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.     

预防性Ⅱ类洞充填法:临床应用

作者介绍了一种既能保留更多牙体组织又能预防继发龋发生的治疗后牙邻面龋损的方法,叫做预防性II类洞充填法. 窝洞制备的特点是:从(牙合)面牙釉质边缘入口制作盒状洞形,(牙合)面不作鸠尾,盒状洞内壁互相垂直,线角圆钝,在舌轴壁和颊轴壁上作固位沟。用釉质凿、釉质斧和龈缘釉质修整器修整各釉质壁直至平滑。为预防与(牙合)面洞缘相连的沟裂发生继发龋,用窝沟封闭剂将其封闭之.选用银汞合金或后牙复合树脂作充填材料,取决于邻面洞的部位和范围。若不考虑美观的话,银汞合金仍是首选的充填材料。如选用后牙复合树脂充填则楔状隙之各壁应作洞斜面.根据选用的充填材料选择垫底     

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。     

喷砂制洞和复合树脂充填对邻牙合面洞细菌微渗漏影响的实验研究

目的通过离体牙细菌微渗漏实验,评估喷砂制洞、5种树脂类材料和银汞合金充填对邻牙合面洞边缘封闭质量的影响.方法将48个完整无龋的离体前磨牙及第三磨牙随机分为两个实验组,第一组采用常规涡轮机裂钻制备窝洞,第二组采用喷砂制洞.所有实验样本制备邻牙合面洞模型,近中牙合面洞的颈缘位于釉质区,远中牙合面洞的颈缘位于根部牙骨质区.用树脂材料充填窝洞,在37℃厌氧环境下浸泡于细菌悬液中20 h.然后通过组织学检查评估细菌渗漏情况.结果所有实验组与对照组银汞合金之间存在显著差异(P<0.01).CLEARFIL AP-X/SE BOND的边缘封闭质量与DURAFILL VS、P-50的差异最显著(P<0.01);喷砂制洞与传统切割制洞对于细菌渗漏情况的影响无明显差异(P>0.05);近(远)中壁微渗漏较颈壁严重(P<0.05).结论树脂材料比银汞合金具有更好的边缘封闭效果,更适合于后牙的充填修复;喷砂技术用于窝洞处理不能减少细菌的微渗漏.     

光照角度对牙体与充填材料间微渗漏影响的研究

目的：通过改变发光二极管（light emitting diode,LED）固化光源与充填材料表面所成角度,研究光照角度对牙体与充填材料间微渗漏的影响。方法：选取21颗完整的离体前磨牙,随机分成3组,以颊面牙颈部釉牙骨质界为中心制备直径2mm,洞深1.5mm的圆形V类洞,酸蚀粘结后,复合树脂充填,以3种不同的角度光照,3组光源均朝向根方,A组：固化光源与充填体表面成30°角光照;B组：成60°角光照;C组：成90°角光照。将3组实验牙置于（37±1）℃恒温箱,0.1%罗丹明B荧光染色剂浸泡24h后,经充填体中央,沿牙体长轴颊舌向纵剖成两半,激光扫描共聚焦显微镜（Laser Scanning Confocal Microscopy,LSCM）下观测龈壁及壁处的微渗漏。结果：改变固化光源与充填材料表面所成角度,对龈壁处微渗漏的影响具有统计学意义（P〈0.01）,龈壁处光照角度为90°时微渗漏最小;壁处3组之间微渗漏无明显差异。结论：固化光源光照角度的改变对牙体与充填材料间的微渗漏有影响。本实验光照角度为90°时牙体与充填材料间微渗漏最小。     

复合树脂预热对修复体边缘微渗漏的影响

目的观察预热树脂和室温树脂充填Ⅱ类洞的龈壁边缘微渗漏的情况。方法20个新鲜离体恒磨牙备近中面Ⅱ类洞,充填光固化后牙树脂P60,充填树脂分2组:电热恒温箱预热树脂至45℃和16℃室温下直接充填树脂。充填后标本经温度循环、品红染色、近远中向连续切片,在体视显微镜下观察染料渗透情况。结果预热树脂组Ⅱ类洞龈壁微渗漏明显小于室温树脂组(P<0.05)。结论应用预热树脂充填可减小Ⅱ类洞龈壁牙骨质-牙本质边缘微渗漏。     

