嵌体修复体的微漏分析

目的:用热循环法对IPS-EmpressII热压铸瓷嵌体、Brilliant树脂嵌体与金合金嵌体边缘微漏的情况作比较。方法:实验中50个完整离体后磨牙浸泡在生理盐水中三周,每个牙被预备为邻洞型,20个无洞斜面,30个有洞斜面。样品被随机分为5组,第1组为瓷嵌体(IPS-EmpressII)用VariolinkII 粘结系统粘结,第2组为树脂嵌体(Coltene Brillant composites) 光/热聚合处理,用One Coat Bond , Duo Cement粘结。第3, 4, 5组为金合金嵌体(Argenco 50 typeIV),分别用松风羧酸水门汀粘固(HY-Bond Polycaboxylate)、松风玻璃离子水门汀粘固(HY-Bond Glasionomer CX)、登士柏(Poly-F)磷酸锌水门汀粘固。对样本作8℃-60℃300次冷热循环后,样品放在0.5%碱性品红中37℃水中恒温24小时,所有样品用金刚砂片沿嵌体长轴作对称性片切,切缘通过修复体近远中中心。在2 × 15倍立体显微镜下对染色深度作测定,统计学用方差分析法,作F 检验和q检验。结果:第1组与第3、4组 之间差异无显著性,第1、2组之间差异有显著性,第2、5组与第3、4组之间差异有显著性。结论:热循环处理IPS-EmpressII瓷嵌体的微漏值最小,树脂组的微漏值大于瓷嵌体组及金嵌体。金合金用松风玻璃离子和松风羧酸锌水门汀粘结微漏值比用登士柏Poly-F磷酸锌水门汀粘结微漏值小。     

CAD／CAM制作陶瓷嵌体的三年临床评价

采用计算机辅助设计／计算机辅助制作系统制作陶疱嵌体修复磨牙牙体缺损，通过三年来对２１例修复体的临床观察均未发现继发龋，病人对修复体的颜色匹配，耐磨性等方面较为满意。临床成功率为７６．２０％。但也发现有５例嵌体拆裂及２例嵌体边缘与牙齿窝洞壁之间出现明显缝隙，其主要原因是嵌体厚度不足，粘固剂选择不当。     

嵌体的临床应用

５０年代在口腔修复临床上,嵌体是与金属全冠、部分冠共同被选作牙体修复的修复体或牙列固定桥修复的固位体,那时作嵌体的材料基本是用金合金。６０年代由于黄金控制供应,就采用不多了。８０年代前后开始应用软质钴铬合金为材料作嵌体,质量不够理想,但也勉强能用。９０年代由于对银汞合金含汞的责难,以及人民生活水平的提高,科学的进步,并采用计算机辅助设计和计算机辅助制作（ＣＡＤ／ＣＡＭ）金属和瓷嵌体,又有条件作一些金合金嵌体了。在笔者所经历的目前仍能随访到的２５件嵌体中,有２件嵌体脱落,１件牙冠折断,均为钴铬合金…     

嵌体修复牙体组织缺损过程中的护理

用银汞合金修复牙体缺损由来已久,但由于其性能的限制,对于修复后牙严重缺损者,仍存在一些不足,如牙体或修复体易折裂、边缘易出现继发龋等。嵌体是一种嵌入牙体内部,用以恢复牙体形态和功能的修复体。用嵌体修复后牙邻牙合面洞,由于嵌体为整体铸造完成的修复体,本身折裂几乎不可能;另外,具有良好的边缘封闭性和咬合接触关系,还可免除汞污染,近年在牙体组织缺损修复中得到越来越广泛的应用。嵌体的制作包括以下几个步骤:医生根据嵌体的适应证选择患牙,进行基牙预备、取模、倒模,嵌体的技工制作、试戴,黏结。在这几个步骤中,除了嵌体的技工制…     

新塑钢嵌体修复后牙缺损的临床应用

新塑钢嵌体修复后牙缺损的临床应用何玉林，陈必胜上海第二军医大学长征医院（２００００３）由于美学因素、汞对牙科人员的毒性和对环境的污染，学者们一直在寻找银汞合金充填物的替代材料。复合树脂由于其美观效果而被用于后牙修复。但复合树脂材料也有一些缺陷，如边缘...     

