无托槽隐形矫技术中附件粘接的临床体会

目的：介绍无托槽隐形矫治技术中常用的辅助装置—＂附件＂的临床粘接技巧,包括粘接中需要注意的问题,供大家分享交流。方法：选取无托槽隐形矫治器17例,根据临床矫治设计方案共需粘结96个附件。所有操作均为四手操作。结果：所有病例均取得很好的附件外观形态,模板脱位顺利,附件与矫治器贴合。4例附件于矫治过程中脱落,须重新进行粘结。结论：此种附件粘接技巧完全满足临床应用。     

3种无托槽隐形矫治器附件粘接方法的比较研究

目的 比较全酸蚀粘接剂、自酸蚀粘接剂和树脂加强型玻璃离子水门汀3种材料粘接无托槽隐形矫治器附件的操作时间和临床效果。方法 将采用无托槽隐形矫治器矫治的30例错牙合畸形患者（附件156个）随机分为3组,每组10例。A组采用3M Adper Single Bond 2全酸蚀粘接剂和3M Z350纳米充填树脂粘接附件,B组采用3M Adper Easy One自酸蚀粘接剂和3M Z350纳米充填树脂粘接附件,C组直接采用GC Fuji Ortho LC树脂加强型玻璃离子水门汀粘接附件。记录每个附件的操作时间,评价粘接时、治疗1个月和6个月时3组附件的失败情况。结果 C组附件的操作时间较A、B组短（P<0.01）。3组附件之间的粘接失败率无统计学差异（P>0.05）,同一组内不同时间的粘接失败率也无统计学差异（P>0.05）。结论 3种材料粘接附件的稳定性均能达到满意的效果,但树脂加强型玻璃离子水门汀操作简便,更适宜临床推广。     

橡皮障在口腔正畸临床中的应用

目的 探讨橡皮障在口腔正畸科粘结托槽中的作用.方法 患者20例作为研究对象,粘结托槽400个.橡皮障组作为试验组;另一组棉球隔湿后作为对照组,对托槽脱落率进行统计学分析.结果 实验组托槽脱落率低于对照组,差异有统计学意义(P＜0.05).结论 橡皮障隔湿作用高于棉球隔湿法,有助于减少托槽脱落率.     

无托槽隐形矫治技术附件的临床粘结技巧

无托槽隐形矫治技术是近年来随着计算机技术、三维重建技术与工程制造技术的发展而出现的一种新型正畸矫治技术,为正畸医生提供了一种新的正畸理念和治疗手段[1-2]。在隐形矫治技术的临床应用中,附件的粘结是非常重要的环节和步骤,它直接影响到牙齿移动的效率和矫治目标的实现[3]。目前无托槽矫治技术的临床研究不断丰富,但有关粘结附件的临床操作技术未见文献报道。     

树脂改良型玻璃离子粘固剂粘接正畸托槽的临床评价

目的评价树脂改良型玻璃离子粘固剂粘接正畸托槽的临床使用效果.方法随机选择30名患者,采用自身对照的方法,进行为期18个月的临床研究.231个托槽用树脂改良型玻璃离子粘固剂(resin modified glass ionomer cement,RMGIC)粘接,234个托槽用复合树脂粘接剂(composite resin,CR)粘接.观察脱落托槽所在的牙位、时间和脱落后粘接剂在牙面上的残留量.计算托槽脱落率和粘接材料残留指数.结果树脂改良型玻璃离子粘固剂粘接的托槽脱落率为23.4%;复合树脂粘接剂粘接的托槽脱落率为9.4%,两者差异有极显著的统计学意义(P＜0.001).不论使用玻璃离子粘固剂还是复合树脂粘接剂粘接托槽,第二前磨牙都是最容易出现托槽脱落的牙位.两种材料粘接的托槽脱落后,牙釉质上的粘接材料残留指数差异没有显著性的统计学意义(P＞0.05).结论与复合树脂粘接剂相比,树脂改良型玻璃离子粘固剂的粘接强度尚不能满足正畸治疗的需要.     

