不同树脂嵌体材料边缘微渗漏的对比研究

目的：通过对比4种树脂嵌体材料的微渗漏大小,为临床树脂嵌体材料的选择提供参考.方法：40颗离体牙按嵌体备洞原则制备近中邻（牙合）Ⅱ类洞,随机分为4组,每组10颗.分别用Z350、P60、Ceramage、Solitaire 2制作嵌体后使用Adper Single Bond 2和Adper 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：4组树脂嵌体材料轴壁和龈壁均出现微渗漏.经单因素方差分析,不同树脂嵌体材料之间的轴壁（F=0.131）及龈壁（F=0.385）微渗漏差异无统计学意义（P＞0.05）;同材料组的龈方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（P＜0.01）.结论：从微渗漏深度大小来进行评价,4种树脂嵌体材料均是临床上制作树脂嵌体理想的材料;树脂嵌体与牙釉质粘结效果比牙本质好.     

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。     

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。     

人工唾液浸泡对牙本质粘结界面纳米渗漏的影响

目的：探讨含细菌的人工唾液对牙本质粘结界面纳米渗漏的影响。方法：选用全酸蚀粘结剂Prime Bond NT（NT）与正常牙本质粘结，制备微拉伸试件。将试件浸泡于含细菌的人工唾液中，分别在即刻、1周、1月、3月时取出，用扫描电镜（SEM）观察粘结界面银沉积情况，并用N1H图像分析软件量化处理，以界面银沉积面积占断裂界面的百分比来评价纳米渗漏程度。结果：粘结界面在即刻、1周、1月、3月时的银沉积面积百分比分别为10．97±5．14、12．25±4．01、16．49±4．43、21．03±5．65。结论：无论浸泡与否，粘结试件都无法避免纳米渗漏的产生；含细菌的人工唾液浸泡使得粘结系统粘结界面纳米渗漏增加，并且银沉积量随着时间的延长而增大。     

流动树脂衬垫对树脂充填二类洞患者修复率的影响

目的 探究流动树脂衬垫对树脂充填二类洞患者修复率的影响。方法 选取我院2020年3月-2021年3月收治的同时存在两颗后牙需要二类洞修复的150例患者作为研究对象,随机分为对照组与试验组,各75例。对照组采用将直接树脂充填,试验组采用流动树脂衬垫+树脂充填,比较两组修复情况、充填体脱落率。结果 试验组外形、边缘着色、边缘适合性评估等级均低于对照组,差异有统计学意义（P＜0.05）;两组釉损评估等级比较,差异无统计学意义（P＞0.05）;试验组充填体总脱落率低于对照组,差异有统计学意义（P＜0.05）。结论 流动树脂衬垫对树脂充填二类洞修复的成功率较高,且能够有效避免充填体脱落,值得临床应用。     

空气喷砂技术对牙髓组织中P物质作用的实验研究

目的：观察空气喷砂技术去龋时对牙髓组织的SP、CGRP神经反应性的影响。方法：实验组为空气喷砂技术组及高速涡轮机组,未制洞大鼠为空白对照组,制备雌性SD大鼠上颌磨牙,ABC免疫组织化学染色法观察牙髓组织内P物质的反应。结果：空气喷砂组大鼠牙髓SP、CGRP强阳性染色,高速涡轮机组大鼠牙髓SP、CGRP弱阳性染色,实验组间、实验组与对照组间均有差别,差别具有统计学意义（P〈0.05）。结论：空气喷砂技术刺激牙髓神经合成SP、CGRP增多,推论该技术在制备窝洞时对牙髓组织刺激性相对较小。     

