两种托槽粘接剂的比较实验和研究

目的：测定树脂和化学固化型玻璃离子托槽粘接剂的抗剪切粘接强度。方法：100颗离体双尖牙被随机分成两组，每组又按照测试时间的不同分成3个亚组。组1、组2分别用京津釉质粘合剂(树脂)、Ketac—Bond(化学固化型玻璃离子粘接结剂)粘接托槽，对所有实验样本进行了抗剪切粘接强度的测试。结果：①树脂和化学固化型玻璃离子的抗剪切粘接强度随时间的增加而增强。②树脂粘接剂的断裂主要发生在釉质—树脂界面，而化学固化型玻璃离子粘接剂的断裂则主要发生在自身内部。结论：树脂型托槽粘接剂固化后24h以内达到临床应用标准，而化学固化型玻璃离子粘接剂在固化后24h以内达不到该标准，不适合于临床应用。     

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。     

氯己定对FujiOrtho LC粘接托槽抗剪切强度的影响初探

目的探讨复方氯己定含漱液对树脂加强型玻璃离子（Fuji Ortho LC）粘接托槽抗剪切强度的影响。方法60颗前磨牙分3组,每组20颗,第1组对照组不用0.20%葡萄糖酸氯己定含漱液涂牙面常规粘接托槽,第2组每天用0.20%葡萄糖酸氯己定液涂牙面2次1周后进行常规粘接托槽,第3组每天2次用0.20%葡萄糖酸氯己定含漱液涂牙面1周,停涂1周后进行常规粘接托槽。粘接托槽后,所有标本储存于蒸馏水中,24 h后用专用仪器测量抗剪切强度,应用方差分析比较各组之间的抗剪切强度,应用卡方检验比较各组粘接剂的残留指数。结果第1组抗剪切强度明显高于第2组,第2组、第3组间抗剪切强度差异无统计学意义;在托槽脱落面形态观察中,各组间ARI指数有差异。结论应用0.20%葡萄糖酸氯己定含漱液后即刻粘接时,Fuji Ortho LC抗剪切强度会明显降低,并且残留在牙面上的粘接材料会有所增加。     

不同临床操作对托槽脱落率的影响

托槽粘接是正畸临床操作中的一个关键步骤，以往学者通过增加粘接剂强度、改善托槽底板外形设计等方法大大减低了其临床脱落率。粘接前的牙面处理主要指通过清洁抛光牙面，去除菌斑及正常覆盖于牙面的有机薄膜，为牙面的酸蚀及托槽的粘接做好准备。粘结中的处理主要包括是采用简单的棉卷隔湿还是应用吸唾器持续吸唾。本文通过对比粘接前和粘结中的不同处理对托槽脱落率的影响，以探讨如何减小脱落率、提高正畸治疗的效率。     

口腔正畸粘接剂的研究进展

口腔正畸治疗的成功,不仅取决于矫治的设计及医生的操作技巧,粘接剂的粘接性能也非常关键。良好的粘接是矫治顺利进行的保障,因此对粘接剂的性能提出了越来越高的要求。本文将对常见的口腔正畸粘接剂及其进展作一综述。     

脱落托槽3种不同方法处理后粘接强度的对比

目的:观察不同方法处理脱落托槽底板后再粘接的粘接强度.方法:选择因正畸需要而拔除的健康前磨牙50 颗,随机平均分为A、B、C、D、E组,B、C、D、E组粘接新托槽并于1 h后去除,并从脱落托槽中选择30枚,随机分成3 组,每组10 枚,分别采取喷砂、打磨、热处理3 种方法处理后,再分别与B、C、D组前磨牙粘接;A、E组前磨牙粘接新托槽.分别测量其抗剪强度并记录粘接剂残留指数(ARI).结果:5组的抗剪强度依次是(18.42±2.85) MPa,(15.91±6.69) MPa,(15.59±7.43) MPa,(17.22±3.65) MPa,(19.32±4.31) MPa,5 组间抗剪强度差异无统计学意义(P>0.05).5 组的ARI总计分依次是6、12、17、8、6 分,其中D组低于C组(P<0.05);A组和E组均显著低于C组(P<0.01);其它组间差异无统计学意义(P>0.05).结论:体外研究中,对脱落托槽底板残留粘接剂分别采取喷砂、热处理、打磨3 种不同方法处理后再次粘接,均可获得和新托槽相近的抗剪强度,3 种处理方法间无明显差别.     