SonicFill系统对II类洞充填后微渗漏影响的研究

目的:探讨树脂充填系统SonicFill对Ⅱ类洞树脂充填后微渗漏的影响。方法:收集口腔颌面外科门诊拔除的各类恒磨牙15例,每例样本中2个Ⅱ类洞随机分为实验组、对照组。实验组:用SonicFill超声树脂充填系统充填窝洞;对照组:用HerculitePrécis纳米树脂斜向分层充填窝洞。500次冷热循环实验后保存于0.5%碱性品红溶液中,24 h后沿近远中向剖开,体视显微镜观察染色情况并记录评分(0-3);扫描电镜测量树脂与牙体组织间微缝隙宽度。轴壁和龈壁染料渗入深度采用Mann-Whitney U检验进行评估;采用两个样本t检验比较微缝隙的宽度,检验水准α设为0.05。结果:染料渗入评分结果表明:SonicFill组与对照组相比,染料渗入的深度明显不同,差异具有统计学意义(P＜0.05);各组内轴壁染料渗入深度明显少于龈壁(P＜0.05)。扫描电镜2000倍视野下微缝隙宽度测量结果表明:SonicFill组与对照组的微缝隙宽度存在明显不同,差异具有统计学意义(P＜0.01);各组内轴壁与龈壁相比,轴壁微缝隙的宽度明显小于龈壁(P＜0.01)。结论:SonicFill超声树脂充填系统能够有效减少Ⅱ类洞树脂充填术后微渗漏的发生。轴壁与龈壁相比,轴壁微渗漏明显小于龈壁。     

Nd：YAG激光对Dyract复合体充填微渗漏的影响

目的　观察Nd :YAG激光照射洞缘牙釉质对复合体Dyract充填微渗漏的影响。方法　新鲜拔除的完整离体牙 5 0颗 ,随机分为实验组 ( 2 6颗 )和对照组 ( 2 4颗 )。在样本牙的颊舌面制备V类洞 ,对照组常规完成Dyract充填 ,实验组用Nd :YAG激光照射洞缘牙釉质后再行Dyract充填。所有样本经冷热循环处理后 ,再进行微渗漏实验。用体视显微镜和SEM观察并拍照记录。结果　激光光蚀组充填体边缘微渗漏比对照组明显低 (P <0 .0 5 )。微渗漏实验与扫描电镜观察结果一致。结论　Nd :YAG激光的光蚀作用有助于增强复合体Dyract与牙体组织的结合 ,改善边缘封闭 ,减少微渗漏 ,有利于充填成功     

几种市售商品充填材料密合度的实验研究

选用几种市售牙体充填复合树脂和玻璃离子水门汀充填Ⅴ类洞(龈壁由牙骨质和牙本质组成),采用染色法观察其边缘微漏的离体牙实验。发现不同充填材料存在不同程度的边缘微漏,酸处理洞缘可显著降低边缘微漏(P<0.05),窝洞的牙釉质壁渗漏显著低于牙骨质壁渗漏(P<0.01)。实验结果提示,充填材料的粘附性能,窝洞边缘的位置以及酸处理技术,都将影响牙体充填的治疗效果。     

复合树脂充填Ⅴ类洞微渗漏研究进展

复合树脂材料凭借良好的美学效果,操作简便,对温度具有绝缘性,且能最大程度保留健康牙体组织等优点而被广泛应用于牙体缺损的修复。但因其固化时会发生聚合收缩,使复合树脂与牙体之间形成数微米的边缘裂缝,即边缘微渗漏,从而导致充填修复失败。由于牙颈部缺损的Ⅴ类洞在龈缘处的釉质较少,边缘微渗漏更易发生。微渗漏是一种多因素共同作用的复杂过程,相关研究报道也很多。本文通过复习相关文献,就影响复合树脂充填Ⅴ类洞后微渗漏的多种因素作一综述,以期为临床实践提供参考和帮助。     

Dentine bond strength and microleakage of flowable composite,compomer and glass ionomer cement

