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;     

4种常见牙本质黏结剂的边缘封闭性研究

目的:研究对比4种临床常用牙本质黏结剂的边缘封闭性.方法:12个离体前磨牙,在颊、舌侧牙颈部釉-牙骨质界处各制备直径2 mm,深1.5 mm盒型洞.随机分为4组,分别使用Single Bond、AdperPrompt、Clearfil SE Bond、Spread iBond黏结,3M Z250树脂充填.500 s/L碱性硝酸银中浸泡24 h,强光显影8 h,沿牙体长轴通过充填体正中颊舌向纵行剖开,体视显微镜下观察各剖面充填体边缘的微渗漏情况,并以扫描电镜观察树脂-牙本质界面的结合状态.结果:各种黏结剂界面均存在微渗漏现象,实验组Single Bond、AdperPrompt、Clearfil SE Bond和Spread iBond渗漏深度分别为(777.23±120.13)μm、(930.12±130.10)μm、(240.33±120.53)μm、(640.12±170.23)μm.Clearfil SE Bond组银渗漏的深度明显低于其他组,(P<0.05),其他3组组间无显著性差异(P>0.05).结论:临床上常用的4种黏结剂均不能避免牙本质黏结界面的渗漏,Clearfil SE Bond对牙本质的封闭性优于Adper Prompt、Spread iBond、Single Bond.     

全酸蚀牙本质粘结剂不同固化方式对Ceramage聚合瓷嵌体微渗漏的影响

目的：观察全酸蚀牙本质粘结剂不同固化方式对Ceramage聚合瓷嵌体微渗漏大小的影响。方法：选择20个离体前磨牙在近远中分别制备长方体形邻牙合面洞,Ceramage聚合瓷制作嵌体后,近中为对照组,采用牙本质粘结剂常规光照固化后树脂水门汀粘结嵌体;远中为实验组,采用牙本质粘结剂涂布后不单独固化,在树脂水门汀粘结嵌体后同时光照固化。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,体视显微镜下测量染料渗入轴壁、龈壁的深度。结果：实验组微渗漏低于对照组,但差异无统计学意义（轴壁t＝0．304,龈壁t＝0．408,P＞0．05）;同组间龈壁微渗漏程度均显著高于轴壁（实验组t＝2．766,对照组t＝2．392,P＜0．05）。结论：全酸蚀牙本质粘结剂不单独固化组和常规固化组相比具有同样的抗微渗漏能力;轴壁抗微渗漏能力好于龈壁。     

微瓷树脂嵌体和复合树脂嵌体微渗漏的对比研究

目的 对比研究1种微瓷聚合树脂嵌体和另外3种复合树脂嵌体的边缘微渗漏情况,为临床选择嵌体材料提供参考。方法 将80颗健康离体上颌前磨牙随机分为8组,每组10颗,嵌体窝洞制备后,分别用微瓷聚合树脂Ceramage（C）和复合树脂Brilliant new line(B)、Z350(Z)、P60(P)间接法制成嵌体,每种材料2组,使用即刻牙本质封闭(immediate dentin sealing,IDS)/延时牙本质封闭(delayed dentin sealing,DDS)技术粘结,冷热循环品红染色后,用金刚砂片将实验牙切开,体视镜下观察微渗漏。结果 4种树脂嵌体龈壁与轴壁微渗漏无显著性差异（P>0.05）,各IDS组与DDS组微渗漏亦无显著性差异（P>0.05）。无论龈壁还是轴壁,采用IDS或DDS粘结技术,4种材料之间皆有显著性差异（P<0.05）并且渗漏情况一致。微渗漏从小到大依次均为C、Z、P、B。结论 单从微渗漏方面评价,Ceramage和Z350均为制作树脂嵌体的良好选择。     