3种粘接剂分别粘接金属托槽至抛光及上釉锆瓷的粘接强度

目的:研究3种粘接剂对抛光及上釉锆瓷与正畸金属托槽粘接强度和耐久性的影响。方法:选用2种通用型粘接剂Single Bond Universal(SBU)和Prime&Bond Universal(PBU),以Transbond^TM MIP(TM)为对照分别将抛光组、上釉组锆瓷与上颌中切牙金属托槽粘接,试样共6组(n=20)。水浴或水浴+冷热循环储存后测试全部试件剪切粘接强度(SBS),分析断裂形态以及粘接剂残留指数(ARI)。结果:粘接剂(P<0.001)和储存条件(P<0.001)显著影响锆瓷与托槽的剪切粘接强度;抛光或上釉(P=0.09)组间无统计学差异。SBU在各组中都表现出较强的粘接强度和较低的ARI,3种粘接剂间的ARI分数存在显著差异(P<0.001)。结论:粘接金属托槽与抛光及上釉锆瓷时,SBU较PBU和TM有更好的粘接性能。     

两种不同类型粘接剂和临床四手操作在正畸托槽粘结过程中的应用效果评价

目的：评价两种不同类型粘接剂和临床四手操作在正畸托槽粘结过程中的应用效果。方法：将正畸门诊40例需粘接托槽患者随机均分为四组,A组10例,四手操作粘接托槽184个,使用光固化粘接剂。B组10例,非四手操作粘接托槽180个,使用光固化粘接剂。C组10例,四手操作粘接托槽188个,使用化学固化粘接剂。D组10例,非四手操作粘接托槽192个,使用化学固化粘接剂。分别记录四组患者粘接托槽所需时间和1周以后托槽脱落情况,进行统计分析。结果：粘接单个托槽平均所需时间A组2．65min,B组3．52rain,C组1．95min,D组2．18min,A组与B组、C组与D组、A组与C、B组与D组分别有明显的统计学差异（P〈O．05）。1月后复诊四组的托槽脱落分别为5个、7个、4个、8个,托槽脱落率分别为：2．72％、3．89％、2．13％、4．16％,四组间没有明显的统计学差异（P〉0．05）。结论：在粘接托槽过程中,使用化学固化粘接剂和通过四手操作均可以明显缩短医生临床操作时间,并对粘接效果没有明显影响,工作效率显著提高。     

两种正畸粘接剂托槽生存率的比较研究

目的：比较自酸蚀粘接剂和全酸蚀粘接剂粘接托槽的临床效果。方法：选择42名固定正畸患者,采用自身对照研究,分别使用一步法自酸蚀粘接剂和两步法全酸蚀粘接剂粘接726个托槽,计算12个月内托槽的脱落率,卡方检验比较4种因素（粘接剂、牙弓、牙位和性别）对托槽脱落率的影响;Kaplan-Meier法绘制托槽生存率曲线,log-rank检验分析上述4种因素对托槽生存率的影响,同时评价牙釉质表面的剩余粘接剂指数。结果：两种粘接剂的托槽脱落率无统计学差异;生存分析表明粘接剂类型和牙弓位置对托槽生存率的影响无统计学差异,但前磨牙托槽的生存率比切牙和尖牙低,女性患者的托槽生存率高于男性;自酸蚀粘接剂的剩余粘接剂指数与全酸蚀粘接剂无统计学差异。结论：自酸蚀粘接剂与两步法全酸蚀粘接剂都具有较高的托槽生存率,均能满足正畸临床粘接的要求。     

Clinical evaluation of different adhesive systems for restoring teeth with erosion lesions

This investigation evaluated the performance of a resin-modified glass ionomer, a compomer, and a bonding system/composite combination for the restoration of cervical erosion lesions without cavity preparation. Forty-eight lesions (11 patients) were restored with a bonding agent/composite combination [Prime & Bond 2.1/PrismaTPH (P & B/TPH); DeTrey/Dentsply], a compomer (Dyract; DeTrey/Dentsply), or a light-curing glass ionomer (Fuji II LC; Fuji). The materials were randomly assigned to the patients in triplets. No cavity preparation was performed. The procedures strictly followed the manufacturers' instructions. The restorations were evaluated clinically, using modified USPHS criteria, and by quantitative scanning electron microscope (SEM) analysis, at baseline and 12 months. The clinical data were statistically evaluated with the Pearson chi-square test, the SEM data (criterion gap formation) were analyzed with the Mann-Whitney U-test and error rates method. Clinically, two restorations could not be evaluated. One Dyract restoration failed. With respect to marginal discoloration, recurrent caries and contour, no significant differences could be found between the materials. The surface texture of P & B/TPH and Dyract was significantly better than that of Fuji II LC at baseline and 12 months. Compared to P & B/TPH and Fuji II LC, Dyract revealed a significant decrease in marginal integrity between baseline and 12 months. In SEM analysis, gap formation was determined as follows: baseline, enamel interface: 4% Dyract= 4% Fuji >2% P & B/TPH and dentin interface: 11% Dyract >9% P & B/TPH >2% Fuji; 12 months, enamel interface: 15% Dyract >4% Fuji >3% P & B/TPH and dentin interface: 11% P & B/TPH >6% Fuji >5% Dyract. The error rates method revealed no significant differences, in general, between the three materials with regard to gap formation. In conclusion, the restorations of erosion lesions with different classes of adhesive materials were well retained after 12 months. None of the materials studied revealed superiority over the other materials. All materials revealed shortcomings with respect to either surface texture, marginal integrity or color stability clinically and for all materials gap formation was recorded in the SEM evaluation. Received: 9 March 1998 / Accepted: 13 May 1998     

