大块充填复合树脂后牙窝洞充填效果的回顾性研究

目的 分析高粘型大块充填复合树脂Filtek Bulk Fill、粘度可变型大块充填复合树脂SonicFill和分层复合树脂Filtek Z350用于后牙深龋窝洞充填的临床效果。方法 回顾分析2019年3月至2019年6月期间于南京大学医学院附属口腔医院牙体牙髓病科行后牙深龋窝洞充填的91例病例,根据治疗时使用的充填材料分为Filtek Bulk Fill(FB)组（n=31）、SonicFill(SF)组（n=27）、Filtek Z350(Z350)组（n=33）。比较三组的充填体术后超过1年的成功率,以及边缘着色、边缘适应性、继发龋、术后敏感等边缘密合性相关指标。结果 大块充填复合树脂在充填体成功率以及边缘密合性方面存在着优于分层复合树脂的趋势,但无统计学意义(均P>0.05)。结论 大块充填复合树脂可用于后牙深龋窝洞充填,且可获得略优于分层复合树脂的治疗效果。     

不同光固化模式对大体积充填树脂固化效率影响的研究

目的比较不同光固化模式对Tetric N-Ceram Bulk Fill以及3M Filtek Bulk Fill flowable大体积充填树脂固化效率的影响。方法制作树脂样本60个,分为A~D四组,A、B两组采用Tetric N-Ceram Bulk Fill树脂制作,分别使用标准模式与软启动模式进行固化,C、D两组采用3M Filtek Bulk Fill flowable树脂制作,固化模式同上,固化结束后每组采用三种不同方法(ISO4049国际标准法、显微硬度法、交联程度法)检测大体积充填树脂的固化效率,结果采用SPSS 22.0软件进行统计分析。结果在标准光照模式下,大体积充填树脂的固化效率比软启动光照模式高,差异有统计学意义(P<0.05),不同的光照模式对树脂的显微硬度无显著影响,差异无统计学意义(P>0.05)。结论大体积充填树脂在标准模式的下固化效率高,光固化模式的改变对树脂的显微硬度无影响。     

3种大块充填树脂的耐磨耗性能及挠曲强度的比较研究

目的:比较3种大块充填树脂的耐磨耗性能及挠曲强度.方法:选取SDR、SonicFill、Tetric N-Ceram Bulk Fill及传统纳米树脂Herculite Precis,分别制作成直径为10 mm、高度为2 mm的圆柱体耐磨耗实验试件和2 mm×2 mm×25 mm长方体挠曲强度实验试件.将磨耗试件固定在往复滑动球-片式磨耗试验机上,以人工唾液作为磨耗介质,加载力为50 N,磨耗1万次后计算体积磨损值.应用万能实验机以1 mm/min的加载速度,测量并计算试件挠曲强度值.采用SPSS13.0软件包对4种复合树脂体积磨损量及挠曲强度值的差异进行单因素方差分析.结果:4种树脂的体积磨损量从大到小依次为SDR(1.2433±0.11) mm3、SonicFill (0.6331±0.09) mm3、Tetric N-Ceram Bulk Fi11(0.3558±0.05) mm3、Herculite Precis (0.3097±0.04) mm3,挠曲强度值从大到小依次为SonicFill(136.2184±14.61) MPa、HerculitePrecis(124.1468±18.25) MPa、Tetric N-Ceram Bulk Fill(119.2082±16.36) MPa、SDR(103.6246±7.03) MPao Tetric N-Ceram Bulk Fill与对照树脂Herculite Precis的体积磨损量和挠曲强度值均无显著差异(P＞0.05).结论:综合材料的耐磨耗性能和挠曲强度,大块充填树脂Tetric N-Ceram Bulk Fill可能更适合作为后牙直接充填材料.     

四种复合树脂充填修复磨牙的临床评估

目的:采用改良的USPHS评价标准和扫描电镜,评估4种复合树脂充填修复磨牙的临床效果。方法:选择4种复合树脂(通用型树脂3M Filtek Z350 XT和Dentsply Spectrum TPH3,后牙专用型树脂3M Filtek P60和大块树脂Voco X-tra fil)充填修复后牙I类洞缺损,在充填术后1、12个月,采用USPHS分级评价标准评估其临床效果。同时在扫描电镜下进一步观察充填体的表面微观形貌。结果:术后1月,大块树脂组在颜色匹配性能上显著逊色于3种传统树脂组(P<0.05),其余性能指标方面4组无统计学差异(P>0.05)。术后12月,大块树脂各项性能显著逊色于其余3组(P<0.05);大块树脂各项指标均显著下降(P<0.05),而其余3组各项指标无显著下降(P>0.05)。扫描电镜观察显示,Z350组表面最光滑,X-tra组表面较粗糙。结论:大块树脂在各方面性能指标上的长期效果均不如传统分层充填树脂,尤其表现在颜色匹配性上。     

