树脂印章法与分层充填技术充填后边缘微渗漏的研究

目的比较树脂印章法美学修复充填与树脂分层充填术后边缘微渗漏的情况。方法选取符合纳入标准的40颗磨牙,于牙合面统一制备深达釉牙本质界以下约1 mm的Ⅰ类洞。随机分成A组20例和B组20例,A组采用印章充填技术进行后牙牙合面美学树脂充填,B组采用树脂分层充填并雕刻牙合面形态。两组充填样本经冷热循环实验后,分别置于2%亚甲基蓝溶液浸泡24 h,干燥后沿样本充填体正中颊舌向剖开,于体视显微镜下观察样本染料渗入情况,评价微渗漏程度,并进行统计学分析。结果染料渗入结果表明:A组(印章充填组)与B组(分层充填组)微渗漏程度差异具有统计学意义(P<0.05),印章组微渗漏低于分层充填组。结论印章法树脂充填术在保证相对美观的同时,可达到更好的边缘封闭,具有临床实用性。     

SonicFill声波树脂直接和间接法修复后牙Ⅱ类洞的微渗漏表现

目的:探讨SonicFill声波树脂通过直接充填技术或树脂嵌体技术修复人离体后牙的Ⅱ类洞,比较两种修复方法边缘微渗漏的差异.方法:收集50颗人离体前磨牙制备标准的Ⅱ类洞型腔,随机分成两组,每组25颗.A组使用SonicFill声波树脂直接充填修复,B组使用SonicFill声波树脂制作树脂嵌体进行修复.通过温度循环后每组随机选取5个样本进行扫描电镜观察,剩余样本用品红染色后在体式显微镜下观察牙合缘和龈缘的染色情况,测量染料渗透深度并分级.结果:扫描电镜下观察到两组修复体与牙体组织均结合良好,但均观察到少量间隙的出现,A组的间隙范围要大于B组;在牙合缘处,B组染料渗透深度低于A组(P<0.05);而在龈缘处两组间染色深度比较差异无统计学意义(P>0.05).结论:本研究结果表明,使用SonicFill声波树脂进行间接法修复比直接充填法获得较好的微渗漏表现.     

四种复合树脂材料与牙体间边缘密合度的研究

目的:对Poss复合树脂及其余3种临床常用复合树脂材料与牙体间边缘密合度比较分析,为临床上更好地选择充填材料提供依据。方法:将40颗离体牙随机分成4组,每组10颗牙,按照国际标准备V类洞,分别用Poss复合树脂,3M Z350复合树脂,Durafill复合树脂,Charisma复合树脂充填牙体,恒温保存,品红染色后,近远中方向剖开牙体,扫描电镜下测量每组充填体与牙体间的边缘密合度。结果:Poss复合树脂与牙体间边缘密合度最小,其次为3MZ350复合树脂,Durafill复合树脂,Charisma复合树脂。结论:Poss复合树脂这种新型材料可以作为临床充填材料,目前临床常用树脂Z350复合树脂与牙体间边缘密合度最小。     

银汞合金联合树脂黏结系统充填窝洞的扫描电镜观察

目的:通过扫描电镜观察银汞合金-树脂黏结剂黏结充填的窝洞,评价银汞合金黏结修复体的黏结界面情况.方法:65颗健康离体牙,分为对照组(5颗),采用常规银汞合金充填法;实验组(60颗),分别使用3种树脂类黏结剂黏结充填.场发射扫描电镜观察黏结界面.结果:实验组银汞合金充填体和牙体的结合面能够被树脂类黏结剂封闭,黏结剂能够与牙釉质、牙本质和银汞合金形成黏结,并可以封闭牙本质小管.自固化黏结剂的黏结完整性优于光固化黏结剂.结论:银汞合金联合通用黏结体系可以封闭银汞合金充填体结合界面,减少继发龋的形成.     