粘结面润湿度对牙本质粘结界面纳米渗漏的影响

目的：观察、比较不同粘结面润湿度对4种全酸蚀粘结剂（OptiBond Solo（OB）、Single Bond（SB）、One-Step（OS）、Prime＆Bond NT（PB））牙本质粘结界面纳米渗漏的影响。方法：选取36颗无龋坏人磨牙，用600目碳化硅砂纸在流水冲洗下预备出统一的牙本质粘结面玷污层。分别用4种全酸蚀粘结剂在不同粘结面润湿度条件下进行粘结处理。每颗牙齿垂直于粘结面切割出4个4mm×0．9mm×4mm粘结试件，避光贮存于氨化硝酸银溶液中24h，在TEM下观察、比较牙本质粘结界面纳米渗漏．结果：不同的粘结面润湿度条件下，4种全酸蚀粘结剂牙本质粘结界面中均可以观察到不同程度的纳米渗漏。结论：粘结面润湿度对含不同有机溶剂粘结剂的牙本质粘结界面纳米渗漏的影响程度不同。     

Cerinate瓷贴面临床修复色彩学研究及粘结树脂对其颜色的影响

目的：探讨不同颜色不同厚度的瓷贴面能否恢复对应Vna比色的牙齿的原来颜色以及不同颜色的粘结树脂对其颜色的影响。方法：制作不同颜色(A1、A2、A3色)不同厚度(0．50mm、0．75mm、1．00mm)的Cerinate瓷贴面，将其用不同颜色的粘结树脂粘固到对应的牙齿预备面上，用测色仪分别测量牙齿预备前及粘固了Cerinate瓷贴面后牙面的L*a*b*值，比较两者的差异。结果：随着预备深度的增加，两者的L*a*b*值越来越接近，不同颜色的粘结树脂对其色彩的影响越来越小。结论：Cerinate瓷贴面可以恢复牙齿原来的颜色，不同颜色的粘结树脂对Cerinate瓷贴面修复的最终颜色有微调作用。     

酸蚀时间对牙本质粘结界面纳米渗漏的影响

目的：观察、比较不同酸蚀时间对4种全酸蚀粘结剂（OptiBond Solo（0B）、singleBond（SB）、One-Step（0S）、Prime＆BondNT（PB））牙本质粘结界面纳米渗漏的影响。方法：选取64颗无龋坏人磨牙，用600目碳化硅砂纸在流水冲洗下预备出统一的牙本质粘结面玷污层，分别选用4种粘结剂在不同粘结面酸蚀时间条件下进行粘结处理；每颗牙齿垂直于粘结面切割出4个4mm×0．9mm×4mm粘结试件，分别在TEM下观察、比较其粘结界面纳米渗漏。结果：4种粘结剂的牙本质粘结界面纳米渗漏均随酸蚀时间的延长而增加。结论：延长酸蚀时间，在牙本质粘结界面中遗留有更多的未封闭结构，加速牙本质粘结界面老化。     

酸蚀时问对牙本质粘结界面纳米渗漏的影响

目的:观察、比较不同酸蚀时间对4种全酸蚀粘结剂(OptiBond Solo(0B)、Single Bond(SB)、One-Step(OS)、Prime&Bond NT(PB))牙本质粘结界面纳米渗漏的影响.方法:选取64颗无龋坏人磨牙,用600目碳化硅砂纸在流水冲洗下预备出统一的牙本质粘结面玷污层,分别选用4种粘结剂在不同粘结面酸蚀时间条件下进行粘结处理;每颗牙齿垂直于粘结面切割出4个4mm×0.9mm×4mm粘结试件,分别在TEM下观察、比较其粘结界面纳米渗漏.结果:4种粘结剂的牙本质粘结界面纳米渗漏均随酸蚀时间的延长而增加.结论:延长酸蚀时间,在牙本质粘结界面中遗留有更多的未封闭结构,加速牙本质粘结界面老化.     