3种复合树脂充填Ⅴ类洞的微渗漏比较研究

目的:比较义获嘉N Ceram纳米瓷化树脂、N Flow流动树脂及Bulk Fill 三次方大块充填树脂充填上颌前磨牙Ⅴ类洞后树脂充填体边缘的微渗漏情况,评估3种不同复合树脂的抗微渗漏性能,寻找较好的充填V类洞的复合树脂材料.方法:选取牙体完整、健康的人离体前磨牙66颗,随机分为3组(n=22).所有样本牙在颊侧颈部制备标准V类箱状洞型(长4 mm、宽3 mm、深2 mm).3组试验牙经选择性釉质酸蚀自黏结后,分别使用N Ceram纳米瓷化树脂(A组)、N Flow流动树脂(B组)及Bulk Fill三次方大块充填树脂(C组)进行充填.充填完成后,3组试验牙均行弱光启动固化,打磨抛光.将3组样本进行1500个周期的冷热循环,2％亚甲基蓝浸泡染色7d,然后沿牙体颊舌向切片.每组随机选取2颗样本牙,在扫描电镜下观察牙体-充填体交界面的密合程度;其余60颗样本牙在体视显微镜下(×40)观察剖面充填体的微渗漏情况.采用Spot Advanced软件测量微渗漏深度,并根据0～3分分别给(牙合)、龈壁微渗漏程度评分.采用SPSS17.0软件包对各组的微渗漏深度分别进行Kruskal-Wallis秩和检验和Mann-Whitney检验.结果:义获嘉Bulk Fill组树脂在3组中龈壁的微渗漏最小,且与另外2组相比有显著差异,N Ceran纳米树脂组与N Flow流动树脂组龈壁的微渗漏均较高(P＜0.05);3组复合树脂材料(牙合)壁的微渗漏无显著差异(P＞0.05);3组树脂(牙合)壁的微渗漏值均比龈壁小且差异显著(P＜0.05).结论:3组树脂在(牙合)壁的微渗漏值无显著差异.义获嘉Bulk Fill组树脂充填V类洞时.在3组中龈壁的微渗漏最小,且与另外2种树脂之间有显著差异.     

变形链球菌侵袭对4种复合树脂粘结界面老化的影响

目的:探讨变形链球菌侵袭对4种复合树脂粘结界面老化的影响。方法:选取2种大块充填复合树脂和2种传统复合树脂,将4种复合树脂材料试件浸入菌液内孵育14 d,之后对试件进行超声清洗,在体视显微镜下观察粘结面裂隙面积占总粘结面积的百分比,以了解粘结表面破坏情况;在每组中选取2个样本,使用离子溅射仪喷金,喷金后的标本用导电胶固定在标本台上,用扫描电镜观察对比4种材料粘结面破坏情况。结果:4种复合树脂在变形链球菌侵袭下具有不同形式的破坏,粘结破坏程度各组之间不存在显著差异,SDR对应的级别平均值最大,Z350稍微大于P60和Tetric N-Ceram Bulk Fill;P60与Tetric N-Ceram Bulk Fill,粘结面破坏均位于粘结面与牙本质间,树脂Z350和SDR裂隙产生在粘结面与树脂间。结论:变形链球菌在短期内可破坏复合树脂表面及粘结界面,成分不同破坏方式不同,破坏程度没有显著差异。     

流动型树脂衬洞对可压型树脂充填Ⅰ类洞微渗漏的影响

目的研究流动型树脂衬洞对两种可压型树脂充填Ⅰ类洞微渗漏的影响。方法 48颗健康离体磨牙制备Ⅰ类洞。样本随机分为TBF组(Tetric N-Cream Bulk Fill)、P60水平组(Filtek P60)、P60斜形组(Filtek P60),每组16颗,每组再分别分为2小组:一组用流动树脂衬洞,另一组不衬洞。将充填完成的样本置于2%亚甲基蓝溶液中浸泡24 h后,经修复体中央沿颊舌向剖开,体视显微镜下观测染料浸入的深度,并进行统计学分析。结果使用流动树脂衬洞的TBF组和P60斜形组微渗漏最小,较其他组差异有统计学意义,两组间差异无统计学意义。结论流动树脂衬洞可以减小树脂充填后的微渗漏,使用瓷化纳米大块树脂充填比P60斜形分层充填更节省操作时间,可获得与P60斜形分层充填术相当的边缘封闭性。     

