两种材料充填后牙咬合面磨耗凹的疗效比较

目的探讨富士Ⅸ玻璃离子与卡瑞斯玛光固化复合树脂充填后牙咬合面磨耗凹的临床疗效。方法64例180颗后牙咬合面磨耗随机分为2组,每组各90颗牙,试验组用富士Ⅸ玻璃离子充填,对照组用卡瑞斯玛光固化复合树脂充填,治疗后1年随访。结果试验组与对照组治疗后1年成功率分别为92．22％、83．33％,失败率分别为1．11％、10．00％,经卡方检验2组差异有统计学意义（P〈0．05）。结论采用富士Ⅸ玻璃离子充填后牙咬合面磨耗凹优于卡瑞斯玛光固化复合树脂。     

复合树脂充填咬合面磨耗凹的临床观察

观察复合树脂充填后牙（牙合）面磨耗凹坑及前牙切缘磨耗凹槽的临床疗效.首先确定磨耗的凹坑及凹槽是否有足够的充填空间,必要时调磨对（牙合）过锐过陡的牙尖及牙嵴,彻底清洁窝洞,然后在不备洞的情况下,采用可乐丽菲露黏接剂及相应复合树脂充填窝洞.70颗患牙随访1a,成功52颗,有效16颗,失败2颗,有效率为97.14%.本法避免了因备洞而危及牙髓的问题,且易被患者接受,操作简便,易于推广应用.     

光固化流体树脂加后牙复合树脂充填3年疗效观察

目的　观察光固化流体树脂加后牙复合树脂充填的临床疗效。方法　用光固化流体树脂加后牙复合树脂充填后牙Ⅰ、Ⅱ类洞 ,并用单纯光固化复合树脂充填后牙Ⅰ、Ⅱ类洞作为对照 ,观察 3年疗效。结果　试验组4 9颗牙 ,3年成功率 85 .71% ;对照组 4 8颗牙 ,3年成功率 6 4 .5 8%。经统计学分析有显著性差异 (P <0 .0 5 )。结论　流体树脂的应用能够增加光固化后牙复合树脂的成功率     

固位沟用于后牙牙冠大面积缺损修复的探讨

目的：探讨在后牙牙冠大面积缺损修复中增加固位沟的效果。方法：选择符合标准的124颗牙冠大面积缺损的后牙，制备洞型并垫底及作梯，然后在剩余牙体组织或洞底及梯上做固位沟，分别用银汞合金和光固化复合树脂充填，复查1－3a后统计成功率及失败病例，进行分析比较。结果：3年总成功率为74．52％，银汞合金组76．92％，光固化复合树脂组69．57％，两者无显著性差异。结论：增加固位沟可有效提高固位力及抗力，从而提高后牙牙冠大面积缺损的修复成功率。     

不同充填材料修复后牙凹坑状磨耗缺损的疗效分析

目的评价3种不同充填材料修复后牙凹坑状磨损的临床疗效。方法240例共380个活髓后牙输面磨耗患者随机分为3组，使用3种不同充填材料进行治疗，A组银汞充填治疗患牙135颗（35．75％），B组Ketac—Mola玻璃离子充填患牙124颗（32．64％），C组Z250复合树脂修复患牙121颗。结果在边缘密合性上B、C组明显优于A组（P〈0．05）；充填物脱落C组比A、B组更明显（P〈0．05）；防治继发龋形成方面B组明显优于A、C组（P〈0．01），但其耐磨性最差。结论实际工作中应根据患者的具体情况、美观要求、经济状况等来选择适当的充填材料以达到最佳效果，复合树脂优势较大。     

固位钉在牙体缺损修复中应用的临床观察

目的：探讨严重牙体缺损临床保守治疗方法,方法：对120例患者160颗粒重牙体缺损的牙齿,死髓牙经彻底根管治疗后,活髓牙经氢氧化钙垫底,前牙用自攻自断螺纹固位钉加光固化复合树脂修复,后牙用自攻自断螺纹固位钉加聚羧酸锌水门汀、银汞合金充填,结果：上前牙优良率85％,差15％,双尖牙及磨牙组优良率为90％,差105。结论：固定钉在严重上体缺损修复中的地应用,是临床保守治疗最佳方案之一。     

2种垫底材料对后牙深龋充填的敏感性比较

目的 比较3M光固化玻璃离子和DMG爱诺赛光固化复合体两种垫底材料对后牙深龋充填的术后敏感性。 方法 84例84颗深龋后牙,随机分为3M组和DMG组,3M组垫底材料为3M VitrebondTM光固化玻璃离子,DMG组垫底材料为DMG Ionosit-Baseliner爱诺赛光固化复合体,自酸蚀后,两组上层均加压填充3M FiltekTM Z350纳米复合树脂,于修复后1天、1周、1个月和3个月,对敏感发生率和自觉疼痛程度进行比较。 结果 术后1天、1周和1个月,3M组和DMG组的术后敏感率和自觉疼痛程度无差异（P>0.05）,术后3个月,3M组的术后敏感率和疼痛程度低于DMG组,差异有统计学意义（P<0.05）。结论 在后牙深龋治疗中,使用光固化玻璃离子垫底材料可降低术后敏感的发生。     