正畸临床托槽脱落原因的探讨

目的:探讨在口腔固定矫治中托槽脱落的原因。方法:患者30例,黏结托槽1303个,黏结剂分别为津京釉质黏结剂、TF非调和黏结剂和3M光固化树脂。结果:托槽总脱落率为54.3%(707/1303),下颌托槽脱落率为63.8%(451/707),上颌托槽脱落率为36.2%(256/707)。统计学分析,光固化树脂与津京釉质黏结剂和非调和黏结剂比较,脱落率差别非常显著(χ2值分别为24.39和8.63,P<0.01),而后两者比较差异不显著(χ2=1.48,P>0.05)。结论:托槽黏结成败,受多因素影响。3种黏结剂比较,以光固化树脂的脱落率最低。     

隐形矫治器、自锁托槽与传统托槽对成人正畸患者牙周指数及龈沟液炎性因子的影响

目的:研究隐形矫治器、自锁托槽及传统托槽对成人正畸患者牙周指数及龈沟液内炎性因子水平的影响.方法:90例成人正畸患者随机分为传统组、自锁组及隐形组(n=30),分别佩戴传统MBT托槽、Damon Q自锁托槽及Invisalign隐形矫治器,观察矫治前、矫治后1、3、6个月及矫治结束时患者菌斑指数(PLI)、探诊深度(PD)及龈沟液内白介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)的变化情况.结果:矫治后1～6个月,传统组及自锁组患者牙周指数及龈沟液内炎性因子水平持续升高(P＜0.05),6个月达最高峰,矫治后1个月自锁组与传统组比较无显著差异(P＞0.05),矫治后3个月至矫治结束自锁组牙周指数及炎性因子水平均明显低于传统组(P＜0.05).隐形组患者PLI、IL-1β及TNF-α在矫治后6个月较矫治前升高(P＜0.05),但矫治后各项指标均显著低于传统组及自锁组(P＜0.05).结论:自锁托槽在正畸矫治中后期对牙周组织的影响小于传统托槽,隐形矫治器及自锁托槽与传统托槽相比,在正畸矫治后各个时期均更利于牙周组织的健康.     

树脂加强型玻璃离子水门汀临床初步应用的研究

目的 :临床普遍使用的复合树脂型正畸釉质粘结剂有许多不足之处 ,如在粘结过程和去粘结过程中导致釉质的丧失 ;托槽周围因菌斑积聚和停留导致脱矿等。玻璃离子水门汀因具有能与牙釉质形成化学性粘结 ,能在潮湿环境中使用 ,具有抗龋性等特性而成为替代传统正畸粘结剂的理想选择。但传统型玻璃离子水门汀的粘结力比复合树脂粘结剂低 ,影响了其在临床的广泛应用。如何提高玻璃离子水门汀的粘结性能 ,使其适合正畸临床粘结的需要一直是研究者们关注的热点。近年来出现的树脂加强型玻璃离子水门汀进行了这方面的尝试。材料和方法 :本研究在 2 0名正畸初诊患者的上颌左右侧分别使用正畸用树脂加强型玻璃离子水门汀 ,复合树脂型正畸釉质粘结剂粘结正畸托槽 ,观察其临床脱落率。其主要目的为了解树脂加强型玻璃离子水门汀在临床使用的脱落率 ,探讨树脂加强型玻璃离子水门汀在临床使用的可行性。结果 :托槽粘结后一个月 ,统计托槽的脱落情况 ,结果如下 :用树脂加强型玻璃离子水门汀粘结的 88个托槽有 5个脱落 (2 .3% ) ;而用复合树脂粘结的 88个托槽有 4个脱落 (3.4 % )。卡方检验结果 (df=1,x2 =0 .117,p >0 .0 5 )显示 ,两种粘结剂的脱落率无显著性差异。结论 :树脂加强型玻璃离子水门汀粘结托槽的脱落率与使用     

无托槽隐形矫治技术中附件的设计及应用研究进展

附件是无托槽隐形矫治技术的重要组成部分, 对实现矫治器固位与辅助牙齿精准移动起着关键作用。本文对目前附件的分类、生物力学研究、临床设计策略、粘结要点、局限不足进行了综述及展望。旨在总结和探讨附件的精准高效应用, 也为附件在无托槽隐形矫治中如何更好的设计提供研究思路。     