3种大块后牙充填树脂体外操作时间与微渗漏的对比观察

目的以传统分层充填树脂为对照比较3种大块充填后牙树脂体外充填所用时间及微渗漏的情况。方法选取符合纳入标准的第三磨牙40颗于面统一制备4 mm×4 mm×4 mm的Ⅰ类洞,随机分成A、B、C、D四组,分别用Sonic Fill超声充填树脂,Sure Fil SDR整层充填流动树脂,Tetric N-Ceram bulk Fill大块充填树脂,Filtek Z350后牙树脂充填,记录每次充填完成的时间,充填样本经冷热循环实验后置于印度墨水中浸泡24 h,干燥后沿样本近远中向剖开,于体视显微镜下观察样本染料渗入深度,并测量计数,进行统计学分析。结果四组操作时间的差异比较,A、B组差异无统计学意义(P>0.05),其余各组两两比较差异均有统计学意义(P<0.05),C组耗时最少,传统分层充填D组耗时最多。四组微渗漏均有发生,数值差异无统计学意义(P>0.05)。结论 3种后牙大块充填树脂均可达到与传统分层充填相同的边缘封闭性,且较后者操作时间短,操作简单。     

5种复合树脂不同水浴时间的压缩强度体外实验评价

目的　评价5种市场常用的复合树脂固化后经不同水浴时间压缩强度的变化。方法　将5种复合树脂（Nulite F,Filtek Z250,Filtek P60,Beautifil II,Charisma）分别制作24个圆柱体试件并固化,每种复合树脂再分为4组,每组6个样本,其中1组浸泡于37 ℃蒸馏水浴1 h,另外3组分别接受蒸馏水浴1 d、7 d和30 d,测试各组的压缩强度值。测试结果以One-way ANOVA和LSD法统计学检验。结果　水浴1 d后,各品牌复合树脂的压缩强度值均有明显提高。树脂试件经1 h水浴时,Filtek Z250的平均压缩强度最高,Beautifil II其次;1 d和7 d水浴后,Filtek P60 和Filtek Z250的压缩强度最高,Beautifil II居中;30 d水浴后,Filtek Z250的压缩强度最高。结论　Filtek P60和Filtek Z250具有较好的抗压性能,复合树脂充填修复一段时间后压缩强度值才能达到最大。     

抛光对三种复合树脂表面粗糙度影响的实验研究

目的：采用临床上常用的3种充填用光固化复合树脂进行抛光后对比研究,为临床医师选择适当的牙体充填材料提供指导。方法：选择3种临床常用的前后牙通用光固化型复合树脂（Filtek Z250,Spectrum TPH,CHARISMA）,均用Sof-lex抛光系统修整、抛光,扫描电镜观察抛光前和抛光后的表面形态,并用表面粗糙度仪测定其粗糙度,对检测结果进行统计学分析。结果：3种复合树脂经同一种抛光系统处理后粗糙度值均增大,不同复合树脂之间的两两比较显示存在显著性差异;Filtek Z250组表面粗糙度值（Surface Roughness,Ra）无论抛光前后,均较其他两种树脂的Ra值小。结论：用Sof-lex抛光系统修整、抛光,Filtek Z250在三种复合树脂中有较/最佳的抛光性能。     

Evidence of the validity of a model of determinants of quality of restorative dental care

A model describing the relationship between self-reported quality of restorative dentistry and dentist characteristics for 119 Montana general dentists is presented. The best predictors formed a significant model explaining 22% of the variance of the quality measure. Results are contrasted with a previous estimation of the model for 102 Washington general practitioners. Evidence for the external validity of the model is presented.     