前牙树脂嵌体的应用及近期疗效观察

笔者采用一种操作较简便、不需复杂设备的复合树脂嵌体间接修复法 ,对前牙牙体缺损的病例进行了治疗 ,临床效果良好。　　一、材料与方法1.病例选择 :前牙牙体缺损 16例 19颗。均为固位不良不宜采用光固化树脂充填或充填后治疗失败者 ;累及前牙切角、切缘、边缘嵴等部位的较大牙体缺损未伤及牙髓 ,患者拒绝采用附加钉固位或近髓而无法采用钉固位 ,因此难以用充填法恢复者 ;前牙牙体较薄 ,尤其是切缘咬合紧 ,难以制备出冠空间 ,无法采用冠修复者。2 .材料 :ＤｙｒａｃｔＡＰ复合材料 ,Ｊｅｌｔｒａｔｅ藻酸盐印模材料 ,ＳｕｐｅｒｂｏｎｄＣ…     

浅谈嵌体和高嵌体修复的临床应用

全冠修复是后牙牙体缺损最常见的修复方式之一,然而全冠修复由于备牙量大,对患牙抗折性存在潜在影响.随着粘接技术和微创修复的发展,嵌体和高嵌体可以大大减少牙体预备量,有效保存残留牙体组织,已逐渐成为后牙牙体缺损修复的主流形式,得到越来越广泛的应用.本文就嵌体和高嵌体修复的材料、适应证、修复效果、预备要点及粘接等各方面作一讨...     

复合树脂嵌体在儿童恒牙应用的临床初步观察

探讨复合树脂嵌体技术在儿童恒牙牙体修复中的应用价值。方法用间接法对５６颗大面积缺损的恒磨牙和双尖牙进行复合树脂嵌体修复,追踪观察６个月－１年。用改良ＵＳＰＨＳ标准临床评价。结果修复固们率为９６．４％,边缘密合性及色泽协调性较好,牙髓状况良好,与修复相关的牙龈指数略有增加。     

铸造嵌体部分冠修复后牙牙体缺损

对后牙牙体大面积缺损,如果用全冠修复,切割牙体组织过多,设计采用铸造嵌体部分冠修复,可尽可能地保存残留牙体组织,修复效果满意．铸造嵌体部分冠要求覆盖包括牙冠面在内的２～４个牙面,利用针道辅助固位．此种修复体切割牙体组织较少,固位效果好,可根据患牙具体灵活设计。     

金合金嵌体在磨牙牙体缺损修复中的临床应用

选择2008年1月至2012年12月在本诊所就诊患者102例,共130颗磨牙（第一磨牙83颗,第二磨牙47颗）。其中男性42例,女性60例,年龄2l-64岁,平均43岁。     

聚合瓷嵌体在后牙牙体缺损修复中的临床应用

［摘要］ 目的 探讨聚合瓷材料在嵌体修复中的临床应用。方法 选择58例患者的86颗牙体缺损后牙进行聚合瓷嵌体修复,在术后第1天、6个月、1年、3年,参考美国加州牙科协会制定的标准,对其临床效果进行观察。结果 86颗聚合瓷嵌体在修复完成后第1天到6个月五项评价指标均达到A 级,成功率为100%;1年观察边缘完整性1例达到B级,成功率为97.6%;3年观察边缘完整性、牙髓状况1例达到C级,成功率为97.6%。结论 聚合瓷材料适用于后牙牙体缺损嵌体修复。     

