纤维增强树脂粘接桥修复老年缺失前牙的临床观察

目的:探讨纤维增强树脂粘接桥修复老年缺失前牙的临床效果。方法:选取48例前牙缺失的老年患者,行纤维增强树脂粘接桥修复缺失前牙,对义齿的固位、功能和使用情况进行30个月的随访临床观察。结果:1例修复体折裂,2例修复体脱粘接,其余45修复体均获得成功,患者咀嚼、容貌改善明显,达到预期对义齿功能和美观的要求。结论:纤维增强树脂粘接桥修复老年缺失前牙是一种大道至简的修复方案,适宜临床推广应用。     

牙周炎患者前牙热压铸全瓷粘接桥3年临床应用研究

目的:观察IPS e.max热压铸造全瓷粘接桥修复牙周炎患者单颗上前牙或2颗以内下前牙缺失的临床效果。方法:36例牙周炎患者经系统性牙周基础治疗后共制作38件双翼前牙热压铸造全瓷粘接桥,修复后3个月、6个月、12个月、24个月、36个月随访。观察修复体完整性、颜色匹配,基牙继发龋及边缘着色。分别记录基牙菌斑指数、牙龈指数、牙周探诊深度和附着丧失,比较修复前后基牙牙周组织的变化。结果:整体修复成功率为92.1%,2例全瓷粘接桥修复后分别于6个月和10个月脱落,均重新粘接后继续使用;1例全瓷粘接桥修复后翼板边缘部分瓷层折断,局部抛光后继续使用,其余35例均无异常,基牙未出现继发龋和边缘着色,修复体颜色与邻牙协调。修复后菌斑指数、牙龈指数、牙周探诊深度较修复前均明显降低,附着丧失修复前后无明显变化。结论:前牙缺失2颗以内的牙周炎患者,采用热压铸造全瓷粘接桥修复,恢复前牙美观和功能的同时可促进病变牙周组织愈合,临床修复效果较好。     

改良everStick C&B纤维树脂粘接桥在老年切牙缺失修复中的疗效观察

目的:评价改良everStick C&B纤维树脂粘接桥在老年切牙缺失修复中的临床疗效。方法:纳入年龄65岁以上切牙缺失患者32例。其中上颌切牙缺失13例、下颌切牙缺失19例;缺牙1颗13例、缺牙2颗11例、缺牙3颗5例、缺牙4颗3例;基牙松动24例、基牙无松动8例。对所有患者均采取改良everStick C&B纤维树脂粘接桥修复治疗。分别于修复完成后6、 12、 18个月复查,复查内容包括修复体脱粘接、折断、颜色变化、缺损以及基牙松动、牙周组织炎症等6项指标。修复完成后6个月对患者进行满意度调查,调查内容包括治疗过程是否舒适、美观效果是否满意、修复后发音、咀嚼是否舒适等3项指标。结果:32位老年患者修复完成后6个月,6项指标均为A级。12个月,出现1例修复体缺损B级,2例基牙牙周组织炎症B级,其余均为A级。18个月,出现1例修复体缺损B级,3例基牙牙周组织炎症B级,其余均为A级。2例修复体缺损B级经过树脂充填后均达到A级。5例基牙牙周组织炎症B级经过牙周洁治后5～7 d均达到A级。患者满意度调查3项指标均为A级。结论:改良everStick C&B纤维树脂粘接桥...     

复合树脂高强纤维夹板在晚期牙周炎中的临床应用

目的本研究从循证医学的观点出发，探索复合树脂高强纤维夹板在晚期牙周炎松牙固定及修复中的疗效。方法选择慢性牙周炎患者20名，在牙周基础治疗完善的基础上，利用复合树脂高强纤维夹板固定松动牙，通过临床疗效评定标准以及口腔健康影响量表进行疗效评估。结果治疗后所有患者均感觉口腔功能得到明显提升，生活质量得到明显改善。结论复合树脂高强纤维夹板在晚期牙周炎的松牙固定中具有广泛的应用前景。     

纤维增强复合材料在口腔医学中的应用

纤维增强复合树脂材料（FRC）是一种工程材料,近年来逐渐引入到口腔材料领域中,因而FRC成为目前国际国内研究的热点。FRC不仅可用于义齿基托加强和修补,还可以应用于牙周夹板,固定义齿修复。桩核系统,种植义齿,覆盖义齿和正畸保持器等。     