粘结面润湿度对牙本质粘结强度的影响

目的：研究、比较不同粘结面润湿度对4种粘结剂（OptiBond Solo（OB）、Single Bond（SB）、One-Step（OS）、Prime＆Bond NT（PB））牙本质粘结强度的影响。方法：选取36颗无龋坏人磨牙，用600目碳化硅砂纸在流水冲洗下预备出统一的牙本质粘结面玷污层。分别用4种全酸蚀粘结剂在不同粘结面润湿度条件下进行粘结处理。每颗牙齿垂直于粘结面切割出8个1.0mm×1.0mm×4.0mm粘结试件，分别进行微拉伸强度（μTBS）测试。结果：4种粘结剂OB（25.24±2.07）MPa、SB（24.28±4.73）MPa、OS（28.29±4.35）MPa和PB（26.87±4.39）MPa在润湿的牙本质粘结面上均取得了最高的牙本质粘结强度（P〈0.01）。结论：不同粘结面润湿度对不同溶剂粘结剂牙本质粘结强度的影响不同。     

“劲润”牙本质保护膜的牙本质粘结性能探讨

目的：探讨“劲润”牙本质保护膜（Hybrid Coat,HyC）的牙本质粘结性能。方法：选取A组（HyC）和其他3组不同类型的牙本质粘结剂：B组（G-Bond）、C组（MegaBond）和D组（single Bond）,比较其对牛牙牙本质的剪切粘结强度,并用实体显微镜观察粘结界面断裂模式。各组试料数分别为n=10,结果通过Tukey-Kramer（P〈0．05）进行统计学分析。结果：B、C、D组均显示了较大的粘结强度,3组之间无统计学差异。A组（HyC）显示了较低的粘结强度,约10．08MPa,与其他3组之间存在显著性差异。断裂模式显示,A组（HyC）以界面破坏为主,而其他3组以凝集破坏和混合破坏为主。结论：本研究结果提示,“劲润”牙本质保护膜（HyC）的粘结强度弱于其他3组牙本质粘结剂。为了保证HyC长期稳定的防过敏效果及粘结性能,在今后的研究中有必要进一步探讨如何提高HyC的牙本质粘结性能。     

冠桥基牙制备后牙本质敏感的临床治疗研究

目的:评价抗敏口腔专业用脱敏膏对于烤瓷冠桥基牙制备后牙本质过敏的治疗疗效。方法:选取做烤瓷冠桥修复的226例患者,随机分为实验组和对照组,各113例。实验组:113例备牙后和烤瓷冠桥粘固前使用抗敏口腔专业用脱敏膏进行脱敏。对照组:113例备牙后、烤瓷冠桥粘固前使用Gluma脱敏剂脱敏。牙本质敏感度的评价采用冷空气喷吹法,记录视觉模拟疼痛评分(visual analogue scale,VAS)值。结果:实验组于备牙后使用脱敏膏治疗基牙敏感显著降低,与使用前对照组比较差异有统计学意义(P<0.001);与对照组相比,实验组粘固后基牙敏感度的差异也有统计学意义(P<0.001)。结论:烤瓷冠桥修复基牙预备后使用抗敏口腔专业用脱敏膏,可以有效治疗牙本质过敏。     

Scanning electron microscopic evaluation of resin-dentin interface after Er:YAG laser preparation

BACKGROUND AND OBJECTIVES: The aim of this study was to observe the morphological characteristics of dentin-resin interfaces when a composite resin was bonded to Er:YAG laser irradiated dentin. STUDY DESIGN/MATERIALS AND METHODS: Human dentin surfaces were divided into three equal areas. One third was prepared using a carbide bur and etched with phosphoric acid, the second third was conditioned using an Er:YAG laser, the third one was irradiated and etched. A hybrid composite resin was bonded on dentin surfaces using a single-component adhesive system. Longitudinal sections were exposed to 5 N HCl then to 1% NaOCl. The thickness of the hybrid layer and the dimensions of the resin tags were measured using scanning electron microscopy (SEM) pictures and an image analysis software. RESULTS: When acid etching was performed, a hybrid layer as well as the characteristic funnel-shaped resin tags were observed. When Er:YAG laser was used alone, no hybrid layer could be detected. The resin tags appeared thinner and exhibited a cylindrical shape. CONCLUSIONS: The acid pre-treatment of the irradiated surface allowed both the seal of the dentinal surface and the increase of the diameter of the resin tags.     

