树脂黏结剂黏结强度的研究进展

随着口腔修复学的发展以及牙列缺损患者对美观要求的提高,烤瓷修复体已经成为固定修复的主要方式,大量实践证明树脂黏结水门汀对烤瓷尤其全瓷修复体的黏结具有非常好的效果。该文对近年来常用树脂黏结水门汀黏结强度及其影响因素等方面进行综述。     

全瓷修复体应用于成人前牙轻度错畸形的临床分析

目的运用现代全瓷修复技术,通过短期治疗,矫正成人轻度前牙错畸形并达到临床美学修复的效果。方法选择具有轻度拥挤或牙体变色及咬合不良,不愿或不适合进行长期正畸治疗,无烤瓷冠修复禁忌证的134例成年患者的478颗前牙进行全瓷修复体美学修复。首先制取研究模型,通过标准全瓷修复程序,制作全瓷修复体,包括全冠370个,贴面108个。使用光敏全瓷粘接树脂材料完成粘接。结果通过3个月的临床追踪调查,修复患者的总满意度达到93%,舒适度达到100%,96.65%的修复体达到了美国公共健康协会修正标准结果中的A级标准。结论全瓷修复体适用于矫正轻度牙列拥挤、变色或咬合关系错乱,因年龄等原因不再适宜运用正畸疗法的患者。     

一步一步做好全瓷修复粘接

随着全瓷材料和微创修复理念的发展,全瓷修复体的临床应用日益广泛。粘接是影响全瓷修复成功的重要因素之一。良好的粘接不仅能为全瓷修复体提供固位和抗力,还能增强修复体边缘封闭、提高修复体美观效果。做好全瓷修复粘接需要3个重要环节:全瓷修复体组织面的粘接处理、预备体表面牙体硬组织的粘接处理以及根据修复体类型正确选择粘接用水门汀。     

3种树脂水门汀对CAD/CAM全瓷-牙本质剪切强度的比较

目的:评价3种树脂水门汀对CAD/CAM全瓷-牙本质剪切强度的影响。方法:选取新鲜拔除的人磨牙30颗,制备牙本质黏结面,随机分为3组(n=10),分别选用全酸蚀树脂水门汀RelyX ARC、自酸蚀树脂水门汀Clearfil DCBond和自黏结树脂水门汀RelyX Unicem对CAD/CAM硅酸锂玻璃全瓷进行黏结,测试3种树脂水门汀对CAD/CAM全瓷-牙本质的剪切强度,并通过立体显微镜观察牙本质的黏结界面。采用SPSS11.0软件包对数据进行统计学分析。结果:RelyX ARC组的剪切强度为(15.90±6.15)MPa,Clearfil DC Bond组的剪切强度为(14.41±5.07)MPa,而RelyXUnicem组的剪切强度为(23.29±7.39)MPa,与前2组相比有显著性差异(P<0.05)。立体显微镜观察显示,3组黏结断面均位于牙本质与树脂水门汀之间。结论:自酸蚀树脂水门汀及自黏结树脂水门汀与CAD/CAM硅酸锂玻璃陶瓷修复体的黏结强度不低于传统全酸蚀树脂水门汀,且临床操作简便,为临床全瓷黏结提供了更多便利与选择。     

氧化锆全瓷修复体颜色再现的影响因素

全瓷修复体因其良好的机械性能及美学效果广泛应用于口腔修复。其中高强度的氧化锆材料备受关注。氧化锆材料机械性能优良,但美学效果相比其他全瓷材料稍有逊色。为使氧化锆材料呈现更好的美学修复效果,部分学者不断研究各种影响氧化锆材料颜色的因素并寻找改善其美学效果的方法。影响氧化锆全瓷修复体颜色的因素较多,本文旨在材料因素、加工因素、临床因素三方面对氧化锆全冠修复体颜色的影响作一综述。     