Er∶YAG激光在Constic树脂修复窝沟龋的实验研究

目的 分析铒激光处理在临床牙体修复效果的研究.方法 选择健康前磨牙80颗.随机分为四组,每组20颗.A组:手机备洞后树脂充填;B组:铒激光备洞后树脂充填;C、D组分别经过铒激光备洞和不同的预处理后充填,每组取10颗观察牙体间与充填体缝隙;其余样本观察微渗漏情况.结果 ①A组较其他三组微渗漏最高,有统计学意义(P＜0.0...     

干扰(牙合)对特发性牙颈部病损临床疗效影响的研究

目的:研究干扰(牙合)对特发性牙颈部病损临床治疗效果的影响.方法:第一部分:纳入该院口腔科特发性牙颈部病损就诊患者83例,患牙295颗;临床检查存在干扰142颗作为治疗1组,无干扰(牙合)153颗作为治疗2组,分别行纳米树脂治疗.随访2年.评价疗效,卡方检验.第二部分:治疗l组失败患牙60颗,随机分为实验组和对照组,各30颗.实验组纳米树脂充填治疗特发性牙颈部病损后精确去除咬合干扰因素,对照组仅纳米树脂充填治疗.治疗2组失败患牙29颗,随机分为实验组14颗和对照组15颗.实验组降低咬合,对照组仅纳米树脂充填治疗.随访1年,评价效疗,卡方检验.结果:第一部分:治疗1组和2组牙颈部病损治疗成功率分别为57.75％和81.05％ (P ＜0.05).第二部分:治疗1组失败患牙60颗,实验组和对照组成功率分别为83.33％和56.67％ (P ＜0.05).治疗2组失败患牙29颗,实验组和对照组成功率分别为85.72％和40％ (P ＜0.05).结论:充填治疗时配合精确去除咬合干扰因素治疗,可提高特发性牙颈部病损的临床疗效.     

3种复合树脂充填Ⅴ类洞的微渗漏比较研究

目的:比较义获嘉N Ceram纳米瓷化树脂、N Flow流动树脂及Bulk Fill 三次方大块充填树脂充填上颌前磨牙Ⅴ类洞后树脂充填体边缘的微渗漏情况,评估3种不同复合树脂的抗微渗漏性能,寻找较好的充填V类洞的复合树脂材料.方法:选取牙体完整、健康的人离体前磨牙66颗,随机分为3组(n=22).所有样本牙在颊侧颈部制备标准V类箱状洞型(长4 mm、宽3 mm、深2 mm).3组试验牙经选择性釉质酸蚀自黏结后,分别使用N Ceram纳米瓷化树脂(A组)、N Flow流动树脂(B组)及Bulk Fill三次方大块充填树脂(C组)进行充填.充填完成后,3组试验牙均行弱光启动固化,打磨抛光.将3组样本进行1500个周期的冷热循环,2％亚甲基蓝浸泡染色7d,然后沿牙体颊舌向切片.每组随机选取2颗样本牙,在扫描电镜下观察牙体-充填体交界面的密合程度;其余60颗样本牙在体视显微镜下(×40)观察剖面充填体的微渗漏情况.采用Spot Advanced软件测量微渗漏深度,并根据0～3分分别给(牙合)、龈壁微渗漏程度评分.采用SPSS17.0软件包对各组的微渗漏深度分别进行Kruskal-Wallis秩和检验和Mann-Whitney检验.结果:义获嘉Bulk Fill组树脂在3组中龈壁的微渗漏最小,且与另外2组相比有显著差异,N Ceran纳米树脂组与N Flow流动树脂组龈壁的微渗漏均较高(P＜0.05);3组复合树脂材料(牙合)壁的微渗漏无显著差异(P＞0.05);3组树脂(牙合)壁的微渗漏值均比龈壁小且差异显著(P＜0.05).结论:3组树脂在(牙合)壁的微渗漏值无显著差异.义获嘉Bulk Fill组树脂充填V类洞时.在3组中龈壁的微渗漏最小,且与另外2种树脂之间有显著差异.     