Background: To assess in vitro the dentine bond strength and microleakage of three Class V restorations viz. flowable composite, compomer and glass ionomer cement. Methods: Eighteen dentine specimens were prepared and randomly distributed among three groups. Three kinds of restoration materials were each bonded on prepared dentine surfaces in three groups as per the manufacturers’ instructions. Group Aelite: Tyrian SPE (a no‐rinse, self‐priming etchant) + One Step Plus (an universal dental adhesive) + Aeliteflo (a flowable composite); Group Dyract: Prime & Bond NT (a no‐rinse, self‐priming dental adhesive) + Dyract AP (a compomer); Group GlasIonomer: GlasIonomer Type II (a self‐cured restorative glass ionomer). Fifteen dentine/restoration microtensile bond test specimens were prepared from each group and were subjected to microtensile bond strength testing. The bond interfaces were observed morphologically using a scanning electron microscope (SEM). Twenty‐four cervical cavities of 4.0 mm mesiodistal length, 2.0 mm occlusogingival height and 1.5 mm depth were prepared at the cemento‐enamel junction (CEJ) on both buccal and lingual surfaces of each tooth. The cavities were each filled with flowable composite (Group Aelite), compomer (Group Dyract) and glass ionomer cement (Group GlasIonomer) using the same material and methods as for the microtensile bond tests. Microleakage of each restoration was evaluated by the ratio of the length of methylene blue penetration along the tooth‐restoration interface and the total length of the dentine cavity wall on the cut surface. Results: One‐way ANOVA and least significant difference (LSD) tests revealed statistically significant differences among the dentine bond strength for Group Aelite (28.4 MPa), Group Dyract (15.1 MPa) and Group GlasIonomer (2.5 MPa). SEM images showed intimate adaptation in the restoration/dentine interfaces of Group Aelite and Group Dyract. All of the systems tested in this study presented microleakage. However, both Group Aelite (0.808) and Group Dyract (0.863) had significantly less microleakage than Group GlasIonomer (0.964). There were no statistically significant microleakage differences between Group Aelite and Group Dyract, and no statistically significant microleakage differences between the occlusal margin and gingival margin. Conclusions: None of the systems tested in this study completely eliminated microleakage. However, both the flowable composite and compomer provided stronger dentine bond strengths and better margin sealing than the conventional glass ionomer cement. Occlusal forces exerted the same effects on microleakage of the occlusal margin and gingival margin in cervical cavities.     

The effect of an additional flowable compomer layer on microleakage of Class V compomer restorations.

BACKGROUND: Polymerisation shrinkage and the associated stress on composite resins and surrounding structures have been regarded as a major cause of leakage and clinical failures in modern polymer restorations. The purpose of this study was to investigate the effect of an additional flowable compomer layer on the microleakage of Class V dental cavities, which were further filled with a compomer. METHOD: Cavities (32) were prepared in human premolars, conditioned with a non-rinsing agent (Prime & Bond NRC) and treated with the bonding agent (Prime & Bond NT). Sixteen of these cavities were then lined with a layer of flowable compomer (Dyract Flow, approximately 0.5 mm) and further filled with Dyract AP. The other 16 cavities were filled without the flowable compomer. The specimens were thermo-cycled in a 0.5% basic fuchsin solution, sectioned and evaluated for dye penetration using a scoring system of 0 to 4. RESULTS: Lower microleakage values were found at the enamel as well as at the dentine sides when a layer of Dyract Flow was used as a liner. Furthermore, significantly (p < 0.05) lower microleakage was found in enamel than in dentine for both layered and unlayered restorations. CONCLUSION: It can be concluded that a layer of flowable compomer (i.e. Dyract Flow) in a cavity under a compomer may be recommended to improve the marginal seal of a restoration.     

Clinical and SEM evaluations of three compomer systems in Class V carious lesions

The aim of this study was to evaluate the clinical performance of three compomer systems: Compoglass F, Dyract AP and F2000 in Class V carious lesions. In addition, some restorations were placed in teeth scheduled for extractions in order to evaluate the compomer/dentin interface with the scanning electron microscope (SEM). A total of 175 Class V carious lesions having the gingival margins extending into cementum were restored with the tested materials. Each restoration was clinically evaluated immediately after placement, after 1 year and after 2 years using the USPHS criteria. After 1 year no loss of restoration was recorded. No significant difference between the materials was observed for any evaluation category. After 2 years, one Compoglass and two Dyract restorations were lost. No loss of F2000 was reported. No significant difference was reported between the tested materials and between the 2-year data and baseline ones. A well-defined hybrid layer as well as resin tags was seen at the interface between the tested materials and vital dentin.     