单端全瓷树脂粘接桥在青少年正畸后缺失切牙间隙保持中的应用1例

本文报道1例右下侧切牙缺失的正畸后青少年病例,利用右下尖牙为基牙,以单端全瓷树脂粘接桥恢复牙列完整,保持缺牙间隙并恢复功能与美观。     

用免疫荧光法快速鉴定牙周炎龈下菌斑中的嗜CO2噬纤维菌

用间接免疫荧光法(IF法)对34例成年人牙周炎患者(AP)的龈下菌斑和40例健康对照者(H)龈缝菌斑中的黄褐嗜CO_2噬纤维菌(C.ochracea Co)和生痰嗜CO_2噬纤维菌(C.spudgena Cs)进行快速鉴定,并用KV选择培养基对标本中的嗜CO_2噬纤维菌进行分离、鉴定,结果两法符合率为85.1％,Cs在AP组的检出率显著高于H组(P<0.05)。提示:Cs与AP的发病有一定关系,IF法快速鉴定龈下菌斑中Co和Cs是良好的方法。     

纤维强化树脂粘接桥在前牙种植过渡修复中的应用

目的评价纤维强化树脂粘接桥在前牙种植过渡义齿修复中的临床应用效果。方法1～2颗上前牙缺失的种植义齿修复患者,在种植体植入术后即刻应用强力纤维强化树脂夹板技术制作粘接式树脂过渡义齿,观察其临床效果。结果共完成21例,1例因咬合过紧、意外咬到硬物脱落,改用隐形义齿修复。其余均无松动脱落,持续至二期修复,最长观察13个月。观察期内临时义齿均出现不同程度变色,但患者对美学效果均感满意。结论纤维强化的粘接式树脂临时桥,美观、舒适、不影响伤口愈合,可满足前牙种植过渡修复的要求。     

Connect超强纤维带+光固化复合树脂在前牙冠桥修复中的应用

前牙缺损,缺失的修复以金属烤瓷冠桥修复为主。我科自2001年起利用超强纤维带＋光固化复合树脂作冠桥修复前牙缺损,缺失,取得满意效果。     

锤造壳冠桥体在个别磨牙缺失修复中的应用

个别磨牙缺失在临床修复中,由于其咬合力较大,不论采用局部活动义齿或固定义齿修复,都存在着一定的自身缺陷。如活动义齿可因咀嚼出现桥体破裂,特别是(牙合)龈距离较低时在临床上则更为多见。而锤造固定义齿由于采用锤造金属咬合面与桥架的方法,其焊接区域较小,整体抗挠曲能力差,可出现固位体与桥     

Use of short fiber-reinforced composite with semi-interpenetrating polymer network matrix in fixed partial dentures

OBJECTIVES: The aim of this study was to determine the static load-bearing capacity of fixed partial dentures (FPDs) made of experimental composite resin (FC) with short fiber fillers and interpenetrating polymer network (IPN) polymer matrix. MATERIALS AND METHODS: Experimental composite FC resin was prepared by mixing short E-glass fibers (3mm in length) of 22.5wt% and IPN-resin 22.5wt% with silane treated silica fillers 55wt%. Four groups of FPDs (3-unit) were fabricated (n=6); Group A: made from commercial composite resin (Sinfony dentin, 3M-ESPE, control), Group B: Sinfony and fiber-reinforced composite (FRC) substructure, Group C: made from FC, Group D: made from FC with 1mm surface layer of Sinfony. The bridges were polymerized with a hand-light curing unit for 40s then post-cured in vacuum curing device (Visio Beta) for 15min before they were statically loaded with speed of 1mm/min until fracture. Failure modes were visually examined. Data were analyzed using ANOVA (p=0.05). RESULTS: ANOVA revealed that bridges made from experimental fiber composite had statistically significantly higher load-bearing capacity (2171N) (p<0.05) than the control restorations (1482N). SIGNIFICANCE: Restorations made from short glass fiber containing composite resin with IPN-polymer matrix showed better load bearing capacity than in those made with conventional composites resin and similar with those reinforced with FRC-substructure.     