无托槽隐形矫治器与传统固定矫治器对患者牙周健康影响的临床观察

纳入18 ～40岁正畸患者60例,A组30例为无托槽隐形矫治组,B组30例为传统固定矫治组,分别检测患者治疗前和治疗后6周、6个月和12个月的各项牙周指数(PI,GI,SBI,PD).治疗前和治疗后6周各项指数组间差异无统计学意义,治疗6月和12月后A组各项指数均低于B组(P＜0.05),无托槽隐形矫治器更有利于牙周组织的健康.     

Adhesion between the resin shell and composite resin.

Adhesiveness between the resin shell and composite resin was examined. As the resin shell, SR-PE-ISOCETTE, made from thermosetting crown and bridge resin, was used. The shear bond strengths between the resin shell and photocurable composite resin bonded by various methods were measured after 1-day of immersion in water at 37 degrees C. Super-bond C & B treatment to the resin shell effectively improved the adhesiveness, giving a bond strength of about 14 MPa. Clearfil new bond, Clearfil porcelain bond, Unifast and MMA/TBBO treatment gave almost the same bond strengths of about 7-9 MPa. Silane coupling agents were not effective for improving the bond strength. It was revealed that 4-META was necessary for obtaining good adhesion between SR-PE-ISOCETTE and composite resin.     

Shear bond strength of visible-light-cured resin relative to heat-cured resin

One promising clinical application of visible-light-cured (VLC) denture resin is for relining complete and partial dentures. Typically, a VLC resin would be used to reline an existing prosthesis fabricated from heat-cured resin (HCR). This study measured the shear bond strength of a VLC resin bonded to HCR specimens by different bonding agents. For comparison, we measured the shear bond strengths of VLC resin bonded to VLC resin specimens and of autopolymerizing resin (APR) to HCR specimens. Cylindrical specimens of HCR (n = 126) and VLC (n = 24) were thermocycled to simulate aging, and the bonding surfaces were prepared by being sanded to approximate clinical roughness. The specimens were divided into seven groups of approximately 20 each, and test materials were bonded by different bonding agents. Statistical analysis by ANOVA and the Student-Newman-Keuls test showed significant differences (p less than 0.05) among all groups except APR to HCR/no bonding agent, VLC to HCR/VLC bonding agent, or VLC to HCR/VLC and HCR bonding agent. The traditional bond of APR to HCR with HCR bonding agent was significantly stronger (p less than 0.05) than the strongest bond of VLC to HCR with HCR and VLC bonding agents.     

Enhancement of adhesion between resin coating materials and resin cements

Resin coating technique is a unique method that improves the dentin bond strength of resin cements in indirect restorations. However, the weak link of a specimen bonded using the resin coating technique was reported to be the bonded interface between the resin coating material and resin cement. The purpose of this study, therefore, was to enhance the bonding performance between a resin coating material and a resin cement. Two light-cured flowable composites, Protect Liner F and Clearfil Flow FX, were used as coating materials, and two dual-cure composite materials, Panavia F 2.0 and Clearfil DC Core Automix, were used as resin cements. The ultimate tensile strength of each material and the microtensile bond strengths of the bonded specimens of resin coating material and resin cement were measured using a crosshead speed of 1.0 mm/min. Three-way ANOVA (p=0.05) revealed that the highest microtensile bond strength was obtained using a combination of Clearfil Flow FX and Clearfil DC Core Automix, and when the surface of the coating material was treated with ED Primer II. It was strongly suggested that materials with a higher ultimate tensile strength, when used in both resin coating and cementation, could enhance the bond strength between the two.     

Ultraconservative resin restorations

Ultraconservative dentistry represents a great step forward for the dentist, the profession, and especially the patient. It involves the early detection and complete elimination of all accessible and non-accessible carious material from the tooth. Untreated caries can be extremely and rapidly destructive. The earliest interception of decay maintains total dental health and increases the likelihood of the restored teeth lasting a lifetime.