Ca(OH)_2垫底在前牙Ⅲ类洞中的临床应用

目的 探讨Ca(OH)_2对龋齿修复中预防牙髓炎的临床作用。方法 选取有2颗同名前牙Ⅲ类龋坏患者,随机选一颗牙先用Ca(OH)_2垫底再行光固化修复,另一颗直接光固化修复。结果 对照组100颗牙有8颗出现牙髓炎症状,有3颗发生继发龋,充填成功率89％;Ca(OH)_2垫底组100颗牙有1颗发生继发龋,无一颗牙髓炎症,充填成功率99％,比较有显著性差异(P<0.01)。结论 光固化复合树脂对牙髓有一定的刺激性,尤其是在年轻恒牙,而Ca(OH)_2垫底后,可以减少牙髓刺激症状。     

流体树脂应用于恒磨牙预防性充填术3年效果评价

目的探讨光固化流体树脂对年轻恒磨牙窝沟龋预防性充填治疗的疗效。方法对56例7～14岁患儿两侧同名磨牙分别采用两种不同的预防性树脂充填方法。试验组:112颗面窝沟龋在磨除龋坏牙体组织后联用后牙复合树脂与流体树脂对龋坏部位和未龋坏窝沟区域进行预防性充填治疗。对照组:112颗面窝沟龋在磨除龋坏牙体组织后采用传统窝沟封闭剂加后牙复合树脂,评价两组3个月、1年、3年的保留成功率。结果随访3年后发现采用Wave Flow流动复合树脂加后牙复合树脂进行预防性树脂充填治疗,充填成功率高达87.5%,对照组仅为67.7%,两组成功率比较具有非常显著性差异。结论光固化流体树脂加后牙复合树脂对年轻恒磨牙的窝沟龋治疗疗效确切,值得临床推广应用。     

自攻钉临床应用的体会

在临床上 ,常见到有的患牙缺损很大 ,缺乏力学固位形 ,致充填体容易脱落的情形 ;过去对该类患牙通常予以拔除或充填后假以牙冠修复。现根据该类患牙的缺损大小及牙体的情况 ,攻入 1～ 4枚自攻自断螺纹钉 ,以增加充填体的固位力 ,使一些残冠得以修复保存 ,或免除了充填后的牙冠修复。1　临床资料 :　笔者集中复查了 1997年 5月～ 1999年4月治疗的患者 10 2人 ,115牙。患者年龄 2 3～ 80岁。前牙46颗 ,其中 42颗牙的补牙材料为光固化复合树脂 ,3颗牙为玻璃离子 ,1颗牙为银汞合金。后牙 6 9颗 ,其中 2 2颗牙的补牙材料为后牙用光固化复合树脂 ,…     

Microleakage around preventive composite fillings in loaded teeth.

The purpose of this study was to evaluate the microleakage around preventive composite fillings in teeth subjected to mechanical loading and thermal cycling, and to assess the influence of the consistency of the composite resin upon the leakage. The fissure enamel was partially removed without dentin exposure in 30 extracted maxillary pre-molars. The cavities were etched with phosphoric acid and filled with undiluted composite (Adaptic) or composite diluted with varying amounts of liquid resin (Adaptic Bonding Agent). Five teeth were not acid etched and served as a control group. All teeth were mechanically loaded and unloaded, simulating masticatory forces, and subsequently thermally cycled between two dye solutions. Extensive leakage was seen around all fillings in the control group, while slight leakage, restricted to the feather-edge margin, was seen in five teeth with acid etched cavities. Three of these contained undiluted composite fillings. Twenty teeth showed no leakage. The results show that preventive composite filling provides good sealing of occlusal fissures, and that the seal is resistant to those thermal and mechanical stresses which may be expected in vivo. The use of diluted composite resin in preventive composite fillings is recommended.     