Direct restoration of severely damaged incisors using short fiber-reinforced composite resin

OBJECTIVES: The aim of this in vitro study was to evaluate the static load-bearing capacity and the failure mode of endodontically treated maxillary incisors restored with complete crowns made of experimental composite resin (FC) with short fiber fillers, with and without root canal posts. Further aim was to evaluate the effect of fiber-reinforced composite resin (FRC) on the failure mode of the restoration. MATERIAL AND METHODS: The experimental composite resin (FC) was prepared by mixing 22.5 wt.% of short E-glass fibers (3mm in length) and 22.5 wt.% of semi-interpenetrating polymer network (IPN) resin with 55 wt.% of silane treated silica fillers. The clinical crowns of 30 human extracted maxillary incisors were sectioned at the cemento-enamel junction. Five groups of direct complete crowns were fabricated (n=6); Group A: made from particulate filler composite resin (PFC) (Grandio Caps, VOCO, control), Group B: PFC with fiber post (everStick, StickTeck), Group C: made from PFC with everStick fiber post and FRC-substructure, Group D: made from FC, Group E: made from FC with FRC-substructure. The root canals were prepared and posts were cemented with resin cement (ParaCem Universal). All restored teeth were stored in water at room temperature for 24h before they were statically loaded with speed of 1.0 mm/min until fracture. Data were analyzed using ANOVA (p=0.05). Failure modes were visually examined. RESULTS: ANOVA revealed that restorations made from experimental fiber composite resin had higher load-bearing capacity (349N) (p<0.05) than the control restorations (173N). No significant difference was found in load-bearing capacity between restorations reinforced with FRC-substructure and those without (p>0.05). CONCLUSIONS: Restorations made from short glass fiber containing composite resin with IPN-polymer matrix showed better load-bearing capacity than those made with either plain PFC or PFC reinforced with fiber post.     

正畸结合高强纤维夹板在牙周病治疗中的应用

目的：评价正畸结合超强玻璃纤维夹板治疗牙周病的临床效果。方法：14例成人牙周病继发牙[牙合]畸形患者,在控制牙周炎症的基础上,应用固定矫治技术进行牙[牙合]畸形的矫治,并采用超强玻璃纤维加树脂作为固定牙周夹板。结果：随访1～3年,牙齿排列整齐,前牙覆[牙合]覆盖关系正常,牙周状况明显改善,有效地巩固了牙[牙合]畸形的矫治效果,增强了美观。结论：正畸治疗是牙周病综合治疗的重要组成部分,可以恢复牙列外形,达到改善和恢复咀嚼功能的目的;超强纤维牙周夹板的应用可有效地保持错[牙合]畸形的矫治效果,保存松动患牙。     

Comparison of load-bearing capacity of direct resin-bonded fiber-reinforced composite FPDs with four framework designs

OBJECTIVES: This in vitro study was aimed to compare the fracture resistance of directly fabricated inlay-retained fiber-reinforced composite (FRC) fixed partial dentures (FPDs) with four types of framework designs. METHODS: Forty-eight directly fabricated inlay retained FPDs were made of FRC and particulate resin composite (everStick/Tetric flow and Ceram). Extracted human mandibular first premolars and first molars were as abutments. The following framework designs were tested: in the Group A (control group), the framework was made of two prepregs of unidirectional glass FRC; the Group B, two prepregs in pontic portion were covered with one layer of multidirectional fiber veil FRC; the Group C, the FRC prepregs were covered in pontic portion with four short unidirectional FRC pieces along the main prepregs; in Group D, one short unidirectional FRC prepregs were placed on the main prepregs in 90 degrees angle to the main framework. After thermal cycling, FPDs of each group (n=12) were randomly divided into two subgroups (n=6). Fracture test was performed at the universal testing machine (1mm/min) where FPDs were loaded from the occlusal direction to the occlusal fossa or to the buccal cusp. Failure patterns were observed with stereomicroscope. Median and 25%/75% percentile values were calculated and nonparametric analysis was performed. RESULTS: Compared with three other framework designs, the FPDs in Group D showed the highest resistance when loading to the occlusal fossa, with maximum load of 2,353.8N (25%/75%: 2,155.5/2,500.0) (p=0.000, 0.000, and 0.005 for compared with Group A, B, and C). The same group showed also higher resistance when loaded to the buccal cusp (1,416.3N (1,409.2/1,480.8)) if compared to the FPDs of the Group A and Group C (p=0.044, 0.010). In general the FPDs showed higher resistant to loading at the occlusal fossa (p<0.05). CONCLUSIONS: This in vitro study showed that inlay-retained FRC FPD constructed with direct technique provided high fracture resistance. The framework design that provided support for the veneering composite of the pontic contributed to the highest load-bearing capacity even when loaded to the buccal cusp.     