LED�̻�ϵͳӦ���������������޸��о�

目的    探讨LED固化系统应用于乳牙复合体修复后，对边缘密闭性、操作时间、操作复杂程度的影响。方法    收集2007—2008年中山大学附属口腔医院儿童口腔科拔除的离体乳磨牙97颗，将牙冠制备成牙片，表面制备Ⅰ类洞，共成功制备牙片84片。将制备了洞型的牙片随机分为A、B、C、D4组，每组21个。A组：F2000复合体+Xeno Ⅲ黏结系统+QTH光固化系统；B组：F2000复合体+Xeno Ⅲ黏结系统+ LED光固化系统；C组：Dyract复合体+Xeno Ⅲ黏结系统+QTH光固化系统；D组：Dyract复合体+Xeno Ⅲ黏结系统+LED光固化系统。温度循环法模拟体内状况处理样本后，扫描电镜观察，并行染料渗透实验。单盲法对二维微渗漏情况进行观察。结果    各组二维微渗漏程度的组间差异无统计学意义（P > 0.05）。经扫描电镜观察可见，无论采用何种组合方式，充填材料均密实无裂隙，周边牙体组织完好无裂纹，黏结剂的分布都比较均匀连续。结论    由于LED固化系统具有良好的边缘密闭性、操作时间短和操作便利等突出优点，值得口腔临床推广使用。     

The influence of finishing time on the marginal seal of a resin-modified glass-ionomer and polyacid-modified resin composite

The aim of this study was to compare the effect of immediate and delayed finishing on the microleakage of encapsulated resin-modified glass-ionomer, Fuji II LC and a polyacid-modified resin composite, Dyract compomer at both the enamel and dentine margins. Standardized Class V cavities were prepared along the cemento-enamel junction on buccal and palatal surfaces of 24 freshly extracted non-carious premolars. Equal numbers of buccal and palatal cavities in each group were restored with Fuji II LC and Dyract compomer following the manufacturer's instructions. The groups with delayed finishing were restored 1 week earlier, stored in saline at 37 degrees C and finished on the same day as the groups with immediate finishing. The specimens were then thermocycled 500 times and subjected to dye penetration testing. The results showed that both materials leaked more at the dentine than enamel margins for both regimes of finishing methods. There was no statistical difference in the microleakage of Dyract finished immediately or later at enamel and dentine margins and Fuji II LC finished immediately or later in dentine. However, a statistical difference existed between the microleakage in Fuji II LC finished immediately and later in enamel.     

The adaptation and cavity sealing ability of compomer restorative materials

PURPOSE: To examine the sealing ability of compomers, used in combination with dentin bonding agents, compared to other classes of tooth-colored materials. METHODS: Thirty wedge-shaped cervical cavities were cut in extracted teeth, with the gingival cavosurface margin involving dentin. Five cavities each were restored with one of the following: the compomers Dyract AP/Prime & Bond NT, F2000 Compomer/Adhesive or Hytac Aplitip/Prompt L-Pop; a conventional glass-ionomer, Ketac Fil Aplicap; a resin-modified glass-ionomer, Fuji II LC Improved; or a resin-based composite, Z100 MP/Scotchbond 1. All teeth were restored, stored moist for 24 hours, then varnished (except the restorations) before thermocycling in rhodamine B dye solution for 1000 cycles (between baths of 6 degrees C and 60 degrees C). The teeth were sectioned longitudinally through the restorations before examination with a confocal microscope. A scale of 0 to 3 was used to score the dye leakage along the enamel margin as well as the gingival margin. RESULTS: The results showed that at the enamel margin, all materials gave a median score of 0 except Z100 MP (median score 3). Leakage was noted at the gingival margin of all materials (median score of 3 except Dyract AP with a median score of 2).     

FiltekTM Z350对犬龈沟液中天冬氨酸转氨酶和碱性磷酸酶的影响

目的:探讨纳米复合树脂FiltekTMZ350(Z350)和临床常用牙体充填材料Dyract-AP复合体(AP)、TPH复合树脂(TPH)、玻璃离子Ⅱ型水门汀(GIC)修复后,犬龈沟液中天冬氨酸转氨酶和碱性磷酸酶的变化,评价FiltekTM Z350作为修复材料对牙周组织健康的影响。方法:3只比格犬,每只选择20个健康牙作为实验牙,分别在颊侧颈部齐龈缘处制备相同大小的洞形后,按象限随机分为4组,分别用Z350、AP、TPH、GIC修复,在术前和术后7、30、90 d测量龈沟液(GCF)量,并检测龈沟液中天冬氨酸转氨酶(AST)和碱性磷酸酶(ALP)的水平。结果:修复后7 d其GCF量、GCF中AST和ALP总量较修复前明显增高,但各组间没有显著性差异(P>0.05);修复后30 d和90 d,GIC组GCF量、GCF中AST和ALP总量均高于其他材料组(P<0.05),FiltekTM Z350组GCF量、GCF中AST和ALP总量低于其他材料组(P<0.05)。结论:在本实验条件下,FiltekTMZ350纳米复合树脂对牙周组织健康的影响小于其他常用修复材料。     