渗透树脂对树脂充填体釉质边缘漂白后微渗漏的影响研究#br#

目的    研究渗透树脂对树脂充填体釉质边缘漂白后微渗漏的影响。方法    选择由郑州大学第一附属医院口腔颌面外科门诊提供的因阻生而拔除的第三磨牙45颗,并在其颊面颈部制备V类洞。将所有离体牙随机分为3组,每组15颗,根据操作方法分别记为树脂充填组、树脂充填+冷光美白组和树脂充填+冷光美白+渗透树脂组。3组离体牙充填后进行500次冷热温度循环,然后在2%的碱性品红溶液中浸泡24 h,把离体牙沿颊舌向纵向剖开,用体式显微镜观察,并用S-EYE软件测量染料渗透深度。结果    3组染料渗透深度总的比较,差异有统计学意义（H = 10.182,P < 0.05）。其中,树脂充填+冷光美白组染料渗透深度大于树脂充填组和树脂充填+冷光美白+渗透树脂组,差异均有统计学意义（P < 0.05）;树脂充填+冷光美白+渗透树脂组染料渗透深度与树脂充填组相比,差异无统计学意义（P > 0.05）。结论    漂白剂加重了树脂充填体边缘的微渗漏,同时渗透树脂的应用能有效减少漂白剂对树脂充填体边缘微渗漏的影响。     

2种椅旁CAD/CAM修复材料冠抗折强度的体外研究

目的:比较2 种椅旁CAD/CAM 即刻修复材料(IPS e.max CAD 和Vita Enamic)体外不同面厚度下冠抗折强度的差异,为临床CAD/CAM 修复体的制作提供参考.方法 :定制树脂全冠预备体代型42 个,以面预备量1.5、2.0、2.5 mm 随机分为3 组,CEREC 扫描代型,储存数据,分别利...     

固化光源对充填体与牙体密合度影响的实验研究

目的:研究两种固化光源固化同一种复合树脂充填体与牙体的密合度.方法:选取20颗离体前磨牙,采用析因设计随机分成10组,在颊面牙颈部制备Ⅴ类洞,使用卤素光固化灯和发光二极管光固化灯固化粘结剂20 s后,分别固化树脂20 s、30 s、40 s、50 s和60 s.将实验牙置于(37±1) ℃人工唾液中浸泡24 h后,置于(37±1) ℃恒温水浴箱内24 h后取出.使用扫描电镜观察牙合壁和龈壁处充填体与牙体的密合度并进行统计学分析.结果:固化粘结剂和树脂使用的光源及固化树脂使用的时间两者之间存在交互作用,差异有显著的统计学意义(P<0.01).10组中缝隙宽度最小均值为0.765 μm,出现在使用LED光固化灯固化粘结剂20 s,LED光固化灯固化树脂30秒组.结论:固化光源可影响充填体与牙体的密合度.适宜的固化时间可使充填体与牙体的密合度增加,固化时间过长或过短均会影响密合度.本研究显示使用发光二极管光固化灯固化粘结剂20 s,发光二极管光固化灯固化树脂30 s时充填体与牙体的密合度最好.     

自制透明硅胶导板在前牙树脂嵌体修复中的微渗漏研究

目的:研究自制透明硅橡胶导板在前牙微创美学修复中对树脂嵌体与牙体之间微渗漏的影响,以期为临床修复方法提供更丰富的选择及理论依据。方法:选择30颗离体前牙作为实验对象,按嵌体制作标准预备成Ⅳ类牙体缺损洞型,随机分为3组:A组(自制透明硅橡胶导板制作树脂嵌体);B组(传统硅橡胶导板制作树脂嵌体);C组为对照组(全酸蚀直接法树脂充填),其中A组嵌体借助透明硅橡胶导板辅助就位粘接,所有标本经冷热循环和染色处理后,体式显微镜下观察试件的微渗漏情况。结果:3组均产生了微渗漏,A、B两组的微渗漏值均较C组小(P＜0.05),有统计学意义。A组的微渗漏值略小于B组,但差异无统计学意义。结论:自制透明硅橡胶导板能够减少修复体与牙体之间的微渗漏。     

对比树脂直接充填和铸瓷高嵌体修复后牙缺损的疗效

目的 探究树脂直接充填和铸瓷高嵌体修复后牙缺损临床疗效的差异性.方法 选取我院2018年2月—2019年2月收治的53例后牙缺损患者,依据随机数字表法分为2组,对照组26例(患牙34颗)予以树脂直接充填修复;观察组27例(36颗患牙)予以铸瓷高嵌体修复.对比两组患者修复时间、正中咬合情况以及随访12个月后的修复效果、修...     