Load-bearing capacity of human incisor restored with various fiber-reinforced composite posts

Objectives

The aim of this study was to evaluate the load-bearing capacity and microstrain of incisors restored with posts of various kinds. Both prefabricated titanium posts and different fiber-reinforced composite posts were tested.

Methods

The crowns of human incisors were cut and post preparation was carried out. The roots were divided into groups: (1) prefabricated serrated titanium posts, (2) prefabricated carbon fiber-reinforced composite posts, (3) individually formed glass fiber-reinforced composite posts with the canal full of fibers, and (4) individually formed “split” glass fiber-reinforced composite posts. The posts were cemented and composite crowns were made. Intact human incisors were used as reference. All roots were embedded in acrylic resin cylinders and stored at room temperature in water. Static load was applied under a loading angle of 45° using a universal testing machine. On half of the specimens microstrain was measured with strain gages and an acoustic emission analysis was carried out. Failure mode assessment was also made.

Results

The group with titanium posts showed highest number of unfavorable failures compared to the groups with fiber-reinforced composite posts.

Significance

With fiber-reinforced composite posts the failures may more often be favorable compared to titanium posts, which clinically means repairable failures.     

Osseointegration of fiber-reinforced composite implants: Histological and ultrastructural observations

ObjectivesThe aim of this study was to evaluate the bone tissue response to fiber-reinforced composite (FRC) in comparison with titanium (Ti) implants after 12 weeks of implantation in cancellous bone using histomorphometric and ultrastructural analysis.Materials and methodsThirty grit-blasted cylindrical FRC implants with BisGMA–TEGDMA polymer matrix were fabricated and divided into three groups: (1) 60 s light-cured FRC (FRC-L group), (2) 24 h polymerized FRC (FRC group), and (3) bioactive glass FRC (FRC–BAG group). Titanium implants were used as a control group. The surface analyses were performed with scanning electron microscopy and 3D SEM. The bone–implant contact (BIC) and bone area (BA) were determined using histomorphometry and SEM. Transmission electron microscopy (TEM) was performed on Focused Ion Beam prepared samples of the intact bone–implant interface.ResultsThe FRC, FRC–BAG and Ti implants were integrated into host bone. In contrast, FRC-L implants had a consistent fibrous capsule around the circumference of the entire implant separating the implant from direct bone contact. The highest values of BIC were obtained with FRC–BAG (58 ± 11%) and Ti implants (54 ± 13%), followed by FRC implants (48 ± 10%), but no significant differences in BIC or BA were observed (p = 0.07, p = 0.06, respectively). TEM images showed a direct contact between nanocrystalline hydroxyapatite of bone and both FRC and FRC–BAG surfaces.ConclusionFiber-reinforced composite implants are capable of establishing a close bone contact comparable with the osseointegration of titanium implants having similar surface roughness.     

