得临床广泛应用。     

机械法去除国产陶瓷托槽安全性的研究

目的使用去托槽钳去除两种底板设计的国产多晶体氧化铝陶瓷托槽,评价对牙齿安全性的影响。方法选择离体上、下颌各15颗双尖牙,随机分为3组。实验组为国产沟槽底板（3条横沟）和网格底板（3×3网格）陶瓷托槽,对照组为临床常用多晶体氧化铝陶瓷托槽（Crystaline IV）。使用37%液体磷酸和京津釉质粘接剂分别粘接上述3种托槽,在0.9%生理盐水中室温保存24h。使用去托槽钳及WDW3050型微机控制电子万能试验机龈向施加剪切力,检测去除强度、粘接剂残留指数（ARI）及托槽断裂个数,并以立体显微镜评价釉质表面损伤情况。结果国产沟槽底板、网格底板陶瓷托槽及Crystaline IV的去除强度分别为18.49±4.00MPa、17.89±4.13MPa和17.62±4.51MPa,三者间无显著性差异。主要去除部位均在粘接剂内部,托槽断裂个数分别为7个、7个和6个。各有一颗使用国产沟槽底板陶瓷托槽和Crystaline IV的牙齿在立体显微镜下发现明显的釉质缺损。结论对于唇面呈弧形的牙体,使用去托槽钳龈向施加剪切力去除国产多晶体氧化铝陶瓷托槽时,去除强度大,易发生托槽断裂,且可能并发釉质剥脱,并不是理想方法。     

Bonding with self-etching primers--pumice or pre-etch? An in vitro study

The purpose of this study was to compare the shear bond strengths (SBSs) of orthodontic brackets bonded with self-etching primer (SEP) using different enamel surface preparations. A two-by-two factorial study design was used. Sixty human premolars were harvested, cleaned, and randomly assigned to four groups (n = 15 per group). Teeth were bathed in saliva for 48 hours to form a pellicle. Treatments were assigned as follows: group 1 was pumiced for 10 seconds and pre-etched for 5 seconds with 37 per cent phosphoric acid before bonding with SEP (Transbond Plus). Group 2 was pumiced for 10 seconds before bonding. Group 3 was pre-etched for 5 seconds before bonding. Group 4 had no mechanical or chemical preparation before bonding. All teeth were stored in distilled water for 24 hours at 37°C before debonding. The SBS values and adhesive remnant index (ARI) score were recorded. The SBS values (± 1 SD) for groups 1-4 were 22.9 ± 6.6, 16.1 ± 7.3, 36.2 ± 8.2, and 13.1 ± 10.1 MPa, respectively. Two-way analysis of variance and subsequent contrasts showed statistically significant differences among treatment groups. ARI scores indicated the majority of adhesive remained on the bracket for all four groups. Pre-etching the bonding surface for 5 seconds with 37 per cent phosphoric acid, instead of pumicing, when using SEPs to bond orthodontic brackets, resulted in greater SBSs.     

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。     

Shear bond strength after multiple bracket bonding with or without repeated etching

The purpose of the study was to measure the in vitro shear bond strength (SBS) of metal brackets after multiple bonding and debonding with and without repeated etching. One hundred and twenty extracted premolars were divided into three equal groups. In group 1, the brackets were bonded and debonded three times with repeated enamel etching and in groups 2 and 3 without repeated etching. In group 2, all composite remnants were removed before bonding, while in group 3, the remnants were levelled. Analysis of variance was used to determine significant differences in SBS with Bonferroni adjustment for the multiple testing procedures. The results showed that in group 1, the mean SBS was 11.69 MPa (SD 2.65) at the first, 14.30 MPa (SD 2.69) at the second, and 12.19 MPa (SD 2.26) at the third debonding. In group 2, SBS decreased from 12.57 MPa (SD 2.54) to below 8.0 MPa. In group 3, SBS remained constant from the first (11.93 MPa; SD 2.14) to the second (12.06 MPa; SD 1.65) debonding and only decreased significantly to 9.74 MPa (SD 1.80) at the third debonding. Less composite remained on the teeth after each debonding sequence. This was characterized by a shift from adhesive remnant index (ARI) scores 2 and 3 after the first debonding to ARI scores 1 and 2 after the second debonding to predominantly scores 0 and 1 after the third debonding. After bracket loss and levelling of composite remnants, the SBS is sufficient for application of orthodontic forces. Repeated etching may involve a higher risk of enamel tear-outs during debonding.     