The effect of different types of flowable restorative resins on microleakage of Class V cavities

This study evaluated the microleakage of Class V cavities restored with three different types of flowable resin restorative material and compared the effects of using their respective manufacturer's dentin adhesive or a different brand. Class V cavities with the occlusal margin in enamel and the gingival margin in dentin were prepared on the buccal and lingual surfaces of 48 non-carious human molars. The teeth were randomly assigned to three equal groups of 16. The first eight teeth in each group were restored with one of the flowable restorative materials (Filtek Flow, Dyract Flow, Admira Flow) using the manufacturer's recommended dentin adhesive (Single Bond, Prime & Bond NT, Admira Bond), and the remaining eight molars were restored using a different brand of dentin adhesive (Gluma Comfort Bond). The samples were thermocycled 200 times (5 degrees C-55 degrees C) with a one-minute dwell time. They were then immersed in a 2% basic fuchsin solution for 24 hours, sectioned and analyzed by stereomicroscopy. There was no statistically significant difference at the occlusal margins for either restoration used with its respective dentin adhesive. At the gingival margins, there was a significant difference among all groups. Flowable ormocer (Admira Flow/Admira Bond) displayed the least leakage at the gingival margins. When these flowable restoratives were used with a different brand of dentin adhesive, statistically significant differences were observed both on enamel and dentin. None of the restoratives tested fully prevented leakage at the gingival margins. No significant differences in microleakage were observed among the restorative materials used with respect to the manufacturer's dentin adhesive or a different brand except for Admira Flow restorative at the gingival margins. The gingival margins had significantly more microleakage than the occlusal margins (p < 0.05) except in the Admira Flow group, where microleakage at the occlusal and gingival margins was almost equal.     

Clinical performance of a compomer and amalgam for the interproximal restoration of primary molars: a 24-month evaluation

OBJECTIVES: To evaluate the clinical performance of a compomer material (Dyract) in comparison with dental amalgam (Contour) for management of proximal caries in primary molars in young children. SETTING: General dental practice, and a dental hospital paediatric clinic. METHOD: This was a prospective study. A split mouth design was used with identical pairs of minimal Class II cavities, of matched tooth type in the same dental arch, usually diagnosed with the use of bitewing radiographs. Seventy-eight pairs of restorations were completed of which 60 pairs were available for evaluation after 24 months. RESULTS: Comparable retention rates were observed for both Dyract and amalgam. The retention rates were high for both materials, with only four amalgam and two Dyract restorations failing over 24 months. Significantly better marginal integrity (P < 0.05) was observed for Dyract compared with amalgam with no significant differences between the two materials for recurrent caries, wear or surface texture. CONCLUSIONS: Dyract seemed to be a suitable alternative to amalgam for proximal restorations in primary molars of young children for use in general dental practice.     

Marginal seal of resin-modified glass ionomers and compomers: effect of delaying polishing procedure after one-day storage

This study evaluated the effects of polishing after one-day storage in water on the marginal gap formation around fillings using three resin-modified glass ionomers, one compomer, one conventional glass ionomer, and one micro-filled composite as a control. The study also examined the marginal gap and bond strength in Teflon cavities and the flexural strength of these restorative materials, which may influence the marginal gap formation. Immediately after the setting procedure, the specimen was polished and a marginal gap of approximately 10-25 micrometers was observed regardless of the type of restorative material used. In contrast, we observed no gap or a 1-2 micrometer gap width when the specimens were polished after one-day storage. Only Dyract did not show this pattern. Statistical difference was observed between immediately polishing and polishing after one-day storage in all materials except Dyract. Hygroscopic expansion, bond strength and flexural strength play important roles in reducing the marginal gap in tooth cavities filled with two types of glass-ionomer restorative materials. In contract, these properties did not play important roles in reducing the marginal gap width for Dyract.