4种嵌体制作材料边缘微渗漏的对比研究

目的 通过对4种材料嵌体粘结后边缘微渗漏及嵌体密合度的分析,为临床嵌体材料的应用提供有关依据。方法 选择40颗上颌第一前磨牙制备成远中嵌体,随机分为4组,每组10颗牙,分别制成树脂、水晶瓷、铸瓷和银钯嵌体,Pana-via F Kuraray树脂黏结剂黏结,体视显微镜观测微渗漏值,并行嵌体与牙体间间隙测量。结果 微渗漏值从低到高顺序为水晶瓷嵌体、复合树脂嵌体、银钯合金嵌体、铸瓷嵌体。水晶瓷嵌体和树脂嵌体间微渗漏结果无差异(P>0.05),两者与银钯合金及铸瓷嵌体间微渗漏值差异有统计学意义,银钯合金嵌体与铸瓷嵌体间微渗漏值差异亦有统计学意义。4组嵌体与牙体间间隙值顺序从低到高为水晶瓷嵌体、复合树脂嵌体、银钯合金嵌体、铸瓷嵌体。水晶瓷、树脂和银钯合金嵌体三组间密合度无差异,铸瓷组与前三组差异有统计学意义。结论 嵌体边缘微渗漏与嵌体材料有一定关系,嵌体与牙体间的密合度是影响嵌体边缘微渗漏的重要因素。     

Clinical tips for improved composite resin inlays

Indirect composite inlays have been used in clinical dentistry for many years. While there are more durable methods of restoring posterior teeth, these materials meet an esthetic need for some patients. To ensure the longest possible longevity, the operator must employ a meticulous clinical technique. These steps have been discussed above and, if followed, will help lead to a successful esthetic restoration.     

Marginal seal of composite inlays using different polymerization techniques

summary The effect of indirect and semi-direct curing systems of Cl II composite inlays on microleakage was investigated in vitro and compared to conventional direct posterior composite restorations. Nearly identical Cl II cavities were restored with the same composite resin using different polymerization systems. Microleakage assessment was carried out after cyclic loading and thermal stressing by assessing the dye penetration. The data showed that all inlay techniques resulted in improved marginal sealing compared with conventional restorations. However, the indirect procedure resulted in significantly reduced microleakage compared to the semi-direct inlay techniques.     

复合树脂嵌体修复磨牙缺损的临床疗效观察

目的观察复合树脂嵌体修复磨牙缺损的临床疗效。方法选择163例磨牙缺损患者的200颗患牙，将其分为2组，每组患牙100颗。分别采用直接法复合树脂嵌体和复合树脂直接充填修复患牙。于修复完成6个月和5年复诊。采用美国公共卫生署修复体临床评价标准对患者口内充填体进行疗效评价。结果修复后6个月，嵌体修复成功率为91．8％（90／98），树脂直接充填成功率为91．8％（89／97），经Х^2检验两者临床疗效差异无统计学意义（P〉0．05）。修复后5年，嵌体修复成功率为87．9％（80／91），树脂直接充填修复成功率为67．4％（60／89），Х^2检验显示嵌体的临床疗效优于树脂直接充填，差异有统计学意义（P〈0．05）。结论复合树脂嵌体修复磨牙缺损临床疗效良好，其长期临床疗效显著优于传统复合树脂直接充填。     

间接树脂嵌体与瓷嵌体三年应用比较

目的:比较树脂嵌体及瓷嵌体用于修复后牙缺损的临床治疗效果.方法:选择中老年患者,临床完成Ceramage树脂嵌体50个,Vita mark II瓷嵌体46个,术后即刻、1年及3年,参考美国公共健康会(USPHS)标准,对其临床效果进行观察.结果:2种嵌体在边缘着色、边缘密合度及继发龋发生等方面差异无统计学意义(P>0....     

