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.     

瓷嵌体与树脂嵌体边缘微渗漏的对比研究

目的：对比研究Ceramage聚合瓷嵌体和复合树脂嵌体、铸瓷嵌体的边缘微渗漏情况.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Ceramage、Z350、P60、IPS EmpressⅡ制作嵌体后使用Single Bond 2和Rely X ARC进行粘接.经冷热循环500次后品红染色,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种材料微渗漏长度经单因素方差分析有统计学意义（轴壁：F=6.667,龈壁：F=11.1,P＜0.01）,q检验进行组间两两比较,IPS EmpressⅡ的微渗漏值高于Ceramage、Z350、P60,差异有统计学意义（P＜0.05）,其他三组间差异无统计学意义（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：从微渗漏深度进行评价,Ceramage聚合瓷是临床上制作树脂嵌体较理想的材料;     

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目的：通过对比4种牙本质黏结剂处理牙面后Ceramage聚合瓷嵌体的微渗漏程度,为黏结剂的临床选择提供参考。方法收集2012年7-9月在周口市第二人民医院口腔科因正畸需要拔除的牙体发育正常、无龋的前磨牙40颗,随机分为4组,每组10颗。40颗离体牙均按照嵌体备洞原则制备近中邻牙合Ⅱ类洞,Ceramage聚合瓷制作树脂嵌体,各组分别涂布牙本质黏结剂Prime＆Bond NT、Adper Single Bond 2、Clearfil SE Bond、Clearfil S3 Bond,用Rely X ARC树脂水门汀黏结嵌体。所有试件经冷热循环500次及品红染色后,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,在体视显微镜下测量染料渗入轴壁、龈壁的深度。结果轴壁：4组的微渗漏程度比较,差异有统计学意义（F=8.3125,P〈0.01）;Clearfil S3 Bond组的微渗漏程度高于Clearfil SE Bond （q=5.7708）、Adper Single Bond 2（q=6.4032）和Prime＆Bond NT组（q=4.0316）,差异有统计学意义（P〈0.01）,而其他3组间差异无统计学意义（P〉0.05）。龈壁：不同黏结剂之间的微渗漏差异无统计学意义（F=0.5897,P〉0.05）。同种黏结剂的龈壁微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Clearfil S3 Bond对牙釉质的封闭效果较差;从微渗漏深度大小和操作方法上进行评价,Clearfil SE Bond是黏结树脂嵌体较理想的牙本质黏结剂。     

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。     

3种窝洞修复方法之间微渗漏的比较

目的:探讨用复合树脂修复Ⅴ类洞时,3种不同修复方法之间微渗漏的差异。方法:挑选36颗3个月内拔除的完整磨牙,制备颊面Ⅴ类洞,将牙随机平均分为3组(n=12),分别使用直接充填法、预热充填法和间接嵌体法完成3M Z350复合树脂修复体,经过500次冷热水循环试验后用品红染色。将牙体纵切成厚度为0.9 mm的薄片,用体视显微镜观测染料渗透深度。结果:预热树脂组和嵌体组之间微渗漏差别无显著性,均显著小于直接充填组(P≤0.05)。结论:使用预热树脂充填和嵌体修复均可减小Ⅴ类洞龈壁边缘微渗漏。     

Ceramage聚合瓷嵌体修复活髓牙Ⅱ类洞的临床评价

目的 比较Ceramage聚合瓷嵌体修复与复合树脂充填活髓牙Ⅱ类洞的临床效果。方法 选取2016年1月至2017年10月来我院就诊的129例患者的156颗活髓Ⅱ类洞缺损的后牙。随机分为两组：其中78颗采用Ceramage聚合瓷嵌体修复,78颗采用Z350复合树脂充填治疗。18个月后分别对边缘着色、边缘密合性、修复体折裂、磨耗程度及继发龋等情况进行评价。结果 Ceramage聚合瓷嵌体组在边缘着色、边缘密合性、修复体折裂、磨耗程度及牙龈健康的5个指标的修复优良率均高于Z350复合树脂组（P<0.05）;Ceramage聚合瓷嵌体组的修复失败率均低于Z350复合树脂组（P<0.05）;两组的继发龋修复优良率差异无统计学意义（P>0.05）。结论 Ceramage聚合瓷嵌体修复后牙活髓Ⅱ类洞的效果明显优于复合树脂直接充填,可以在临床推广使用。     