Experimental evidence of formation of imines in the course of reduction of hydrazones

The reduction of hydrazones is generally suggested to proceed through a reductive cleavage of the nitrogen–nitrogen bond followed by a reduction of the carbon–nitrogen bond. This sequence of reduction processes is here supported for fluorenone (V) and benzophenone (VI) hydrazones as well as by a comparison of the reduction of fluorenone and benzophenone hydrazonium ions (I,III) with corresponding imines (II,IV). Another proof of the presence of imines as intermediates is the splitting of four-electron waves of hydrazones V and VI and hydrazonium ions I and VIII into two waves at pH < 2. This has been interpreted as due to differences in slopes dE_1/2/dpH and pK_a-values of protonated hydrazine derivatives on one side and corresponding imines on the other. In this pH-range imines formed in reductions of VI and VIII are reduced in a single two-electron wave, those of I and V in two one-electron steps. Fluorenone imine (II) is sufficiently stable to allow recording of time-independent current–voltage curves between pH 6 and 11. In this pH-range the imine (II) is reduced in two one-electron steps. Benzophenone imine (IV) has been found stable between pH 4.6 and 12. At pH 4.6–8 the reduction of the imine IV takes place in a single two-electron step, at pH 8–12 in two one-electron steps. Final proof of the initial cleavage of the N–N bond is presented by comparison with the reduction of nitrones.     

不同剂型玻璃离子水门汀溶解性比较研究

目的:研究、比较不同剂型玻璃离子水门汀的溶解性和表面微观形态改变,为临床使用提供依据.方法:将3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)及GC玻璃离子水门汀(双糊剂型)分别在人工唾液中浸泡30 d,冷热循环15000次,烘干测重,比较前后质量变化,计算溶解率,并用扫描电镜观察表面微观改变.结果:不同剂型的玻璃离子水门汀溶解率由高到低分别为3M树脂加强型玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(水粉剂型)、GC玻璃离子水门汀(双糊剂型).3种玻璃离子水门汀经浸泡溶解后,SEM扫描表面微观形态可观察到GE玻璃离子水门汀(双糊剂型)表面形态改变较少,其他2组玻璃离子水门汀表面微观改变较多.结论:双糊剂型玻璃离子水门汀理化性能及溶解率均低于传统水粉剂型,是未来临床修复治疗的的良好选择.     

Evaluation of efficacy of chemiluminescence for diagnosis of leukoplakia

ObjectiveLeukoplakia is the most common potentially malignant disorder preceding oral cancer. Chemiluminescence has been developed as an adjunct to conventional examination for the diagnosis of these potentially malignant disorders. This study was conducted to assess the efficacy of chemiluminescence in the diagnosis of leukoplakia and to compare the results with histopathological examination.Study designA total of 50 patients with leukoplakia were included from the outpatients attending the Department of Oral Medicine and Radiology, Dental Hospital, Bengaluru, Karnataka, India. These patients were subjected to conventional oral examination followed by chemiluminescent examination with Vizilite (Zila, Fort Collins, CO, USA) and biopsy for histopathological confirmation.ResultsThe sensitivity, specificity, positive predictive value, and negative predictive value of chemiluminescence were 93.75%, 55.56%, 78.95%, and 83.3%, respectively. The overall accuracy of chemiluminescence was 80%. A statistically significant association was observed between histopathology results and chemiluminescence results.ConclusionAlthough it is an easy, safe, minimal time consuming, and noninvasive technique, it has only adjunctive utility and it does not replace biopsy for the diagnosis of leukoplakia.     

颌骨动静脉畸形的栓塞治疗

目的：总结直接穿刺结合经血管内介入栓塞治疗颌骨动静脉静脉畸形的经验。方法：收治凳骨动静脉畸形患者6例,均进行了介入栓塞治疗。采用的栓塞材料为附凝血棉纤毛的螺圈,聚乙烯醇泡沫微粒和二氰基丙烯酸对丁酯。数字减影颈动脉造影在PHILIPSV300下完成。结果6例颌骨动静脉畸形患者中4,例急性出血得到了快速、有效控制,1例慢性渗血的右下 骨动静脉畸形患者,介入栓塞治疗,拔除松动的右下凳第一磨牙,有效地控制了出血,另1例伴局部软组织搏动性膨隆的上凳骨动静脉畸形患者,介入治疗后膨隆的搏动性得到明显改善,栓塞治疗后分别随访3－24个月,均未发现有口腔内渗血或出血。随访的X线片上,病灶区可见新骨形成。结论：局部穿刺结合经血管内介入栓塞治疗颌骨动静畸形是一种安全、有效的治疗方法。     