Tensile bond strength of a flowable composite resin to ER:YAG-laser-treated dentin

BACKGROUND AND OBJECTIVES: This in vitro study evaluated the influence of a flowable composite resin (FCR) on the tensile bond strength of resin to dentin treated with the Er:YAG Laser (L) and diamond bur (DB). STUDY DESIGN/MATERIALS AND METHODS: Ninety dentin surfaces obtained from 45 third molars were ground and randomly divided into six groups (n = 15): G1-DB, G2-DB+FCR, G3-L (100 mJ, 10 Hz, 37.04 J/cm2), G4-L (100 mJ, 10 Hz, 37.04 J/cm2)+FCR, G5-L (250 mJ, 2 Hz, 92.60 J/cm2), and G6-L (250 mJ, 2 Hz, 92.60 J/cm2)+FCR. After surface etching with 37% phosphoric acid and the application of an adhesive system, inverted conical specimens were prepared with a hybrid composite resin. In groups G2, G4, and G6 a FCR was placed before the hybrid composite resin. After 24 hours-storage in distilled water, the tensile test was performed in a universal testing machine (0.5 mm/minute, 500 N). RESULTS: Data were submitted to Kruskal Wallis test (P = 0.01). The mean bond strength values (MPa+/-SD) were: G1-13.54 (+/-2.99), G2-14.67 (+/-2.32), G3-9.49 (+/-3.09), G4-14.60 (+/-2.76), G5-8.97 (+/-3.89), and G6-13.02 (+/-2.18). Groups G1 and G2 presented the highest bond strength values, which were statistically similar to those of G4 and G6. The groups treated with laser and without the FCR (G3 and G5) showed the lowest shear bond strength values. CONCLUSIONS: FCR can increase the adhesion to dentin treated with Er:YAG laser within different parameters.     

Ablation of composite resins using Er:YAG laser--comparison with enamel and dentin

OBJECTIVES: The purpose of this work is to investigate comparative ablation rate between composite resins and dental hard tissues (enamel and dentin) after Er:YAG laser irradiation to verify possible development of an ultra-conservative dentistry to with minimum effect for the teeth tissue. METHODS: We have used 11 extracted or exfoliated primary anterior and posterior teeth and six extracted permanent molar teeth. Three different types of composite resin were chosen (microfiller, hybrid, and condensable) in terms of chemical and structural composition. Composite tablets and the teeth were irradiated with a Er:YAG laser at different laser beam energy level per pulse (100, 200, 300, and 400 mJ). Diameter and depth of each resulted microcavity were measured and the material removed volumes were calculated. The resulted values were plotted and fitted to allow a comparative observation of the material removed as a function of energy level per pulse. RESULTS: While the idea of ultra-conservative dentistry seems to apply well for enamel of primary and permanent teeth, at the present stage it does not apply well for primary or permanent dentin. For dentin, the composition and content of water makes the Er:YAG laser ablation equal or superior in rate compared with the three used resins. SIGNIFICANCE: This work presents of a comparative study of Er:YAG laser ablation, allowing to analyze the possible selective ablation between composite resin placed and cured and dental hard tissues, with the goal to propose a new clinical technique: differential ablation for composite resin restorations using Er:YAG laser.     