金属嵌体修复磨牙邻(牙合)面洞的疗效

目的 比较金属嵌体与银汞合金充填磨牙邻(牙合)面洞的疗效。方法 选取上(牙合)第一磨牙因龋损而制备近中邻(牙合)面洞者,分别以金属嵌体或银汞合金修复各50颗牙,跟踪观察5年(1997～2002年),比较结果。结果 用嵌体修复上颌第一磨牙近中邻(牙合)面洞成功48颗牙,失败2颗牙,用银汞合金修复成功37颗牙,失败13颗牙。结论 用嵌体修复上颌第一磨牙近中邻(牙合)面洞的疗效明显优于银汞合金修复者。     

改良CAD/CAM全瓷嵌体对微渗漏影响的实验研究

目的:比较传统法和改良法制作CAD/CAM氧化锆基底全瓷嵌体发生微渗漏的差异。方法:离体磨牙30个随机分成对照组与实验组,均按Ⅱ类洞制备箱状洞型,实验组洞缘预备短斜面并于相应部位制作氧化锆边缘,对照组洞缘不预备短斜面,边缘用饰瓷封闭。两组样本进行疲劳循环和冷热循环试验,染色法检测微渗漏情况。结果:实验组嵌体边缘微渗漏小于对照组,有显著性差异。结论:采用改良法制作CAD/CAM全瓷嵌体能有效减少边缘微渗漏。     

2种材料嵌体用于后牙Ⅱ类洞修复的临床效果比较

目的: 比较CAD/CAM全瓷嵌体与Ceramage 聚合瓷嵌体修复活髓后牙Ⅱ类洞的临床效果。方法: 选取牙体缺损活髓后牙需制备Ⅱ类洞的患者97例,共100颗患牙。随机分为2组,分别制作CAD/CAM全瓷嵌体与Ceramage 聚合瓷嵌体修复。比较2组修复后12个月、24个月的效果,参照改良美国公共卫生服务评价体系（USPHS）,评价术后牙敏感、修复体折裂、修复体脱落、边缘着色情况。采用SPSS13.0软件包对2种材料嵌体修复12个月、24个月的计数资料进行X²检验,等级资料进行Wilcoxon秩和检验。结果: 12个月时,2组病例均修改成功,结果无显著差异（P>0.05）。24个月时,术后牙敏感、修复体脱落例数,2组比较无显著差异（P>0.05）;修复体折裂发生例数,聚合瓷组低于全瓷组（P<0.05);边缘着色发生例数,聚合瓷组高于全瓷组（P<0.05）。结论: 聚合瓷嵌体修复活髓后牙Ⅱ类洞术后抗折裂力高于CAD/ CAM 全瓷嵌体,缺点是边缘着色发生率较高,应根据患者的需求选择合适的修复方案。     

三种粘结剂粘结嵌体的微渗漏对比研究

目的：评价复合树脂嵌体及纯钛嵌体采用3种不同粘结剂的微渗漏情况。方法：选择72颗健康上颌前磨牙,随机分为6个实验组,每组12颗。按嵌体备洞要求制备Ⅱ类洞。前三组制作纯钛嵌体,分别用玻璃离子、树脂改良型玻璃离子和树脂粘结剂粘结固位。后三组制作复合树脂嵌体,分别用玻璃离子、树脂改良型玻璃离子和树脂粘结剂粘结固位。结果：同一种材料嵌体用不同粘结剂处理,其微渗漏程度差异有显著性（P〈0.05）;在相同粘结处理不同种嵌体的组间比较,其微渗漏差异P〉0.05。结论：树脂改良型玻璃离子粘结剂与树脂粘结剂抗微渗漏性能优于玻璃离子粘结剂。     

两种后牙树脂充填窝洞的边缘微渗漏观察

目的：观察并比较3MP90和P60两种后牙树脂与3M第七代自酸蚀粘接剂联合使用充填窝洞的边缘微渗漏情况。方法：40颗健康离体后牙随机分为A、B、C、D 4组,颊面正中制备5 mm×3 mm×2 mm的箱状洞型。其中A、B组用P90,C、D组用P60树脂分层充填;A、C组用Adper EasyTM one,B、D组用Single bond 2。标本经温度循环后,1%亚甲基蓝溶液染色48 h,显微镜下观察每颗牙3个剖面（近中、远中及正中）6个位点的染料渗入深度,采用计量资料两样本均数比较的t检验进行统计学分析。结果：A组与C组,B组与D组之间微渗漏有统计学差异（P〈0.05）;A组与B组,C组与D组之间微渗漏无统计学差异。结论：P90树脂的边缘封闭性优于P60。     

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。     

An in vitro evaluation of the marginal integrity of a porcelain inlay system.