Effect of the applied load on surface contact fatigue of dental filling materials

OBJECTIVE: The purpose of this study was to investigate the effect of the applied load in a rolling-ball device on the surface contact fatigue of two dental filling materials: a microfilled composite (FA) and a glass ionomer (GFII). METHODS: Disk specimens 10 mm diameter by 1.5 mm thick were set into cavities cut in plates of PMMA. After setting, the specimens were ground and polished using wet-carborundum paper followed by 1 microm alumina and then stored for 24 h in water at 23 degrees C. The surface fatigue test was carried out using loads ranging from 100 to 500 gf through a ruby ball 2 mm diameter using a rolling-ball device. The ball was set to rotate at 720 rpm and a surface profile was determined on impressions recorded at regular intervals. Fatigue life was defined as the number of cycles to produce a track 5 microm deep and was determined by interpolation. Data were statistically analyzed by ANOVA and t-tests at a significance level of 0.05. RESULTS: At loads ranging from 200 to 500 gf the fatigue life was 0.7-10.6 x 10(5) cycles for FA, and 0.7-4.8 x 10(3) cycles for GFII. For both materials the fatigue life was reduced significantly by increasing the test load (p<0.05). The surface contact fatigue life for FA was at least 100 times greater than that for GFII at all loads. SIGNIFICANCE: The rolling ball device was confirmed as a simple and meaningful device for the study of surface contact fatigue. A microfilled composite is very much more resistant to contact fatigue than a glass ionomer.     

4种牙色充填材料与乳牙粘结强度的比较研究

目的：比较4种牙色充填材料与乳磨牙的剪切粘结强度,为临床应用提供理论依据。方法：选用滞留乳磨牙80颗,随机分成8组,分别用复合树脂、多聚酸改良复合树脂、树脂改良玻璃离子、玻璃离子及相对应的酸蚀粘结剂或齿面处理剂按使用说明制作牙釉质和牙本质粘结试件,测定其剪切强度,并在体视显微镜下观察试件断面界面破坏情况。结果：4种牙色材料的剪切强度牙釉质组均明显高于牙本质组,复合树脂与多聚酸改良复合树脂组牙质剪切粘结强度无统计学差异,其它任意两组之间均有高度统计学差异。结论：复合树脂与多聚酸改良复合树脂牙质粘结强度无明显差别,均高于玻璃离子和树脂改良玻璃离子,以玻璃离子粘结强度最低。     

不同成型片对邻面修复体表面粗糙度的影响

目的 比较使用不同材质成型片的邻面修复体表面粗糙度.方法 选择不同品牌或型号的流体复合树脂、膏体复合树脂以及玻璃离子水门汀充填材料,在体外邻面缺损模型上使用金属和聚酯成型片,模拟II类洞直接充填修复,应用表面粗糙度仪,对各修复体的表面粗糙度进行测量和比较.结果 流体树脂修复体的表面粗糙度Ra值是(0.176±0.063)μm,低于膏体复合树脂(0.456±0.115)μm和玻璃离子水门汀(0.810±0.210)μm,各组间差异具有统计学意义(P<0.001).使用金属和聚酯成型片对树脂类修复体的表面粗糙度影响不大(P>0.05),应用玻璃离子水门汀时,金属成型片的修复体表面更为光滑(P<0.05).结论 临床进行复合树脂邻面洞充填时,可以选择金属或聚酯成型片;而使用玻璃离子水门汀时,建议使用金属成型片.     

Effect of cariogenic biofilm challenge on the surface hardness of direct restorative materials in situ

Objectives

The presence of cariogenic biofilm could result in surface degradation of composite and ionomeric restorative materials. Thus, this study evaluated in situ the alterations in the surface microhardness of these materials under biofilm accumulation and cariogenic challenge.