全瓷修复体颜色效果的影响因素

影响全瓷修复体颜色的因素很多,本文就全瓷修复体各个部分对颜色效果的影响作一综述,以期能更好地指导临床工作。     

树脂粘接剂在全瓷修复中的应用

全瓷修复是当今口腔固定修复的发展趋势之一。全瓷修复体依赖良好的树脂粘接剂以保证其临床成功。目前,全瓷修复树脂粘接剂与牙本质的粘接技术及瓷表面处理技术仍在不断探索改进之中,以期进一步提高临床粘接效果。本文对全瓷修复树脂粘接剂的组成及其与牙本质的粘接、与全瓷修复体的粘接原理、技术和效果作一综述。     

不同厚度In-Ceram全瓷修复体的色差分析

目的 :研究不同厚度In Ceram全瓷修复体对整体颜色的影响。方法 :应用MINODACR 3 2 1色差仪测试In Ceram全瓷修复体底核及其上构筑不同厚度的不透明牙本质瓷及体瓷 ,采用国际照明委员会 (CIE) 1976L a b 标准色度系统分析背景颜色对修复体颜色的影响。结果 :随着不透明牙本质瓷及体瓷厚度的增加 ,修复体对背景颜色的遮盖能力增强 ,当不透明牙本质瓷厚 0 .2mm ,修复体在 1.6mm时背景颜色对其颜色无肉眼可见差别 ,当不透明牙本质瓷厚 0 .4mm ,修复体在 1.4mm时背景颜色对其颜色无肉眼可见差别。结论 :临床可根据牙体变色情况酌情选择不透明牙本质瓷及体瓷的厚度 ,以期达到与天然牙颜色最匹配的效果。     

影响修复颜色效果的因素及对策Ⅳ.与颜色效果相关的修复材料问题

良好的修复颜色效果需要建立在正确选择和准确掌握修复材料及加工方式的基础上.烤瓷修复体与全瓷修复体的结构不同,因此两者的光学效果有本质的区别;全瓷修复体的颜色和光学特性与天然牙更接近,但不同全瓷材料制作的修复体其颜色和光学特性也有明显差异;正确表现颜色效果还需要技师准确掌握正确的修复体瓷层构建方法.本讲将针对以上问题进行讨论.     

树脂粘接剂在全瓷修复中的应用

全瓷修复是当今口腔固定修复的发展趋势之一。全瓷修复体依赖良好的树脂粘接剂以保征其临床成功。目前，全瓷修复树脂粘接剂与才本质的粘接技术及瓷表面处理技术仍在不断探索改进之中，以期进一步提高临床粘接效果。本文对全瓷修复树脂粘接剂的组成及其与牙本质的粘接、与全瓷修复体的粘接原理、技术和效果作一综述。     

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.     

树脂粘接剂在全瓷修复中的应用进展

随着人们对修复体美观的要求越来越高，各种瓷修复体的临床应用日益广泛，并出现了与之相应的新型粘接材料——树脂粘接剂。其与临床常用的粘接剂相比，具有良好的半透明性、较高的粘接强度、不易溶解及色泽匹配好等优点。在树脂粘接剂的发展过程中新材料、新技术不断问世和改进，顺应了口腔临床迫切需求的趋势。本文就国内外树脂粘接剂的研究进展及应用情况进行回顾、分析和归纳，系统总结树脂粘接剂的历史发展、临床分类、粘接强度及其影响因素、未来发展趋势等方面的情况，以期为树脂粘接剂更好地应用于临床提供参考。     

Factors to achieve aesthetics in all-ceramic restorations

The demand for aesthetic restorations has increased during the last years. Dental ceramics are a successful alternative for some cases because of aesthetics and biocompatibility. Therefore, the aim of this literature review was to present the factors necessary to fabricate all-ceramic restorations with aesthetics similar to natural dentition. A search of English-language peer-review literature was completed using MEDLINE database from 1975 to 2009 including the keywords "aesthetic," "metal-free crown," "all-ceramic," and "color." It was observed that several factors influence aesthetics of all-ceramic restorations. Color scale, light source during color evaluation, characteristic of core material, color of supporting tooth, presence of root post, and type of cement are clinical factors that may influence color of the restorations. Laboratorial factors as technique for ceramic condensation, thickness, temperature, and number of firing cycles also influence the result of these crowns. Although several clinical and laboratorial factors influence aesthetics of all-ceramic restorations, the aesthetic success and longevity of these restorations depend on the integration with surrounding periodontal tissue.     