Influence of Adhesives and Methods of Enamel Pretreatment on the Shear Bond Strength of Orthodontic Brackets

Aim

The objective of present study was to examine influence of adhesives and methods of enamel pretreatment on the shear bond strength (SBS) of orthodontic brackets. The adhesives used were resin-reinforced glass ionomer cements-GIC (Fuji Ortho LC) and composite resin (Transbond XT).

Material and Methods

The experimental sample consisted of 80 extracted human first premolars. The sample was divided into four equal groups, and the metal brackets were bonded with different enamel pretreatments by using two adhesives: group A-10% polyacrylic acid; Fuji Ortho LC, group B–37% phosphoric acid; Fuji Ortho LC, group C–self etching primer; Transbond XT, group D–37% phosphoric acid, primer; Transbond XT. SBS of brackets was measured. After debonding of brackets, the adhesive remnant index (ARI) was evaluated.

Results

After the statistical analysis of the collected data was performed (ANOVA; Sheffe post-hoc test), the results showed that significantly lower SBS of the group B was found in relation to the groups C (p=0.031) and D (p=0.026). The results of ARI were similar in all testing groups and it was not possible to determine any statistically significant difference of the ARI (Chi- square test) between all four experimental groups.

Conclusion

The conclusion is that the use of composite resins material with appropriate enamel pretreatment according to manufacturer’s recommendation is the “gold standard” for brackets bonding for fixed orthodontic appliances.Key words: orthodontic brackets, shear strength, adhesive, enamel preparation     

Early shear bond strength of a one-step self-adhesive on orthodontic brackets

OBJECTIVE: The purpose of this study was to determine whether a self-adhesive universal cement, RelyX Unicem (3M ESPE, Seefeld, Germany), can be used successfully to bond orthodontic brackets to enamel. MATERIALS AND METHODS: Forty human molars were cleaned, mounted, and randomly divided into two groups: 20 orthodontic brackets were bonded to teeth using RelyX Unicem, and 20 brackets were bonded using the Transbond XT (3M Unitex, Monrovia, Calif) adhesive system. The teeth were debonded within 30 minutes after initial bonding using a universal testing machine. After debonding, the enamel surface was examined under 10x magnification to determine the amount of residual adhesive remaining on the tooth. Student's t-test was used to compare the shear bond strength (SBS) of the two groups, and the chi-square test was used to compare the Adhesive Remnant Index (ARI) scores for the two adhesive systems. RESULTS: The mean SBS of the brackets bonded using the RelyX Unicem was 3.7 +/- 2.1 MPa and was significantly lower (t = 2.07, P = .048) than the SBS of the brackets bonded with the Transbond system (x = 5.97 +/- 4.2 MPa). The comparisons of the ARI scores between the two groups (chi(2) = 17.4) indicated that bracket failure mode was significantly different (P = .002) with more adhesive remaining on the teeth bonded with Transbond XT. CONCLUSIONS: The SBS of the self-adhesive universal cement needs to be increased for it to be successfully used for bonding orthodontic brackets.     

纳米银羟基磷灰石涂层陶瓷托槽的研制及力学性能研究

目的：研制新型抗菌涂层托槽,并对其表面特性及力学性能做初步研究。方法：采用微束等离子喷涂方法在托槽背板上制备涂层,采用X射线衍射仪,X荧光光谱分析仪,扫描电镜进行涂层分析。收集40颗健康离体前磨牙,随机分为两组：实验组和对照组。实验组选用纳米银羟基磷灰石涂层陶瓷托槽,对照组选用普通陶瓷托槽,并对其分别实施剪切力测试,评价托槽的力学性能。结果：此新型抗菌托槽涂层稳定均匀,厚度约100μm,涂层托槽的剪切力为7．34±1．72MPa,ARI指数平均值为1．45,满足临床要求。结论：托槽背板的涂层性能良好,且力学性能达到标准,可满足正畸临床需要。     