Design of clinical trials of traditional therapies of periodontitis

The present paper on the design of clinical trials of periodontal therapy first addresses the issue of the etiology of periodontal disease. It is suggested that most if not all forms of destructive periodontal disease are caused by microorganisms and that there are different forms of disease with different microbial etiologies. The progressive nature of destructive periodontal disease is subsequently discussed and it is emphasized that, in a given patient, periodontal sites which show signs of inflammation and attachment loss may not over a period of several months and years show further sign of attachment loss. The present methods of assessing periodontal disease do not allow us to discriminate between potentially active and inactive sites in untreated patients. The significance and variability of indicators of periodontal disease such as bleeding on probing, probing pocket depth and probing attachment level measurements are discussed. The errors inherent in the various measurements are analyzed and suggestions are presented describing how alterations in any of the above parameters could be identified and presented in a clinical trial. Of concern for the statistical analysis of clinical data of periodontal disease is the definition of the "experimental unit". For a number of years, the "experimental unit" in periodontal trials was the patient. It is clear, however, that different sites within the same individual show different patterns of disease progression and lesion morphology and often respond differently to periodontal therapy. Statistical analyses must consequently be designed which recognize differences in site-to-site infection and lesion morphology within a common host. Until such analyses are available, the investigator should be wary of pooling data within the same individual, since such pooling may obscure meaningful alternatives which may take place in individual periodontal sites. Some goals of periodontal therapy are subsequently identified. 4 goals are discussed more in detail, namely: to establish conditions which will allow the patient to maintain a dentition without further breakdown of the periodontium; to reduce pocket depth to establish an anatomy in the dentogingival region which with proper maintainance care will prevent the re-establishment of the subgingival infection; to gain attachment as a result of treatment; to assess the effect of a certain chemotherapeutic agent on periodontal disease.     

正畸患者切牙影像失真发生情况分析

目的研究正畸患者曲面体层片上的切牙影像失真发生情况，并分析其原因。 方法从中山大学附属口腔医院放射科影像数据库中选取500例正畸患者的曲面体层片和头影测量侧位片，所有曲面体层片均采用咬合杆投照，分别从切牙牙体影像放大、缩小、牙根变短、根尖模糊等评价指标分析上下颌切牙影像失真的发生情况，在头影测量侧位片上测量中切牙根尖-对颌切牙切缘的距离，探讨切牙影像失真发生的原因。采用SPSS 19.0统计软件对所得数据进行统计学检验。 结果500例患者中，切牙牙体影像正常者共417例，切牙牙体影像失真者共83例，影像失真发生率16.6%，其中切牙牙体影像放大17例、牙体影像缩小0例、牙根变短30例，牙根影像变短伴模糊36例。影像失真患者的根尖-切缘距离大于影像正常的患者，差异有统计学意义（F = 5 187.18，P = 0）；影像失真患者的覆盖值大于影像正常的患者，差异有统计学意义（F>477，P = 0）。 结论严重牙颌面畸形如反 、深覆盖是导致曲面体层片的切牙影像失真的主要原因之一。     

正常青年Monson球面半径的测量研究

目的测量正常青年Monson球面半径。方法选择60名(男30名,女30名)正常青年制取全口印模,应用立体摄影成像的原理与方法对Monson球面半径进行测量和统计学处理。结果Monson球面的半径平均为10.173 cm,大于理论值10.160 cm,差异有显著性(P<0.01);男、女性球面半径差异无显著性。结论本实验所得到的数据可作为全口义齿修复中记录颌位关系的一个参量。     

鼻测量法的进展

唇裂术后继发畸形是指唇裂修复术后,仍遗留或继发于手术操作和生长发育变化而表现出来的一类畸形[1]。包括唇畸形、鼻畸形和颌骨畸形。其修复较原发性唇裂修复更复杂,更灵活多变。而导致其修复复杂性的一个重要原因即是局部组织结构复杂变异和缺乏可靠的三维测量手段[2],鼻畸形     

《口腔医学》杂志2007年度有关信息的分析

目的通过对《口腔医学》2007年全年文献的回顾和分析,了解我国口腔临床医学的研究现状。方法阅读2007年《口腔医学》全年的文献,对各种信息进行了分类汇总,根据设计类型对临床一次性文献进行了分类,并对其中的试验性研究文章进行质量分析。结果《口腔医学》2007年全年的一次性文献274篇,基础和临床文献分别为108和166篇,以临床文献为主(60.58%)。在临床研究文献中,属于观察性、分析性和试验性的文献分别为97、9和60篇,观察性文献所占比例为36.14%,高于以往的报道。60篇观察性文献中,全都设有对照;统计方法应用得当者44篇;真正做到随机、盲法的分别只有4和2篇。结论我国口腔临床方面的研究水平近年来提高明显,但设计的科学性方面有待提高。