Microleakage of different cementation techniques in Class V ceramic inlays

Microleakage between the restorative materials and the cavity walls of teeth remains a problem. The purpose of this study was to evaluate the microleakage around Class V ceramic inlay restoration using three different cementation techniques. Class V preparations were made on the buccal surfaces of 45 freshly extracted premolar teeth. The teeth were randomly divided into three groups of 15. In the first group, dentine bonding agent (DBA) (Clearfil Liner Bond 2V) was applied immediately after the tooth preparation (D-DBA). In the second group, DBA was applied to the prepared cavities while luting ceramic inlays (I-DBA). In the third group, DBA was not applied at either stage (No-DBA). Impressions were made and ceramic inlays (Ceramco II) fabricated and cemented in the Class V cavities. The restorations were stored in water at room temperature for 24 h. All restorations were thermocycled and then subjected to a dye penetration test. After sectioning, leakage at cavity/restoration interface was scored. Statistical analysis was performed using Kruskal-Wallis, Mann-Whitney U and Wilcoxon's signed tests. Results showed no significant difference among three different cementation techniques (P > 0.05). Microleakage at the dentine margins was greater than that at the enamel margins (P < 0.05).     

Influence of ultrasound application on inlays luting with self-adhesive resin cements

The study was aimed at assessing the influence of the cement manipulation and ultrasounds application on the bonding potential of self-adhesive resin cements to dentin by microtensile bond strength testing and microscopic observations of the interface. Fifty-six standardized mesio-occlusal class II cavities were prepared in extracted third molars. Class II inlays were made using the nano-hybrid resin composite Gradia Forte (GC Corp, Tokyo, Japan), following the manufacturer??s instruction. The sample was randomly divided into two groups (n?=?28) according to the luting technique. Half of the specimens were luted under a static seating pressure (P), while the other ones were cemented under vibration (V). The inlays were luted using the following self-adhesive resin cements: G-Cem (G, GC Corp., Tokyo, Japan) Automix (GA) and Capsule (GC); RelyX Unicem (RU, 3?M ESPE, Seefeld, Germany) Clicker (RUC) and Aplicap (RUA). Microtensile sticks and specimens for scanning electron microscope (SEM) observations were obtained from the luted teeth. The interfacial strengths measured for the cements under static pressure or ultrasonic vibration were [median (interquartile range)]: GC/V 4 (2.3?C7.9); GC/P 6.8 (4.1?C10.1); GA/V 3 (1.9?C6.7); GA/P 1.9 (0?C5.1); RUC/V 6.6 (4.6?C9.8); RUC/P 4.1 (1.8?C6.4); RUA/V 6.2 (2.4?C10.4); RUA/P 3.4 (0?C5.4). The cement formulation influenced dentin bond strength of G. RU bond strength was affected by the luting technique. SEM analysis revealed a homogeneous structure and reduced porosities for both cements as a result of ultrasonic vibration. RU benefited from the application of ultrasounds, while GC achieved higher bond strengths than GA.     

Effect of different luting procedures on the seating of ceramic inlays

This in vitro study evaluated the effect of different luting procedures on the proper seating of ceramic inlays and on the marginal seal through microleakage testing. Sixty mesial-, occlusal-, distal- (MOD) cavities were prepared in third molars, and distributed among four groups. In the control group 1, the cavity surface was treated with dentin and enamel bonding agents; ceramic inlays were placed into the cavity and light cured. In group 2, the dentin and enamel bonding agents were cured prior to the placing of the inlays, and following the insertion. In group 3, the inlays were luted without enamel bonding. In group 4, the inlays were cemented using a one-bottle bonding and two times light curing. The groups with only one time light curing at the end of the luting process exhibited the smallest luting space following cementation. The smallest dye penetration values were obtained for the two groups with separate light curing of the dentin bonding agent. Reducing the film thickness of polymerized dentin bonding agents, i.e. by changing the composition of the bonding agents, could facilitate proper seating of ceramic inlays together with a better marginal seal.