4种树脂嵌体磨损性和微渗漏的比较

目的研究4种树脂嵌体的磨损性能和边缘微渗漏情况,为临床选择嵌体材料提供参考。方法磨损实验:将Ceramage(C)、Brilliant new line(B)、Z350(Z)、P60(P)制成树脂嵌体,应用UMT-2微摩擦磨损实验机,将试件与天然牙对磨,称重法计算磨损量,扫描电镜观察磨损表面形貌。微渗漏实验:将80颗上颌前磨牙随机分为8组,每组10颗,嵌体窝洞制备后,分别用C、B、Z、P间接法制成嵌体,每种材料2组,分别使用即刻牙本质封闭(immediate dentin sealing,IDS)和延时牙本质封闭(delayed dentin sealing,DDS)技术粘接,冷热循环品红染色后,沿嵌体长轴剖开,体视镜下观察微渗漏。结果 4种树脂摩擦18 000次后总磨损量从小到大依次是Z、P、B、C。C、B、Z随摩擦次数增加,一定摩擦次数间产生的磨损量呈减少趋势。相同材料的树脂嵌体,其IDS组与对应DDS组的微渗漏情况差异没有统计学意义(P>0.05),其龈壁微渗漏与对应轴壁微渗漏差异亦没有统计学意义(P>0.05);但4种不同材料嵌体间的微渗漏情况皆有统计学差异(P<0.05),微渗漏从小到大依次为C、Z、P、B。结论 Z350拥有优良的耐磨性能和较小的微渗漏;随摩擦次数增加,Ceramage一定摩擦次数间产生的磨损量呈减少趋势,且边缘微渗漏最小。Z350和Ceramage均为制作树脂嵌体的优良选择。     

牙本质黏结界面的微渗漏与纳米渗漏

目的：观察牙本质黏结界面微渗漏与纳米渗漏,探讨两者的关系。方法：在离体人磨牙的颊、舌侧颈部制备盒形单面洞（直径3mm,洞深2mm）,将牙分为2组,每组5个牙。对2组牙的窝洞分别应用黏结剂Single Bond、Clearfil SE Bond,然后充填复合树脂并光照固化。所有牙齿进行冷热循环5000次,之后在牙齿表面涂指甲油。将牙齿浸泡于500g/L氨化硝酸银液（pH8.0）中,24h后再浸泡于显影液中8h。随后将牙纵向剖开,暴露充填物剖面,在体视显微、扫描电镜下观察剖面充填物龈缘渗漏情况。结果：所有牙剖面修复体龈缘均存在程度不同的微渗漏,有微渗漏的黏结界面处并未发现因黏结原因所造成的裂缝或微裂隙,但在混合层内观察到纳米渗漏。结论：牙本质黏结界面的微渗漏染色不一定因界面裂缝所致,界面无裂缝的纳米渗漏同样可造成微渗漏染色。     

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.     

5种牙本质黏结剂对人牙周膜细胞毒性的比较

目的：比较5种牙本质黏结剂对人牙周膜细胞的毒性作用。方法：原代培养人牙周膜细胞,采用四甲基偶氮唑盐比色法(MTT)和浸提液法,观察5种牙本质黏结剂(Super Bond C&B、Clearfil SE Bond、G-Bond、Single Bond2、Adper Easy One)不同体积分数浸提液(100%、50%、25%)作用不同时间(24 h、48 h、72 h)对人牙周膜细胞的毒性作用。采用SPSS19.0软件包对数据进行统计学分析。结果：5种牙本质黏结剂对人牙周膜细胞的细胞毒性Super BondP<0.05),48 h与72 h无显著差异(P>0.05)。结论：5种牙本质黏结剂细胞毒性程度不同,Super Bond C&B、G-Bond和Clearfil SE Bond的细胞毒性均较轻微,Single Bond2的细胞毒性较强。     

五种牙本质粘接剂对乳牙牙本质边缘封闭性的比较

目的 检测5种牙本质粘接剂对乳牙牙本质的粘接性能,为牙本质粘接剂的临床使用提供依据.方法 将50颗因滞留而拔除的乳前牙按随机数表法分为5组,每组10颗.用棒状金刚砂车针EX-41在唇面中1/3处制备约直径1.5mm、深1mm的Ⅰ类洞,各组分别使用FL-BondⅡ、Clearfil Protect Bond、Clearfil SE Bond、AdperTMEasy One和AdperTM Single Bond 2,每组分别按说明进行粘接,树脂充填.冷热循环5000次,体视镜下观察充填物边缘染料渗入的深度、分级进行统计.结果 各组均发生微渗漏,各组间微渗漏程度差异无统计学意义(P＞0.05).结论 AdperTM Easy One组的边缘封闭性与其他4组相同,由于操作简便更适用于儿童乳牙的粘接.     

