试色糊剂和黏结剂对瓷贴面修复体颜色影响的一致性研究

目的 观察试色糊剂和相应色号树脂黏结剂对IPS e.max瓷贴面修复体最终颜色的影响及影响的一致性.方法 叠加IPS e.max热压铸瓷片和复合树脂块模拟瓷贴面覆盖预备后的基牙.在瓷试样和树脂试样之间分别加入试色糊剂和树脂黏结剂(TR、B0.5、A1、A3和WO色)形成试样复合体.使用分光光谱仪测量复合体颜色,并分别用...     

E-max和IPS-EMPRESS Ⅱ全瓷贴面对变色牙颜色改善的研究

目的:观察对比E-max和IPS-EMPRESSS Ⅱ两种全瓷贴面对变色牙颜色改善的修复效果,为临床应用提供参考。方法:对36颗变色上前牙分别采用E-max和IPS—EMPRESS Ⅱ全瓷贴面修复。用Shade-Eye-NCC电脑比色仪分别测定修复前牙齿、贴面就位(无试色糊剂)和试粘接(分别用WOT和Tro试色糊剂)及最后粘接后两种修复体唇侧的中1/3处的L*、a*、b*值,根据色差公式△E=[(△L*)2+(△a*)2+(△b*)2]1/2,对比两种瓷贴面对变色牙的修复效果,为临床应用提供参考。结果:IPS-EMPRESSSⅡ全瓷贴面粘接后与牙体预备前的色差值为7.9960,粘接后与试戴(无试色糊剂)的色差值为2.3906,粘接后与试戴(有试色糊剂)的色差值为1.6578。E-max全瓷贴面粘接后与牙体预备前的色差值为8.2428,粘接后与试戴(无试色糊剂)的色差值为1.4638,粘接后与试戴(有试色糊剂)的色差值为1.2596。两组全瓷贴面试戴后(无试色糊剂)、试粘接(有试色糊剂)、粘接后与基牙牙体预备前△E*在统计学上差异有显著性,两组全瓷贴面修复前后的的L*、a*、b*值之间有统计学差异,修复后的L*增大,a*、b*值减少。试粘接后L*值和b*值增大,a*值减少。修复后的L*、a*、b*值与贴面自身相比存在差异,修复后的L*值偏小,a*、b*值偏大。两组瓷贴面在采用WOT糊剂粘接后L*值、b*值最大,与Trt组比,差异均有统计学意义。结论:E-max全瓷贴面比IPS-EMPRESSSⅡ全瓷贴面更有效改善变色牙的颜色,IPS-EMPRESSSⅡ全瓷贴面粘接后较试戴(无试色糊剂)明亮度降低比E-max瓷贴面明显。     

铸瓷贴面厚度对修复体颜色匹配性的影响

目的:分析瓷材料厚度变化对瓷贴面修复体颜色匹配性的影响。方法:选用36颗树脂人工牙按临床要求进行贴面牙体预备。制作二硅酸锂热压铸陶瓷贴面(HT和LT瓷块),按修复体中1/3的厚度分为0.50 mm、0.75 mm和1.00 mm组(n=6)。使用树脂粘接剂将瓷贴面粘接于预备后的树脂人工牙上。比色仪测量瓷贴面试样颈部、中部和切端区域的色度参数。计算瓷贴面试样与A2色标(Vita Classical比色板)的色差值△E。结果:3种厚度瓷贴面修复体与A2色标的色差值范围2.17~6.60,其中0.75 mm和1.0 mm组HT瓷贴面试样在颈部和中部与A2色标的色差值小于3.3。双因素方差分析表明瓷材料厚度和测色部位显著影响瓷贴面试样与A2色标的色差值(P< 0.001)。结论:瓷材料厚度变化影响瓷贴面修复体的颜色参数。随瓷材料厚度增加,LT瓷贴面亮度降低色彩饱和度增加,而HT瓷贴面亮度增加色彩饱和度降低。     

树脂粘接剂色调对牙体瓷贴面美学效果的影响

目的 比较树脂粘接剂与同色调试色糊剂颜色效果的一致性,评价树脂粘接剂色调对牙体瓷贴面美学效果的影响,以期为临床提供参考.方法 选用48颗树脂右上颌中切牙,用随机化数字表随机分为8组(每组6颗),模拟临床贴面牙体预备.制作二硅酸锂压铸陶瓷贴面,分别使用8种色调(LV-3、LV-2、MV、HV+2、HV+3、WO、TR、A3色)试色糊剂试色,并用同色调树脂粘接剂粘接于树脂牙上.使用比色仪测量瓷贴面粘接前、试色时及粘接后的色度参数,并计算粘接前后贴面色差值(△E1)和试色时与粘接后贴面色差值(△E2).结果 8种色调树脂粘接剂△E1范围为0.93～ 6.79,其中LV-3、HV+3和WO色调树脂粘接剂△E1分别为3.31、4.90和6.79.除HV+3色调树脂粘接剂△E2为3.65外,其余色调树脂粘接剂粘接后与试色时的瓷贴面色差值在0.72～ 1.79之间.结论 LV-3、HV+3和WO色调树脂粘接剂能改变贴面的最终颜色.除HV+3色调外,其余色调树脂粘接剂与同色调试色糊剂对瓷贴面颜色的影响有较好的一致性.     