Cements and adhesives for all-ceramic restorations

Dental cements are designed to retain restorations, prefabricated or cast posts and cores, and appliances in a stable, and long-lasting position in the oral environment. Resin-based cements were developed to overcome drawbacks of nonresinous materials, including low strength, high solubility, and opacity. Successful cementation of esthetic restorations depends on appropriate treatment to the tooth substrate and intaglio surface of the restoration, which in turn, depends on the ceramic characteristics. A reliable resin cementation procedure can only be achieved if the operator is aware of the mechanisms involved to perform the cementation and material properties. This article addresses current knowledge of resin cementation concepts, exploring the bonding mechanisms that influence long-term clinical success of all-ceramic systems.     

Clinical evaluation of an all-ceramic restorative system: 24-month report

PURPOSE: To clinically evaluate an all-ceramic restorative system (Finesse All-Ceramic) when used in conjunction with an ultra-low fusing porcelain (Finesse) using bonded esthetic resin cements (Enforce & Calibra). METHODS: 40 posterior and anterior crowns, 20 all-ceramic inlays and onlays, and 26 veneers were placed in 43 patients. Standard ceramic preparations were performed followed by conventional polyvinylsiloxane (Aquasil) impression techniques using cord retraction. The bonded resin cement was used to place the restorations following manufacturer's instructions. A majority of restorations (95-100%) were evaluated to be optimal at baseline (B), 6, 12, and 24 months using a modified Ryge criteria for the following categories: color match, marginal adaptation, porcelain staining, secondary caries, postoperative sensitivity, and retention. RESULTS: There were sufficient shades available to obtain desired esthetic result with 98% of all restorations being rated Alfa for shade match to Vita Lumin shade guide. The overall 2-year success rate (inlay/onlays, crowns, and veneers) was 98.75%.     

The influence of different cements on the fracture resistance and marginal adaptation of all-ceramic and fiber-reinforced crowns

PURPOSE: This in vitro study investigated the marginal adaptation and fracture resistance of heat-pressed glass-ceramic and fiber-reinforced composite molar crowns luted with resin, resin-modified glass-ionomer, or zinc-oxide-eugenol-free cements. MATERIALS AND METHODS: A total of 24 heat-pressed all-ceramic and 24 glass fiber-reinforced composite crowns were constructed and cemented using the above-mentioned luting agents (eight crowns per cement). The restorations were thermocycled and mechanically stressed, and fracture resistance was determined. Marginal adaptation was evaluated before and after stress application using semiquantitative analysis in a scanning electron microscope. RESULTS: All-ceramic and fiber-reinforced composite crowns reached the highest fracture resistance after stress application in combination with the resin cement. When luted with resin-modified glass-ionomer or zinc-oxide-eugenol-free cements, the fracture resistance of all-ceramics decreased significantly, while the fiber-reinforced composite crowns maintained their fracture resistance level; the lowest values were found for zinc-oxide-eugenol-free cements. The marginal adaptation remained unchanged after stress for all-ceramics and fiber-reinforced composite restorations if they were luted with resin cements. Luting with resin-modified glass-ionomers significantly deteriorated the marginal adaptation after stress application, with the exception of the crown-cement interface of all-ceramics. CONCLUSION: The highest fracture resistance and marginal adaptation were found for all-ceramic and glass fiber-reinforced composite molar crowns if they were luted with resin cement.     

Influence of cement type on the marginal adaptation of all-ceramic MOD inlays.