There is currently no consensus of opinion regarding form of the finish line for porcelain inlays. This study compared beveled and nonbeveled finishing lines. Twenty-four Class II MOD cavities of a standardised design were prepared in extracted premolar teeth. Twelve were finished using a half enamel occlusal bevel and 12 were not beveled. Porcelain inlays were fabricated and luted with a dual-polymerizing resin material. The completed restorations were stored in water, thermocycled, and analysed using a scanning electron microscope. The quality of the enamel/composite resin interface was found to be considerably better than that of the inlay/composite resin interface. The adaptation of composite resin to enamel was of equal quality for both beveled and nonbeveled preparations.     

The adaptation and sealing ability of light-cured glass ionomer retrograde root fillings

The adaptation and sealing ability of a light-cured glass ionomer cement when used as a retrograde root filling was assessed using a confocal optical microscope with and without a fluorescent dye. This material was compared with a conventional glass ionomer cement and amalgam. The root canals of 60 extracted human single-rooted teeth were prepared and filled with gutta-percha and sealer. All the teeth were apicected, retrograde cavities were prepared, and then divided into three groups of 20 teeth each and filled with the test materials. The light-cured glass ionomer cement was well adapted to the retrograde cavity and apicected root surface. Within the retrograde cavity the cement was often well adapted to one wall, but gaps were found on the opposite cavity wall. This was probably caused by the polymerization contraction of the material. In contrast, the amalgam retrograde root fillings were poorly adapted to the cavities, with gaps between the cavity walls and amalgam. This group exhibited the poorest sealing ability as measured by the extent of dye penetration. The conventional glass ionomer cement was often found smeared over the root face, and there were unfilled voids at the base of some retrograde cavities. The results of the dye leakage study were analysed statistically. The sealing ability of the light-cured glass ionomer cement was significantly better than that of amalgam (P less than 0.001). The dye penetration around the light-cured glass ionomer cement and the conventional glass ionomer cement was not significantly different (P greater than 0.05). However, the sealing ability of the conventional glass ionomer cement was significantly better than that of amalgam (P less than 0.05).     

Effect of bevelling on the occurrence of fractures in the enamel surrounding composite resin fillings

Three different types of cavities: (1) with a 90 degree cavo-surface angle, (2) with a bevel at the cavity margin 0-25-0-50 mm wide, and (3) with a bevel at the cavity margin 0-5-1-0 mm wide, were prepared in extracted human teeth. Fifteen cavities of all three types were filled with Adaptic. Fifteen cavities of Type 2 and of Type 3 were filled with cosmic and the same number and types of cavities with prestige. The fillings were polished 10 min after starting the mix of the composite resins. Fractures in the enamel at the cavity margins were visualized by discoloration with methylene blue. Fractures were observed around all types of cavities, but, for all types of materials, an increased bevel at the margin gave an increased number of fillings without fractures in the enamel. However, great variations in the frequency of fractures were also observed; i.e. Adaptic showing a small frequency, Cosmic a medium and Prestige a great frequency of fillings connected with fractures at the enamel margin.     

不同嵌体修复体的粘结微渗漏研究

目的：对比评价Panavia EX粘结IPS-Empress Ⅱ铸瓷嵌体、铸造镍铬合金嵌体、铸造金合金嵌体、复合树脂嵌体的边缘密合度和微渗漏情况。方法：选择近期拔除的20个完整下颌磨牙,制备成近中——远中嵌体洞型,随机分为4组,每实验组5个牙。4组嵌体使用Panavia EX粘结后,恒温保存,5g/L碱性品红染色24h,2次纵剖牙体后,体视显微镜观测嵌体密合度和微渗漏值。结果：在树脂类粘结剂粘结下,各组嵌体的微间隙和微渗漏的数值均存在显著性差异,按测量数值由小到大排序为：金合金嵌体〈间接树脂嵌体〈铸瓷嵌体〈镍铬合金嵌体。结论：在抗微渗漏方面,金合金性能最好;临床上应慎重选择镍铬合金嵌体。     

流动树脂衬垫对树脂充填Ⅱ类洞龈壁微渗漏的影响

目的：了解流动树脂衬垫对树脂充填Ⅱ类洞龈壁微渗漏的影响。方法：选择30颗离体前磨牙随机分成A、B、C组,每组10颗,在近远中面制备长方形Ⅱ类洞,分别用通用型树脂直接充填（A组）,龈壁全层流动树脂衬垫后通用型树脂充填（B组）,流动树脂部分衬垫轴壁、龈壁后通用型树脂充填（C组）。所有试件经过温度循环、染色、近远中向连续切片,在30倍体视显微镜下观察龈壁染料渗漏情况。结果：C组的微渗漏明显小于A组和B组（P〈0．05）,A组和B之间差异无统计学意义（P〉0．05）。结论：实验研究表明,使用流动树脂作为衬垫层能明显降低Ⅱ类洞龈壁的微渗漏。