试色糊剂对Ips-empress Ⅱ全瓷贴面颜色的影响

目的：观察试色糊剂对全瓷贴面颜色的影响.方法：收集临床上严重变色或缺损的上前牙50颗,行全瓷贴面修复（Ips-empressⅡ全瓷系统制作）.贴面粘结前由同一实验人员用试色糊剂试色,将全瓷贴面就位后未涂试色糊剂时作为对照组,用电脑比色仪测定其及5种试色糊剂[A1、A3、Transluent（Trt）、White opaque（WOT）和B0.50paque（B0.5）]试色后的L＊、a＊、b＊值,用卡尺测量被测点的瓷层厚度,根据公式△Ea＊b＊=（△L＊2＋△a＊2＋△b＊2）1/2、Cab=（a＊2＋b＊2）1/2、Hab=arctan（b＊/a＊）计算每种糊剂试色后的色差及Cab、Hab值,采用单因素方差分析比较色差值（△Ea＊b＊）和L＊、Cab、Hab值的变化.结果：50例全瓷贴面被测点的平均瓷层厚度为1.088mm,用5种试色糊剂试色后,与对照组之间的色差大小依次为WOT、B0.5、A3、A1、Trt,WOT糊剂和B0.5糊剂引起的色差分别为2.371NBS和1.842NBS,临床上肉眼可以识别,主要表现为L＊值和Cab值增大（P＜0.05）.其余3种糊剂引起的色差不明显,其间均无统计学差异（P＞0.05）.结论：试色糊剂有遮色作用,且对黏结剂的选择具有一定指导意义.对变色严重的基牙,可以选用遮色性能较强的WOT或B0.5黏结剂,以削弱基牙颜色对贴面颜色的影响;对变色不严重或无需遮色的基牙,可以酌情选用其他3种黏结剂进行粘结.     

粘接剂与基牙颜色对三种CAD/CAM全瓷贴面颜色的影响

目的 评价全瓷修复体材料、基牙颜色及粘接剂对CAD/CAM椅旁系统修复体色泽的影响.方法 选择三种CAD/CAM椅旁全瓷修复材料：IPS Empress CAD、IPS E.max CAD和Cerec Blocs.每种材料各制备出厚度为（0.8±0.02）mm的试样18片,随机分为3组,以聚四氟乙烯为模板,制作15mm×13mm×2mm的3种颜色的基牙树脂试件,分别采用2种颜色（Transparent与Bleach）的粘接剂粘接瓷片与基牙树脂,每组3片,静压2min,光照20s,使用台式分光亮度仪测量三种全瓷材料的透光度,比较粘接前后修复体的L＊、a＊、b＊值,并计算粘接前后的色差△E.结果 不管基牙颜色或瓷片种类如何,透明色粘接剂组粘接前后的色差△E皆显著大于漂白色粘接剂组.Cerec Blocs组粘接前后的色差最大,E.max组的色差最小,而Empress则介于两者之间.结论 三种全瓷材料中,Empress的透光度最佳,Cerec Blocs陶瓷材料更易受基牙颜色与粘接剂的影响.透明色粘接剂对基牙树脂与瓷贴面复合体的颜色影响大于漂白色粘接剂.     

陶瓷材料对瓷贴面颜色的影响

目的研究两类三种陶瓷材料对瓷贴面修复颜色的影响,为临床工作中瓷贴面修复体与比色板的颜色匹配性提供指导。方法制作直径10mm、厚度0.7mm的A2色瓷贴面圆盘试件,按陶瓷材料及制作工艺分为无遮色长石质烤瓷组、遮色长石质烤瓷组、IPSe.maxPress铸瓷组3组。每组10个试件,共计30个试件。选择Natural Die Material Shade Guide比色板中的ND4、ND6、ND8三种颜色,分别代表轻、中、重度变色牙底色,采用对应颜色树脂各制作1个底色圆盘。对每个瓷贴面试件分别以3种底色圆盘为基牙底色,采用Vita Easyshade电脑比色仪测量瓷贴面修复体的色度值。计算各组瓷贴面修复体与标准比色片A2的色差。结果在轻、中、重度变色牙背景条件下,两种陶瓷材料的瓷贴面修复体与标准比色片A2间色差的比较结果为,IPS e.max Press铸瓷组<无遮色长石质烤瓷组<遮色长石质烤瓷组,差异有统计学意义(P<0.05)。结论采用长石质烤瓷贴面及IPS e.max Press热压铸瓷贴面模拟修复不同程度的变色牙时,热压铸瓷贴面与标准比色片的颜色匹配性高于长石质烤瓷贴面。     