声波充填术与分层充填术对树脂微渗漏的影响

目的:扫描电镜下比较声波充填术与分层充填术对树脂微渗漏的影响。方法:选取20个离体牙在邻牙合面制备3 mm×4 mm x5 mm窝洞,利用Sonicfill声波充填及分层充填术充填窝洞,光固化后并随机分为A组和B组。用2%亚甲基蓝溶液浸染1周,扫描电镜下观察试件剖面(近远中向),观察染液渗入深度,评价微渗漏程度,并对检测结果进行统计学分析。结果:A、B组微渗漏差异无统计学意义。结论:声波充填术比分层充填术更节省操作时间,可获得与分层充填术相当的边缘封闭性。     

SonicFill系统对II类洞充填后微渗漏影响的研究

目的:探讨树脂充填系统SonicFill对Ⅱ类洞树脂充填后微渗漏的影响。方法:收集口腔颌面外科门诊拔除的各类恒磨牙15例,每例样本中2个Ⅱ类洞随机分为实验组、对照组。实验组:用SonicFill超声树脂充填系统充填窝洞;对照组:用HerculitePrécis纳米树脂斜向分层充填窝洞。500次冷热循环实验后保存于0.5%碱性品红溶液中,24 h后沿近远中向剖开,体视显微镜观察染色情况并记录评分(0-3);扫描电镜测量树脂与牙体组织间微缝隙宽度。轴壁和龈壁染料渗入深度采用Mann-Whitney U检验进行评估;采用两个样本t检验比较微缝隙的宽度,检验水准α设为0.05。结果:染料渗入评分结果表明:SonicFill组与对照组相比,染料渗入的深度明显不同,差异具有统计学意义(P＜0.05);各组内轴壁染料渗入深度明显少于龈壁(P＜0.05)。扫描电镜2000倍视野下微缝隙宽度测量结果表明:SonicFill组与对照组的微缝隙宽度存在明显不同,差异具有统计学意义(P＜0.01);各组内轴壁与龈壁相比,轴壁微缝隙的宽度明显小于龈壁(P＜0.01)。结论:SonicFill超声树脂充填系统能够有效减少Ⅱ类洞树脂充填术后微渗漏的发生。轴壁与龈壁相比,轴壁微渗漏明显小于龈壁。     

铸瓷高嵌体修复牙体严重缺损的 年轻恒磨牙的效果分析

目的 评价铸瓷高嵌体修复严重缺损的年轻恒磨牙的临床效果。方法 选取牙体严重缺损的第一恒磨牙60颗,随机分为2组,分别进行树脂直接充填（树脂组）和铸瓷高嵌体修复（高嵌体组）。在修复后3、6、12、24个月检查两组患牙的修复体状态及咬合情况。按照改良USPHS/Ryge标准对修复体进行评价,使用T-Scan Ⅲ咬合分析系统进行咬合分析,记录牙龈状况和邻接关系恢复情况。结果 治疗后12个月,两组边缘适合性评分的差异有统计学意义,高嵌体组的A级多于树脂组（P<0.05）。治疗后12和24个月,两组表面光滑度评分的差异有统计学意义,高嵌体组的A级多于树脂组（P<0.05）。树脂组的患牙与对侧同名牙力百分比的差异均有统计学意义,患牙平均力百分比低于对侧同名牙（P<0.05）;而高嵌体组的患牙与对侧同名牙力百分比的差异均无统计学意义（P>0.05）。两组的牙龈状况和食物嵌塞情况均无明显差异（P>0.05）。结论 在本研究条件下,高嵌体组在修复体边缘适合性和表面光滑度方面,成功率较树脂组高,咬合力恢复也较树脂组更佳。在修复牙体严重缺损的年轻恒牙时,铸瓷高嵌体修复可作为推荐方案之一,有较好的修复效果。     