Bond strengths and adhesive remnant index of self-etching adhesives used to bond brackets to instrumented and uninstrumented enamel

PURPOSE: This study evaluated bond strengths of orthodontic brackets to instrumented and uninstrumented enamel using self-etching adhesive systems when compared to a total-etch adhesive system. The adhesive remnant index (ARI) was also determined after debonding. METHODS: 140 bovine incisors were included in acrylic resin, and divided randomly in two groups: instrumented vs. uninstrumented enamel. For the instrumented enamel, specimens had their facial enamel ground flat to 600-grit. In each group, specimens were subdivided into four experimental subgroups according to the adhesive technique used: Transbond Plus, Adper Prompt L-Pop, iBond, and Adper Single Bond, applied following manufacturers' instructions. Orthodontic brackets were bonded to the treated instrumented or uninstrumented enamel with Transbond XT light-cured resin-based composite cement, and the bond strength was tested in shear mode after 7 days. One group where no etch and no adhesive were used served as a control. ARI scores were determined after debonding. RESULTS: There was no statistically significant difference in mean bond strengths between instrumented and uninstrumented enamel for any of the adhesive systems (P > or = 0.05). No significant differences were observed for bond strengths among the adhesives tested (P = 0.308), and all experimental groups resulted in mean bond strengths significantly higher than the controls (P < 0.05). Statistically significant differences were identified when ARI scores were compared, with less adhesive remnants being observed for iBond (uninstrumented enamel) and the control groups (P < 0.05).     

Comparison of bond strength between simple foil mesh and laser-structured base retention brackets.

The aims of the current study were to evaluate the bond strength of a new metallic orthodontic bracket with a laser structured base (Discovery, Dentaurum, Ispringen, Germany), and its effects on the site of bond failure and on the behavior of the enamel after debonding. One hundred and twenty recently extracted human premolars were bonded with 1 of 2 types of mechanical interlock base metal brackets: a standard system with a simple foil mesh pad (Minitrim, Dentaurum) and the Discovery bracket. A resin-based, chemically activated bonding system, No-mix (Dentaurum), was used as the adhesive system in this trial. The teeth were immersed in normal saline solution at 37 degrees C for 7 days before debonding and were randomly assigned to different subgroups. A testing machine was used to evaluate tensile and fatigue bond strengths for both brackets. After debonding, the amount of residual adhesive on the bracket and enamel detachment were assessed according to the adhesive remnant index (ARI) and the enamel detachment index (EDI) with a scanning electron microscope and an energy dispersive X-ray spectrometer. The scores obtained from the ARI and the EDI showed that the laser structured base brackets had a significantly higher bond strength (mean +/- SD: 17.1 +/- 0.7 MPa) that was 2 times higher than that observed with the simple foil mesh brackets (mean +/- SD: 8.7 +/- 1.4 MPa) (P <.001). Bond failure with the laser structured base was at the enamel-adhesive interface with an ARI score of 3 in 80% of the teeth, and bond failure with the simple foil mesh base was at the bracket-adhesive interface with an ARI score of 0 in 75% of the teeth. A small area, with less than 10% of the enamel damaged (1 on the EDI) and 1.5 microm in thickness, was observed for both brackets. The laser structured base bracket's bond strength was double that of the simple foil mesh bracket but was equally safe and did not induce significant enamel detachment.     

Thermal debracketing of single crystal sapphire brackets.

Because of their optical clarity, single crystal sapphire brackets provide an esthetic advantage over many other types of orthodontic brackets. However, debonding of these brackets has caused iatrogenic damage to enamel. Thermal debonding has been proposed for use in removing sapphire brackets without causing damage to teeth. This study determined the temperature required at the enamel/resin interface to thermally debond sapphire brackets from etched bovine enamel using 23 different commercially available orthodontic resins and one experimental product. The results indicate a wide range of debonding temperatures for the various resins. As a group, the powder-liquid materials had a statistically lower debonding temperature than the two-paste, the no-mix products, or the light-cured materials, for which the temperatures were all similar. This paper presents relative information a clinician can use in selecting an orthodontic bonding resin to minimize thermal damage to the teeth while debonding sapphire brackets.