核瓷和体瓷厚度对IPS e.max全瓷修复体颜色的影响

目的:研究核瓷与体瓷的瓷层厚度对IPS e.max全瓷修复体颜色的影响。方法:制作不同核瓷与体瓷厚度的IPS e.max圆盘形试件,按核瓷厚度(mm)将试件分为0.8、1.0、1.5 3大组。用ShadeEye NCC比色仪测量各试件的颜色参数,并计算各核瓷厚度组内堆塑不同厚度体瓷后试件之间的色差(△E)。结果:L*值随瓷层的总厚度增加而降低,a*值和b*值随总厚度增加而增加。体瓷厚度变化对L*、a*、b*值均有显著影响(P<0.001);核瓷厚度变化对L*、b*值有显著影响(P<0.001);核瓷与体瓷的相互作用对L*值有显著影响(P<0.001)。0.8 mm核瓷组内各试件之间的△E全部大于2.0;1.0 mm核瓷组内堆塑0.2 mm体瓷与1.0 mm体瓷试件之间的△E大于2.0;其余试件之间△E均小于2.0。结论:IPS e.max核瓷与体瓷厚度以及这2个瓷层的相互作用均能对颜色参数产生显著影响;修复体的核瓷厚度越大,堆塑体瓷后不同部位的颜色差异越小。     

Rely XTM Veneer试色糊剂遮色性的临床评价

目的:观察Rely XTM Veneer试色糊剂的遮色性.方法:100颗变色的上前牙,其中50颗全瓷冠修复、50颗全瓷贴面修复(均为Ips-empress Ⅱ系统制作).粘接前用试色糊剂[A1、A3、Transluent(Trt)、White opaque(WOT)和B0.5 opaque(B0.5)]代替粘接剂对基牙进行遮色,遮色后用ShadeEye-NCC电脑比色仪测定修复体的L*、a*、b*值,并记录测点的瓷层厚度.数据采用SAS6.12软件处理,根据公式色AE=[(△L*)2 (△a*)2 (△b*)2]1/2、L=L*、C=[(a*)2 (b*)2]1/2、H=arctan(b*/a2)计算并分析每种糊剂试色后的△E、L、C和H.,单因素方差分析全冠和贴面组的△E、L、C和H.结果:全瓷冠采用5种试色糊剂遮色后,WOT组的色差最大,与A1、A3、Trt、B0.5组之间有统计学差异(P＜0.05);全瓷贴面采用5种试色糊剂遮色后,WOT组的色差最大,B0.5组次之,WOT组和与A1、A3、Trt组之间有统计学差异(P＜0.05);贴面组与全冠组的色差间有统计学差异(P＜0.05).结论:WOT糊剂的遮色性最强,B0.5糊剂次之,其余3种糊剂的遮色性较为接近;瓷层厚度影响粘接剂的遮色效果.     

瓷层厚度对IPS e.maxR全瓷修复体颜色的影响

目的:研究不同核瓷和牙本质瓷厚度对IPS e.max全瓷修复体颜色和半透明性的影响.方法:制作不同厚度(0.30、0.60、0.90 mm)的IPS e.max Press MO1 核瓷瓷片,在不同厚度的核瓷表面堆塑不同厚度(0.30、0.60、0.90 mm)的IPS e.max Ceram A2牙本质瓷,用CM-700d分光测色计分别测量每种厚度的颜色参数L*a*b*值,计算TP值和相邻两组之间的色差(ΔE).结果:在白背景下,随着瓷层厚度的增加,L*值呈下降趋势,各厚度组之间差异有统计学意义(P＜0.01);核瓷厚度不变时,a*值呈上升趋势,各厚度组之间有统计学差异(P＜0.01);C3和C9组的b*值随着牙本质瓷厚度的增加而增加,C6组中以D6组的b*值最高,各厚度组之间差异有统计学意义(P＜0.01).TP值随着瓷层厚度的增加而显著降低,各厚度组之间均有统计学差异(P＜0.01).随着瓷层厚度的增加,相邻两组之间的色差(ΔE)呈减小趋势.结论:核瓷和牙本质瓷厚度对IPS e.max全瓷修复体颜色和半透明性有显著影响.     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形     

口底癌34例临床分析

目的探讨口底癌的临床特性、治疗方法及预后。方法对我院自1992—2002年住院治疗的34例口底癌患者进行回顾性分析。结果34例口底癌患者中,男28例(82.4%),女6例(17.6%),男女比为4.7∶1,平均发病年龄58岁。发病部位:前口底22例(64.7%),后口底12例(35.3%)。淋巴结转移率41.2%。单纯手术组、化疗加手术组、放疗加手术组、化疗加手术加放疗组的5年生存率分别为45.5%、60.0%、50.0%、62.5%。结论口底癌以中老年患者好发,男性居多。易发生淋巴结转移,综合疗法疗效较好。