Evaluation of some properties of two fiber-reinforced composite materials

Objective. Water sorption, flexural properties, bonding properties, and elemental composition of photopolymerizable resin-impregnated fiber-reinforced composite (FRC) materials (everStick C&B and BR-100) (FPD) were evaluated in this study. Material and methods. Bar-shaped specimens (2×2×25 mm) were prepared for water sorption and flexural strength testing. The specimens (n=6) were polymerized either with a hand light-curing unit for 40 s or, additionally, in a light-curing oven for 20 min and stored in water for 30 days. Water sorption was measured during this time, followed by measurements of flexural strength and modulus. A shear bond strength test was performed to determine the bonding characteristics of polymerized FRC to composite resin luting cement (Panavia-F), (n=15). The cement was bonded to the FRC substrate and the specimens were thermocycled 5000 times (5–55°C) in water. SEM/EDS were analyzed to evaluate the elemental composition of the glass fibers and the fiber distribution in cross section. Results. ANOVA showed significant differences in water sorption according to brand (p<0.05). Water sorption of everStick C&B was 1.86 wt% (hand-unit polymerized) and 1.94 wt% (oven polymerized), whereas BR-100 was 1.07 wt% and 1.17 wt%, respectively. The flexural strength of everStick C&B after 30 days’ water storage was 559 MPa (hand-unit polymerized) and 796 MPa (oven-polymerized); for BR-100, the values were 547 MPa and 689 MPa, respectively. Mean shear bond strength of composite resin cement to the FRC varied between 20.1 and 23.7 MPa, showing no statistical difference between the materials. SEM/EDS analysis revealed that fibers of both FRC materials consist of the same oxides (SiO₂, CaO, and Al₂O₃) in ratios. The distribution of fibers in the cross section of specimens was more evenly distributed in everStick C&B than in BR-100. Conclusion. The results of this study suggest that there are some differences in the tested properties of the FRC materials.     

Evaluation of fracture resistance of pulpotomized second primary molars restored with fiber-reinforced composite

ObjectivesFiber reinforcement of composite restorations can help decrease the fracture risk in restored pulpotomized teeth with severe coronal lesions.This study aimed to evaluate the fracture resistance of pulpotomized second primary molars restored with fiber-reinforced composite (FRC).MethodsThis experimental study was done on 40 extracted primary second molars in four groups (n = 10). The negative controls were intact untreated teeth; while, other samples were pulpotomized with the mesio-occlusal-distal (MOD) access cavities prepared on their buccal and lingual surfaces. Positive control group was left unrestored. Composite group received glass ionomer on Zonalin and was restored with flowable composite and then composite. The FRC group received glass ionomer as the preceding group; the glass fiber was embedded within flowable composite, and the cavity was restored with composite. The compressive forces leading to fracture were recorded in Newton. Comparisons were made through one-way ANOVA and Tukey's post-hoc test (α = 0.05).ResultsThe highest mean fracture resistance belonged to the intact teeth (604.45 ± 59.02 N), then the FRC group (584.31 ± 57.18 N). Unrestored teeth had the lowest fracture resistance (235.60 ± 45.60 N); however, they were not significantly different from composite group in this regard (P = 0.47). Although FRC group had significantly higher fracture resistance than the unrestored and composite group, it was not significantly different from intact teeth.ConclusionsFiber reinforcement improved the fracture resistance of pulpotomized primary molar with large MOD cavities.     

The effect of high fiber fraction on some mechanical properties of unidirectional glass fiber-reinforced composite

Objectives

This study was designed to evaluate the effect of an increase of fiber-density on some mechanical properties of higher volume fiber-reinforced composite (FRC).

Methods

Five groups of FRC with increased fiber-density were fabricated and two additional groups were prepared by adding silanated barium-silicate glass fillers (0.7 μm) to the FRC. The unidirectional E-glass fiber rovings were impregnated with light-polymerizable bisGMA-TEGDMA (50-50%) resin. The fibers were pulled through a cylindrical mold with an opening diameter of 4.2 mm, light cured for 40 s and post-cured at elevated temperature. The cylindrical specimens (n = 12) were conditioned at room temperature for 2 days before testing with the three-point bending test (Lloyd Instruments Ltd.) adapted to ISO 10477. Fiber-density was analyzed by combustion and gravimetric analyzes.

Results

ANOVA analysis revealed that by increasing the vol.% fraction of E-glass fibers from 51.7% to 61.7% there was a change of 27% (p < 0.05) in the modulus of elasticity, 34% (p < 0.05) in the toughness, and 15% (p < 0.05) in the load bearing capacity, while there was only 8% (p < 0.05) increase in the flexural strength although it was statistically insignificant. The addition of particulate fillers did not improve the mechanical properties.

Significance

This study showed that the properties of FRC could be improved by increasing fibervolume fraction. Modulus of elasticity, toughness, and load bearing capacity seem to follow the law of ratio of quantity of fibers and volume of the polymer matrix more precisely than flexural strength when high fiber-density is used.