铸瓷高嵌体修复牙体严重缺损的年轻恒磨牙的效果分析

目的 评价铸瓷高嵌体修复严重缺损的年轻恒磨牙的临床效果。方法 选取牙体严重缺损的第一恒磨牙60颗,随机分为2组,分别进行树脂直接充填（树脂组）和铸瓷高嵌体修复（高嵌体组）。在修复后3、6、12、24个月检查两组患牙的修复体状态及咬合情况。按照改良USPHS/Ryge标准对修复体进行评价,使用T-Scan Ⅲ咬合分析系统进行咬合分析,记录牙龈状况和邻接关系恢复情况。结果 治疗后12个月,两组边缘适合性评分的差异有统计学意义,高嵌体组的A级多于树脂组（P<0.05）。治疗后12和24个月,两组表面光滑度评分的差异有统计学意义,高嵌体组的A级多于树脂组（P<0.05）。树脂组的患牙与对侧同名牙力百分比的差异均有统计学意义,患牙平均力百分比低于对侧同名牙（P<0.05）;而高嵌体组的患牙与对侧同名牙力百分比的差异均无统计学意义（P>0.05）。两组的牙龈状况和食物嵌塞情况均无明显差异（P>0.05）。结论 在本研究条件下,高嵌体组在修复体边缘适合性和表面光滑度方面,成功率较树脂组高,咬合力恢复也较树脂组更佳。在修复牙体严重缺损的年轻恒牙时,铸瓷高嵌体修复可作为推荐方案之一,有较好的修复效果。     

Effect of residual caries-disclosing solutions on microleakage of a dental adhesive system.

OBJECTIVE: The purpose of this in vitro study was to determine the effect of residual caries-disclosing dyes on a dentinal adhesive system and accompanying resin composite, using microleakage as the quantifying criterion. METHOD AND MATERIALS: The dye pretreatment groups (10 teeth in each group, n = 60) were as follows: Group 1, Caries Detector; group 2, Cari-d-tect; group 3, Seek; group 4, Snoop; group 5, To Dye For; and group 6, control (no dye pretreatment). Circular preparations were cut on the facial or lingual surface of each tooth. Caries-disclosing dyes were placed on the preparations; this was followed by treatment with 35% phosphoric acid etchant, application of a Single-Bond adhesive, and insertion of Z-100 hybrid resin composite. Following thermocycling, the teeth were sealed with nail varnish, placed in methylene blue dye, invested in acrylic resin, labeled, and sectioned. Leakage was examined (20x magnification) by dye penetration at the occlusal and gingival surface positions of the specimen blocks using an ordinal ranking system. The data were analyzed using two-way analysis of variance with P < .05 as the significance level. RESULTS: Results of the study showed that, at the occlusal surface position of the restorations, significantly greater leakage was exhibited by To Dye For compared to Snoop. At the gingival surface position, significantly greater leakage was exhibited by: (1) Caries Detector, Cari-d-tect, Seek, and To Dye For compared to the controls; and (2) To Dye For compared to Snoop. When comparing the same dye pretreatment groups with respect to occlusal versus gingival surface positions, significantly greater leakage was exhibited at the gingival surface positions, except for the control group. CONCLUSION: Our data showed that all dye groups leaked (except Snoop at the occlusal surface position), and significantly greater leakage was exhibited at the gingival surface position of all groups except the control. Snoop revealed the least leakage of all the dyes tested.     

Microleakage of endodontically treated teeth restored with fiber posts and composite cores after cyclic loading: a confocal microscopic study