OBJECTIVE: The aim of this study was to investigate the in-vitro marginal adaptation of all-ceramic class II inlays which were luted with conventional multi-stage pre-treatment cements and one new type of cement, which requires no conditioning. METHODS: The marginal adaptation of 56 all-ceramic inlays was determined with scanning electron microscopy and microleakage tests. The marginal integrity of each tooth was evaluated at cement-dentin and cement-enamel junctions, with regard to the transitions between tooth-cement and cement-inlay. The inlays were luted on human molars with two resin cements, one compomer, one resin modified glass-ionomer and one new resin cement in accordance with the manufacture's recommended pre-treatment. Light- and chemical-curing modifications were investigated. All tests were performed after thermal cycling and mechanical loading (TCML). RESULTS: For the resin cements and the new material the marginal integrity was higher than 90% before and after TCML. The marginal adaptation was between 55-80% for the resin modified glass-ionomer and lower than 20% for the compomer. The microleakage was lower than 20% for all cements, only the compomer showed values up to 100% penetration. SIGNIFICANCE: The difference in marginal integrity between the new universal resin cement without any tooth pre-treatment and conventional resin cements after total-etching, priming and bonding was not significant. Resin GIC may be used with restrictions and compomer cement should not be used with all-ceramic class II inlay restorations.     

粘接材料对渗透铝瓷全瓷修复体颜色的影响

目的 探讨不同粘接材料对渗透铝瓷全瓷修复体颜色的影响。方法 制作12个A2色直径12.5 mm、底层厚度0.5 mm的GI－Ⅱ渗透铝瓷试件,在其上烧结A2色1.0 mm厚的 Vitadur α饰面瓷完成渗透铝全瓷试件,并制作12个直径12.5 mm、厚2 mm的铸造Ni-Cr合金背景试件。将全瓷试件和背景试件分别用树脂粘接剂、玻璃离子粘固粉、磷酸锌粘固粉粘接,根据粘接材料的不同分为3组,每组4个。用JY9800型白度色度计测量各组粘接前、后的L*、a*、b*颜色参数。结果 粘接材料对全瓷修复体的最终颜色有一定的影响,其中树脂对修复体的颜色影响最小,磷酸锌粘固粉的影响最大,其粘接前后的色差可肉眼分辨。结论 全瓷修复体的粘接推荐使用树脂粘接剂,以减小粘接材料对全瓷修复体最终颜色的影响。     

Effect of preheating on the physicochemical properties and bond strength of composite resins utilized as dental cements: An in vitro study

Statement of problemLittle is known regarding the use of preheated composite resins to bond indirect restorations and its impact on mechanical properties when compared with resin cements.PurposeThe purpose of this in vitro study was to compare the chemical and physical properties and bond strength to enamel and ceramics of preheated composite resins and resin cements.Material and methodsTwo composite resins, the microhybrid Filtek Z250XT and the nanoparticulate Z350XT were tested, and 2 commercially available resin cements, the dual-polymerized Rely-X ARC and the light-polymerized Rely-X Veneer were used as controls. A device (HotSet) was used to preheat the composite resins to 69 °C before light-polymerization. The following properties were tested: flexural strength, modulus of elasticity, fracture toughness, microshear bond strength to enamel and ceramics, degree of conversion, flow, sorption and solubility, and color stability. Statistical analysis was done with ANOVA and Holm-Sidak for multiple comparisons (α=.05).ResultsPreheating had no significant effect on the degree of conversion, flexural strength, fracture toughness, solubility, or microshear bond strength to the enamel of the tested composite resins (P>.05). However, preheating increased the sorption and reduced the microshear bond strength to the ceramic (P<.05). The flowability of the composite resins increased with heating but showed lower values when compared with both resin cements (P<.05). Color stability was more affected in the preheated composite resins than in the resin cements.ConclusionsThe preheating process resulted in little to no benefit in the evaluated properties for the composite resins. Resin cements appear to be the best option for cementing indirect restorations.