Methods

In a split-mouth, double-blind, cross-over study, 10 volunteers wore palatal intra-oral devices containing bovine enamel slabs restored with composite resin (CR – Z250) or resin-modified glass ionomer (RMGI – Vitremer). Two phases of 14 days were carried out, one for each restorative material. In one side of the device, biofilm was allowed to accumulate under a plastic mesh, whereas in the opposing side, regular brushing was carried out 3 times/day with a dentifrice containing 1100 μg F/g as NaF. A 20% sucrose solution was applied extra-orally 10×/day on each restored dental slab. Knoop microhardness was used to calculate the percentage of surface hardness loss (%SHL).

Results

All materials showed a decrease in surface hardness after the in situ period. The restorative materials presented the following average for %SHL: RMGI without biofilm accumulation = 8.9 and with biofilm accumulation = 25.6, CR without biofilm accumulation = 14.7 and with biofilm accumulation = 17.0.

Conclusion

Biofilm accumulation and the presence of cariogenic challenge promoted faster degradation of ionomeric materials, but this was not observed for composite resin.

Clinical significance

The oral environment affects the surface hardness of aesthetic restorative materials. Biofilm accumulation and cariogenic challenge promote surface degradation for ionomeric materials, but not for composite resin.     

Tunnel or saucer-shaped restorations: a survival analysis

The aim of the present effectiveness trial was to compare the survival of restorations placed in saucer-shaped cavities to that of restorations placed in tunnel preparations. Ten operators placed a total of 85 tunnel and 97 saucer-shaped restorations. The dentinal part of the tunnel was restored by resin-modified glass ionomer cement. The remaining part of the tunnel was restored by composite resin using an adhesive technique. Composite resin was used to restore the saucer-shaped cavities. The restorations were assessed clinically and radiographically for up to 79 months, with a mean observation time of 28.8 months for tunnel, and 30.3 months for saucer-shaped restorations. The survival proportion of the tunnel restorations was 46%, and the survival proportion for the saucer-shaped restorations was 76%. A main reason for failure of the tunnel restorations was fracture of the marginal ridge (24% after 24 months). Caries development in relation to the restoration was significantly higher for tunnel restorations compared with saucer-shaped restorations (41 and 19%, respectively, after 24 months). There was no difference between the two types of restoration in marginal deterioration and caries progression in the neighboring tooth (40% after 24 months). Based on findings from the present study, it is suggested that saucer-shaped restorations should be preferred for tunnel restorations in small- and mid-sized cavities.     

Clinical evaluation of the bond between composite resin and etched glass ionomer cement

One hundred and thirty-eight non-undercut Class V abrasion lesions were restored using glass ionomer cement overlaid by composite resin. Four techniques were used: enamel and glass ionomer acid-etched, enamel only acid-etched, ionomer only acid-etched, and neither enamel nor glass ionomer acid-etched. The restorations were examined after six months, one year and two years and evaluated for integrity and marginal staining, the latter employing a direct clinical method and a set of photographic standards. The relative failure of restorations at six months was maintained at subsequent time intervals, and at two years the failure incidence was 10, 35, 43 and 58 per cent for the above four techniques respectively. Marginal staining was most evident around those restorations for which only the glass ionomer had been etched. The results indicate that the retention of composite to etched glass ionomer is similar to that of composite to dentine using many dentine bonding agents. The several advantages of glass ionomers over dentine bonding agents are discussed.     

A new flash-free orthodontic adhesive system: A first clinical and stereomicroscopic study

Objective:To analyze the clinical and laboratory properties of the recently introduced APC flash-free orthodontic adhesive.Material and Methods: After bonding of 80 brackets on human teeth (group A: APC flash-free adhesive n  =  40, group B: APC Plus adhesive n  =  40), the following measurements were recorded: time for bonding, stereomicroscopic evaluation of excess adhesive, color penetration (methylene blue, 0.5%/24 h), and Adhesive Remnant Index (ARI) score after debonding.Results:The time needed for bonding differed significantly between the two groups (A: 19.5 s/tooth vs B: 33.8 s/tooth). The adhesive excess, which was metrically measured from the bracket edge, ranged from 166.27 µm to 81.66 µm (group A) and 988.53 µm to 690.81 µm (group B). After methylene coloration in group A, 52 of 80 measurements showed discoloration on the bracket-adhesive and/or adhesive-enamel interface, while for group B, 78 of 80 were coloration positive. The ARI scores did not differ, with an average ARI score of 2.0 for group A and 2.8 for group B.Conclusion:The flash-free adhesive significantly reduced the time needed for the bonding process. The excess resin expanded 0.16 to 0.08 mm over the bracket margin. The new technology seems to facilitate a smooth and sufficient marginal surface of the adhesive, which clinically might improve reduction of plaque accumulation.