STATEMENT OF PROBLEM: The effectiveness of the seal obtained with carbon fiber posts and composite cores is still unclear. Both 3-step dental adhesives and self-etching adhesive primers have been suggested as adhesive systems. PURPOSE: This confocal microscopic study evaluated the microleakage of teeth endodontically treated and restored with fiber posts and composites with 3 adhesive systems. MATERIAL AND METHODS: A total of 72 human mandibular premolars were endodontically treated and divided into 6 groups of 12 teeth each. The first 3 groups were treated with an endodontic sealer containing zinc oxide-eugenol (ZOE) and restored with temporary filling materials containing ZOE. The last 3 groups were treated with ZOE-free materials. Post spaces were prepared in the root canals. The first group treated with ZOE-based materials was restored with fiber posts cemented with zinc phosphate cement and composite cores without adhesive. The other 2 groups of ZOE-treated teeth were restored with fiber posts cemented with All Bond 2 and Panavia 21 dental adhesives, respectively. The last 3 groups were restored with fiber posts cemented with All Bond 2, Panavia 21, and Panavia Fluoro cement, respectively. The teeth were loaded intermittently at 2 cycles per second in a moist environment and, after 300,000 cycles, immersed in a solution of Rhodamine B dye for 48 hours. A confocal microscope was used to observe the teeth. The ratio between the length of the interfaces observed and the length of the dye penetration was evaluated. Two teeth from each group acted as controls and were not subjected to dynamic loads. RESULTS: All resin cement groups leaked significantly less than the group cemented with zinc phosphate cement. No statistically significant difference was found between the microleakage of teeth treated with ZOE-based and non-ZOE-based materials. Teeth restored with All Bond 2 dental adhesive leaked significantly less than those restored with Panavia cement. CONCLUSION: The 3-step dental adhesive (All Bond 2) resulted in a better marginal seal than that obtained with the self-etching primers (Panavia 21 and Panavia F). The use of endodontic sealers and temporary filling materials containing ZOE had no detrimental effect on the marginal seal of carbon fiber post/composite resin core restorations.     

The effect of different types of flowable restorative resins on microleakage of Class V cavities

This study evaluated the microleakage of Class V cavities restored with three different types of flowable resin restorative material and compared the effects of using their respective manufacturer's dentin adhesive or a different brand. Class V cavities with the occlusal margin in enamel and the gingival margin in dentin were prepared on the buccal and lingual surfaces of 48 non-carious human molars. The teeth were randomly assigned to three equal groups of 16. The first eight teeth in each group were restored with one of the flowable restorative materials (Filtek Flow, Dyract Flow, Admira Flow) using the manufacturer's recommended dentin adhesive (Single Bond, Prime & Bond NT, Admira Bond), and the remaining eight molars were restored using a different brand of dentin adhesive (Gluma Comfort Bond). The samples were thermocycled 200 times (5 degrees C-55 degrees C) with a one-minute dwell time. They were then immersed in a 2% basic fuchsin solution for 24 hours, sectioned and analyzed by stereomicroscopy. There was no statistically significant difference at the occlusal margins for either restoration used with its respective dentin adhesive. At the gingival margins, there was a significant difference among all groups. Flowable ormocer (Admira Flow/Admira Bond) displayed the least leakage at the gingival margins. When these flowable restoratives were used with a different brand of dentin adhesive, statistically significant differences were observed both on enamel and dentin. None of the restoratives tested fully prevented leakage at the gingival margins. No significant differences in microleakage were observed among the restorative materials used with respect to the manufacturer's dentin adhesive or a different brand except for Admira Flow restorative at the gingival margins. The gingival margins had significantly more microleakage than the occlusal margins (p < 0.05) except in the Admira Flow group, where microleakage at the occlusal and gingival margins was almost equal.     

不同材料及方法修复楔状缺损的临床评价

目的：探讨不同材料及方法用于楔状缺损修复的临床效果。方法：选择402例中度楔状缺损患者183名,楔状缺损深度1－2 mm,仅出现牙本质过敏、无牙髓炎症状。将患牙随机分为3组：A组3M玻璃离子充填组;B组光固化复合树脂充填组;C组3M玻璃离子+光固化复合树脂充填组。随访3-12个月。结果：C组修复成功率86.33％,高于A组77.69％及B组74.44%。C组与A、B两组差异均有统计学意义（P<0.05）,A、B两组间差异无统计学意义（P>0.05）。结论：采用玻璃离子和复合树脂夹层技术修复楔状缺损,对于预防术后敏感和降低充填体裂隙率及保持充填体的完整性均有较好的临床疗效。