Microleakage around preventive composite fillings in loaded teeth

Abstract – The purpose of this study was to evaluate the microleakage around preventive composite fillings in teeth subjected to mechanical loading and thermal cycling, and to assess the influence of the consistency of the composite resin upon the leakage. The fissure enamel was partially removed without dentin exposure in 30 extracted maxillary premolars. The cavities were etched with phosphoric acid and filled with undiluted composite (Adaptic®) or composite diluted with varying amounts of liquid resin (Adaptic Bonding Agent®). Five teeth were not acid etched and served as a control group. All teeth were mechanically loaded and unloaded, simulating masticatory forces, and subsequently thermally cycled between two dye solutions. Extensive leakage was seen around all fillings in the control group, while slight leakage, restricted to the feather-edge margin, was seen in five teeth with acid etched cavities. Three of these contained undiluted composite fillings. Twenty teeth showed no leakage. The results show that preventive composite filling provides good sealing of occlusal fissures, and that the seal is resistant to those thermal and mechanical stresses which may be expected in vivo . The use of diluted composite resin in preventive composite fillings is recommended.     

SOFT-START光聚合技术对复合树脂充填体边缘微渗漏影响的实验研究

目的 :探讨SOFT -START光聚合技术对光固化复合树脂充填后边缘微渗漏的影响 ,为该技术的推广应用提供实验依据。方法 :选择因正畸需要拔除的第一前磨牙的志愿者 2 0人共 80个牙 ,随机分成 4组 ,每组 2 0个牙。在每个牙牙合面中央制备Ⅰ类洞 ,常规酸蚀、冲洗、吹干、涂布粘接剂。 1组、2组 :充填Z2 5 0树脂 ,3组、4组 :充填Charisma树脂 ;1组、3组采用传统光固化方式固化 ( 75 0W /cm2 × 40s) ;2组、4组 :采用SOFT -START光聚合技术固化 ( 2 0 0W /cm2 × 10s ,75 0W /cm2 × 3 0s)。所有牙充填后在口内留置 7d后拔除 ,0 .5 %品红溶液渗入法染色 ,体视镜下观察 ,判定微渗漏程度。结果 :采用SOFT -START光聚合技术组充填体微渗漏程度显著低于传统固化方式组。结论 :SOFT -START光聚合技术有助于减少光固化复合树脂的聚合收缩 ,可提高充填体边缘封闭性 ,减少微渗漏产生     

粘接剂与复合树脂的配伍性对微渗漏影响的探讨

目的通过对几种临床常用的粘接剂和复合树脂两两配伍使用,评价修复体的微渗漏情况,并初步探讨粘接剂和复合树脂粘接修复的配伍性。方法按照ISO/TS 11405标准要求,选择近期拔除的人第三磨牙45颗,在颊舌侧牙颈部分别制备直径3mm的Ⅴ类洞,随机分为9组,每组5颗牙,10个洞。分别采用三种粘接剂和各厂家要求的三种配套复合树脂两两配伍进行充填,材料固化后,浸入2%的亚甲基蓝溶液中染色24小时。沿牙体长轴在窝洞中心处纵切为两半,立体显微镜下观察亚甲基蓝染料渗入情况,并按ISO/TS 11405标准要求记分。结果同一复合树脂与不同的粘接剂配伍组间存在显著差异;对于三种粘接与不同的复合树脂配伍,除XP bond与不同的复合树脂配伍组之间均具有显著差异外,其余两种粘接剂未见明显差异。结论在临床选择粘接剂和复合树脂及在实验室条件下评价修复体边缘微渗漏时,应考虑粘接剂与复合树脂的配伍性。     

后牙病理性磨损树脂修复的临床效果探讨

目的:观察用直接树脂充填法和间接树脂充填法修复后牙病理性磨损的临床效果。方法:选择后牙牙合面有病理性磨损且具有充填空间的患者48例,患牙144颗,其中有牙本质过敏症状者38例98颗牙。患者按门诊顺序随机分为直接法修复组和间接法修复组2组各24例,在不备洞的情况下分别采用可乐丽菲露复合树脂直接或间接修复,比较治疗3个月及1年后树脂充填的临床效果、牙本质敏感情况和咀嚼效率改变情况。结果:治疗后3个月时复查,直接法和间接法两组患牙树脂充填体A级率无显著性差异(卡方检验,P>0.05);治疗1年后复查,间接法组患牙树脂充填体A级率优于直接法组,两组差异有统计学意义(卡方检验,P<0.05)。间接法组牙本质敏感治疗总有效率优于直接法组,两组差异有统计学意义(卡方检验,P<0.05)。治疗3个月及治疗1年后,间接法组的咀嚼效率高于直接法,两组差异有统计学意义(t检验,P<0.01)。结论:间接树脂法比直接树脂充填法修复后牙病理性磨损有较好的临床效果。     