硬化牙本质粘接界面纳米渗漏的激光扫描共聚焦显微镜观察

目的使用激光扫描共聚焦显微镜（CLSM）观察牙颈部硬化牙本质在全酸蚀和自酸蚀粘接系统形成粘接界面的纳米微渗漏情况。方法选取12颗因牙周病拔除的具有典型楔状缺损的上颌前磨牙为实验组，随机分为3组；选取12颗新鲜拔除的无龋人上颌前磨牙为对照组，人工形成楔状缺损，随机分为3组。选用3种牙本质粘接系统，即Single Bond（SB）、Clearfil SE Bond（CB）、Xeno Ⅲ（XB），按照厂家说明分别应用于牙本质楔状缺损表面。自凝树脂封闭根尖，6组试样分别浸泡于0.1%罗丹明B异硫氰酸盐的50%乙醇溶液中24 h，慢速砂片切割后CLSM下进行观察。结果粘接剂种类、牙本质类型对粘接界面的纳米渗漏长度有显著影响（P<0.05）。无论正常牙本质还是硬化牙本质，SB产生的纳米渗漏长度均大于CB和XB，且差异有统计学意义（P<0.05）。CB、XB之间差异无统计学意义（P>0.05）。正常牙本质上SB产生的纳米渗漏长度与硬化牙本质上SB产生的纳米渗漏长度间差异无统计学意义（P=0.148）；而CB、XB作用于正常牙本质上产生的纳米渗漏长度均大于硬化牙本质，且差异有统计学意义（P<0.05）。结论3种类型粘接系统均有纳米渗漏发生，硬化牙本质的粘接界面下纳米渗漏多发生在树脂与正常牙本质、硬化牙本质三者结合处的树脂与正常牙本质结合界面。     

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。     

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。     

新型通用型牙本质粘接剂修复Ⅴ类洞微渗漏疗效研究

目的    评价一种新型通用型牙本质粘接剂All Bond Universal对Ⅴ类洞边缘的封闭效果。方法    120颗新拔除的正常双尖牙随机分为4组（30例）,分别在颊舌侧颈缘上1 mm处制备标准的Ⅴ类洞（2 mm × 2 mm × 2 mm）,分别用新型通用型粘接剂All Bond Universal（全酸蚀和自酸蚀两种方法）、全酸蚀粘接剂Prime& Bond NT和自酸蚀结剂G Bond进行粘接和样本制备,经50 %氨化硝酸银染色后,体式显微镜下观察边缘微渗漏的染色情况,记录评分结果,数据用SPSS 20.0软件包进行统计学分析。结果    3种粘接剂均存在微渗漏现象,使用All Bond Universal的微渗漏评分低于同种使用方法的其他两组（P＜0.05）,All Bond Universal两种使用方法的微渗漏评分差异无统计学意义（P＞0.05）,龈方微渗漏评分整体高于牙合方（P＜0.05）。结论    新型通用型牙本质粘接剂All Bond Universal是一种临床应用方便、有效的牙本质粘接剂,全酸蚀和自酸蚀两种方法对边缘微渗漏的影响无差异,但其远期效果须进一步实验研究。     

The effect of current-generation bonding systems on microleakage of resin composite restorations.

OBJECTIVE: The aim of this study was to determine the microleakage of current-generation dentin bonding systems in Class II resin composite restorations. METHOD AND MATERIALS: Class II (occlusodistal or occlusomesial) cavity preparations with a gingival margin 2 mm apical to the cementoenamel junction were prepared on 70 noncarious, extracted human premolar teeth. Teeth were randomly divided into five groups and treated with different-generation bonding systems (Optibond FL, Gluma One Bond, Clearfil SE Bond, acid etching plus Clearfil SE Bond, and Prompt-L-Pop). All cavities were restored in a posterior resin composite and subjected to 200 thermocycles (at 5 degrees C to 55 degrees C; 30-second dwell time). After immersion in 0.5% basic fuchsin dye for 24 hours, the teeth were sectioned longitudinally and evaluated for dye penetration using a binocular stereomicroscope. RESULTS: There was no statistically significant differences among bonding systems in the degree of microleakage in the occlusal walls. For gingival walls, statistically significant differences were found only between the Clearfil SE Bond and Prompt-L-Pop groups and the Clearfil SE Bond with acid etching and Prompt-L-Pop groups. The greatest microleakage was observed in Prompt-L-Pop specimens. CONCLUSION: Most of the tested dentin bonding systems were able to eliminate microleakage completely in the occlusal walls, but some systems exhibited statistically significant differences in leakage in the gingival walls.     

Bond strength of self-etching primers to enamel and dentin of primary teeth.