过氧化脲漂白剂对釉质粘结强度的影响

目的：评价不同载体、不同浓度过氧化脲（Car bami de Per oxi de,CP）漂白剂对粘结釉质强度的影响。方法：60颗离体磨牙随机分为7组。1～6组颊舌面分别用以卡波姆（Carbopol）、聚乙烯吡咯烷酮（PVP）、泊洛沙姆（Pol oxamer）为增稠载体的含100g/L CP、200g/L CP的漂白剂在37℃、100%湿度条件下每天漂白8h,其中部分样本再浸入10%的抗坏血酸钠凝胶中3h,持续2周后即刻粘结树脂或延迟2周粘结。7组为对照组。准备界面为1mm×1mm的条形试件。通过微拉伸法测试釉质粘结强度,对不同类型的断面进行扫描电镜（scanni ng el ect i on mi croscope,SEM）观察。利用Spss11.0软件通过双因素方差分析（Two-way anal ysi s of var i ance）和SNK-q检验对其微拉伸粘结强度（iM cr ot ensi l e bond st r engt h,MTBS）进行统计分析。结果：各实验组2周漂白后即刻粘结,釉质粘结强度明显低于对照组（P〈0.05）;10%CP漂白同时抗氧化治疗或延迟粘结,釉质的粘结强度和对照组没有明显差异（P〉0.05）;20%CP漂白同时抗氧化治疗或延迟粘结,可明显提高釉质的粘结强度（P〈0.05）,但和对照组仍有显著差异（P〈0.05）。同种载体下,经10%CP漂白后的釉质粘结强度高于20%CP漂白组（P〈0.05）。同种浓度下,不同增稠载体组间的粘结强度没有显著差异（P〉0.05）。结论：漂白后即刻粘结,釉质的粘结强度随CP浓度的增高而下降;延迟2周粘结或抗氧化治疗可从一定程度上提高釉质的粘结强度,缩短漂白后粘结的时间;增稠载体对釉质的粘结强度没有显著影响。     

Er:YAG laser cavity preparation and composite resin bonding with a single-component adhesive system: relationship between shear bond strength and microleakage

BACKGROUND AND OBJECTIVES: The purpose of this study was to assess the performances of a single-component adhesive system when an Er:YAG laser was used to prepare cavities. STUDY DESIGN/MATERIALS AND METHODS: Shear bond strength tests were performed on composite rods bonded with a single-component adhesive system to dentin surfaces prepared using either bur+acid, Er:YAG laser (fluence = 44 J/cm2), or Er:YAG laser+acid. Class V cavities were prepared differently according to the molar surface: buccal surfaces were prepared using a diamond bur, and lingual surfaces using the Er:YAG laser. In group 1, cavity walls were not acid treated after Er:YAG laser preparation. In group 2, only the enamel walls were acid treated. In group 3, all the enamel and dentin walls were acid treated. Microleakage was assessed using a methylene blue dye penetration method. RESULTS: Bond strength values did not differ significantly between the three groups (P = 0.162). Better marginal adaptation was obtained between the composite resin and cavity walls when Er:YAG laser preparation was followed by a total acid etching (P = 0.008). CONCLUSIONS: Our results supported the use of single-component adhesive systems in cavities prepared using Er:YAG laser. The step of acid etching must be maintained for the whole cavity walls in regard of the microleakage values.     

不同表面处理方式在复合树脂再修复技术中的对比研究

目的:探讨酸蚀-冲洗、一步法、两步法自酸蚀粘结以及硅烷偶联剂结合以上三种粘结技术对3MZ350老化复合树脂再修复粘结强度的影响,为临床应用提供参考。方法:制作50个树脂条样本,抽取7个为空白对照组不做任何处理,剩余随机分成六个实验组,并进行表面粘结处理,(N=6,n=7)。对完成的试件进行微拉伸检测,并做统计学分析。扫描电镜观察实验组试件表面处理后的粘结面形态。结果:实验组中,硅烷偶联剂+二步法自酸蚀的粘结强度最大(58.73±0.12)MPa,酸蚀-冲洗的粘结强度最小(45.22±0.45)MPa。实验组与对照组比较有统计学意义(P0.05)。结论:硅烷偶联剂联合二步法自酸蚀的粘结强度最大,有利于临床老化复合树脂再修复技术的利用。