Hybrid-coat联合树脂充填治疗敏感型楔状缺损的临床疗效观察

目的: 研究Hybrid-coat联合树脂充填治疗敏感型楔状缺损的临床疗效。方法: 选择2016年7月—2016年12月在上海交通大学医学院附属第九人民医院口腔综合科就诊的敏感型楔状缺损患者70例,共159颗患牙,随机分为2组。联合组35例患者,81颗患牙采用Hybrid-coat脱敏后,复合树脂充填治疗楔状缺损。直接充填组35例患者,78颗患牙直接使用复合树脂充填。2组经过不同方式治疗后,采用SPSS 13.0软件包对各组患者在统一临床检查标准下的有效率（术后即刻,术后1、3、6个月复查）进行统计学分析。结果: 2组在树脂充填后,Hybrid coat联合树脂充填组在术后3个月和术后6个月分别有1颗和2颗牙充填体脱落,直接充填组在术后6个月有2颗牙充填体脱落,2组差异无统计学意义。Hybrid coat联合树脂充填组术后即刻、术后1、3、6个月的脱敏有效率分别为91.36%、88.89%、79.01%和70.37%,均高于直接充填组分别为78.21%、76.92%、69.23%和61.54%;术后即刻和术后1个月,2组差异有统计学意义（P<0.05）;术后3个月和6个月,2组差异无统计学意义。结论: Hybrid-coat联合复合树脂充填治疗敏感型楔状缺损有良好疗效,早期能明显改善牙敏感症状。     

Correlation between marginal adaptation of composite resin restorations and bacterial growth in cavities

The purpose of the present study was to correlate the marginal adaptation of composite fillings to the bacterial growth in the cavities. Forty-three cavities prepared in vivo on human third molars were acid etched and filled with the composite resin Concise. After 4 months the teeth were extracted and examined for marginal leakage along the restorations. After histologic preparation an average of 38 sections from each cavity were stained and investigated for bacteria on the cavity walls and in the exposed dentinal tubules. General marginal leakage was found in 14 of the restorations and bacterial growth in 12. For 35 of the 43 restorations there was a agreement between marginal leakage and bacterial growth (P = 0.0002). Based on the results it is concluded that bacteria in a cavity can be used as an indicator of marginal leakage along the restoration.     

Microstructure of inner surfaces on composite restorations related to filling procedure.

The inner surfaces of 40 Concise restorations placed in vivo on permanent molars have been studied by scanning electron microscopy. Only grinding traces could be seen on fillings from cavities which had not been etched, while the morphologic structure of the enamel and dentin was reflected on fillings from acid-etched cavities. Application of low-viscous non-composite resin in the cavities before filling with the composite resin did not influence the enamel pattern on the fillings, while the amount of processes of resin corresponding to the dentinal tubules in etched cavities was significantly increased. In the discussion the difference in surface structure of the fillings is correlated to marginal leakage along similar restorations.     

Proximo-occlusal composite restorations in primary molars: marginal adaptation, bacterial penetration, and pulpal reactions

Marginal adaptation and bacterial penetration were studied in 32 primary molars filled with composite resin in shallow class II cavities. The restorations had served in the mouth for 3 years (mean, 3 years and 4 months; range, 8 months to 6 years and 4 months). Ground sections of the retrieved teeth were evaluated with polarized light microscopy and demineralized sections with light microscopy. Clinically excellent restorations, free from bacteria, were found in 25%. Gaps were recorded in 42%, under- or over-contouring and porosities in 95%, caries in the cervical area in 58%. Bacteria were observed subjacent to the fillings in 75% and in the dentin tubules in 61%. Pupal necrosis was found in 7 of 16 teeth. Marginal discoloration, visible crevice, or color mismatch was associated with marginal defects, bacterial leakage, and pulpal reactions.     

树脂直接充填与超瓷嵌体修复牙体缺损的微渗漏比较

目的 探讨用Filtek Z350复合树脂和超瓷嵌体修复Ⅰ类、Ⅱ类洞的边缘微渗漏的差异.方法 选取40颗新鲜拔除的第三磨牙,随机分成4组,每组10颗.A1组为Ⅰ类洞树脂直接充填,A2组为Ⅱ类洞树脂直接充填,B1组为Ⅰ类洞型超瓷嵌体修复,B2组为Ⅱ类洞超瓷嵌体修复.4组均置于1％碱性品红溶液染色21 d.用低速金刚砂锯沿牙体长轴近远中向切开,制备牙齿切片,体视显微镜观测粘接界面染色剂渗透深度.结果 （1）Ⅰ类（Z=5.909）、Ⅱ类洞（轴壁Z=5.504,龈壁Z=2.958）超瓷嵌体的边缘微渗漏都显著小于Z350复合树脂直接充填（P＜0.05）;（2）无论树脂直接充填（Z=1.413）还是嵌体修复（Z=0.455）,Ⅰ类、Ⅱ类洞的微渗漏差异无统计学意义（P＞0.05）.结论 超瓷嵌体修复是牙体缺损理想的修复方法.