PURPOSE: The objective of this in vitro study was to evaluate the tensile bond strength of three self-etching primers to human primary enamel and dentin. METHODS: Forty (40) freshly extracted primary molars were sectioned bucco-lingually and embedded in self-curing acrylic resin with the facial or lingual surfaces exposed. The specimens were wet ground to 600 grit SiC paper to expose a flat enamel or dentin surface. The materials tested were: Prompt L-Pop (LP2, ESPE), Clearfil SE Bond (CSE, Kuraray America), Etch and Prime 3.0 (EP, Degussa) anda control, Prime and Bond NT (NT, Dentsply/Caulk). The adhesive systems were applied according to the manufacturers' instructions. An inverted, truncated cone of composite (Pertac II, ESPE) with a 2-mm bonding diameter was cured using a polytetrafluoroethylene jig. The specimens were debonded in tension using a universal testing machine (Instron) at a crosshead speed of 0.5 mm/min. RESULTS: Analysis of variance (ANOVA) showed significant differences existed between the four systems and two surfaces. To enamel of primary teeth, Prime and Bond NT had significantly higher bond strength (25.9 MPa) than when bonding with the three acidic primers Prompt L-Pop (18.5 MPa), Etch and Prime 3.0 (19.3 MPa) and Clearfil SE Bond (18.7 MPa). Complete bond failures occurred with Prompt L-Pop and Etch and Prime 3.0 to dentin of primary teeth. With a mean of 39 Mpa, the bond strength to dentin of primary teeth with Clearfil SE Bond was significantly higher than with Prime and Bond NT (12.5 MPa). CONCLUSIONS: The results of this in vitro study show that the four adhesive systems tested bonded effectively to enamel of primary teeth, but only CSE achieved adequate bond strengths to dentin of primary teeth.     

Bonding to enamel and dentin using self-etching adhesive systems.

OBJECTIVES: This study investigated the effectiveness of three different dentin adhesive systems on the adhesion of resin composite to both dentin and enamel. METHOD AND MATERIALS: The flat dentin and enamel surfaces of 60 extracted human molar teeth were exposed by wet grinding with 600-grit silicon carbide paper. One total-etch self-priming adhesive system (Prime & Bond NT), one two-step self-etching primer adhesive system (Clearfil SE Bond), and one "all-in-one" self-etching adhesive system (Prompt L-Pop) were evaluated. Each bonding system was applied according to the manufacturer's instructions and followed by composite (TPH Spectrum) application. Twenty-four hours after bonding, the teeth were subjected to shear testing. There were 10 replicates for each group. RESULTS: Prompt L-Pop exhibited significantly higher bond strength values to enamel (27 +/- 4.2 MPa) than all other groups. There were no statistically significant differences for shear bond strength to dentin among adhesives. Prompt L-Pop showed the statistically significantly higher bond strength to enamel than dentin. There were no statistically significant differences between the enamel and dentin bond strengths of Clearfil SE Bond and Prime & Bond NT. CONCLUSIONS: The self-etching adhesive systems produced high bond strengths to human coronal dentin and ground enamel surfaces. These materials seem to be very promising for further clinical applications, and the results are very encouraging for the clinical success of these simplified adhesive systems. The self-etching adhesive systems produced even better bond strengths to both enamel and dentin than conventional total-etch systems, especially the "all-in-one" system, which produced the highest bond strength to enamel.     

Marginal seal comparisons between resin-bonded Class II porcelain inlays, posterior composite restorations, and direct composite resin inlays

The microleakage of indirect porcelain and direct composite resin-bonded inlays was compared with that of posterior composite resin restorations using Class II preparations of extracted molar teeth. The resin-bonded inlay restorations provided a better marginal seal at the cervical restoration/dentin interface than did the composite resin restoration. The efficacy of this marginal seal varied with the particular treatments and materials used. Resin-bonded porcelain inlays had a higher incidence of cervical excess from the composite resin luting agent than did the posterior composite resin restorations.     

Tensile bond strength of self-etching adhesive systems to primary dentin

PURPOSE: To assess in vitro the bond strength of three self-etching adhesive systems to primary teeth dentin. METHODS: Fifteen crowns of primary molars were sectioned mesiodistally and embedded in acrylic resin (n=30). Dentin was exposed and the specimens were randomly assigned in groups (n=10): (1) Clearfil SE Bond; (2) Prime & Bond NT/NRC; and (3) One Up Bond F. A 3 mm-diameter dentin bonding site was demarcated, the adhesive systems were applied and resin composite cones were bonded. After 24 hours in distilled water, tensile bond strength was tested to failure (0.5 mm/minute). Data were submitted to statistical analysis using one-way ANOVA and Scheffé test. RESULTS: Means were (MPa): (1) 16.60 (+/- 4.10); (2) 8.48 (+/- 4.51); and (3) 6.75 (+/- 1.26). CSE Bond yielded significantly higher bond strengths (P < 0.05). Prime & Bond NT/NRC and One Up Bond F means were markedly low and no statistically significant difference was observed between them.