天然牙摩擦磨损的评价

牙体磨损是指牙体在咀嚼和非咀嚼运动过程中,牙面与牙面之间摩擦或牙面与食物之间摩擦导致的牙体硬组织丧失。天然牙磨损从摩擦学角度分为两体磨损、三体磨损、疲劳磨损和化学酸蚀磨损。天然牙摩擦磨损性能研究方法主要有体内临床观察研究、体外试验研究和体内外联合试验研究,而体外试验可以更好地控制试验参数。天然牙摩擦磨损研究又分为摩擦学性能评价以及磨损性能和机制研究两类。学者们有的以体外磨损模拟咀嚼和磨牙症,磨损量用磨损前后质量的丢失进行评价;有的研究了不同年龄段的釉质的耐磨损性能;有的以TA2纯钛球评价了天然牙釉质不同断面的耐磨损性能;有的以纳米划痕技术测量了天然牙各向异性的耐磨损特性;有的以磨斑形貌对磨损机制进行研究。尽管学者们对天然牙摩擦磨损及其机制作了大量的工作,但其结果不尽相同,难以支撑天然牙的磨损失效机制。其失效机制研究的部分缺失,已成为了限制口腔材料发展的关健因素。     

6种不同修复材料与天然牙牙釉质摩擦、磨耗性能的比较

目的：通过体外摩擦、磨耗实验,比较临床常用的陶瓷材料、多种合金及天然牙釉质的摩擦、磨耗性能,为临床上选择与对颌牙磨耗性能相近的修复材料,更好地保护对颌牙提供一定的实验依据。方法：将陶瓷、纯钛、钛合金、镍铬合金、金钯合金、银汞合金和近期拔除的成人下颌第三磨牙的釉质平面,与滑石瓷磨头磨耗机上对磨。耐磨性能的评定采用称重法。用针一盘磨损试验仪测定各种材料的滑动摩擦系数。应用SPSS11．5软件包进行统计学处理．对各试件、天然牙的质量损失量进行统计学分析,对比分析摩擦系数。结果：单位面积的磨损量以天然牙釉质最小,但与瓷块、银汞合金、金钯合金无显著性差异（P〉0．05）,与其余各组均有显著性差异（P〈0．01）;纯钛最大,与其余各组均有显著性差异（P〈0．01）,镍铬合金、金钯合金与其余各组均有显著性差异（P〈0．01）。瓷块的摩擦系数稳定在0．68,银汞合金的摩擦系数为0．12,金钯合金的摩擦系数为0．11,镍铬合金为0.41,纯钛为0.38,钛合金为0．48,天然牙釉质为0．65。结论：6种修复材料的耐磨性均比天然牙釉质差．纯钛的耐磨性最小,钛合金及镍铬合金、金钯合金次之,陶瓷的耐磨性最大。     

天然牙与全瓷饰面瓷的磨损特性研究

目的通过体外模拟实验观察全瓷饰面瓷材料（Vintage AL、Vita- alpha）与天然牙釉质的摩擦学行为特点,探讨其摩擦磨损机制。方法实验前对材料进行力学性能检测。采用摩擦磨损机观察3种材料的摩擦磨损行为,记录摩擦力矩数,计算摩擦系数;测量磨斑宽度;磨损试件表面采用动态原子力显维镜（DFM）观察;采用能谱仪分析摩擦实验前后样品元素的变化。结果3种材料显微硬度值存在统计学差异（P<0.05）;两种饰面瓷的三点弯曲强度比较有统计学差异（P<0.05）,断裂韧性差别无统计学意义。3种材料摩擦系数呈现一定时间规律性,耐磨能由高到低排列为Vintage AL、Vita- alpha、天然牙釉质。磨斑宽度比较有统计学意义（P<0.05）。DFM结果显示釉质主要表现为磨粒磨损和组织结构的变形,偶可见组织断裂片;饰面瓷摩擦表面可见大量犁沟和磨粒,偶见微裂。结论本实验中3种材料呈现良好的耐磨性。天然牙的磨损机理主要是磨粒磨损和组织结构变形;全瓷饰面瓷的磨损机理主要为磨粒磨损、黏着磨损和疲劳磨损,不同磨损类型在两种饰面瓷发挥的作用不完全相同。     

天然牙与牙科修复材料的摩擦学研究

天然牙与牙科修复材料之间存在摩擦现象,为了防止天然牙过度磨损,同时延长修复体使用寿命,有必要了解天然牙与牙科修复材料间的摩擦学特性,选取相匹配的修复材料。本文就天然牙和牙科修复材料摩擦学性能的研究作一综述。     

不同口腔修复材料与天然牙耐磨性能的比较

目的：通过体外模拟实验对几种口腔修复材料与天然牙釉质的磨耗性能进行对比研究并探讨其机制.方法：（1）将钴铬合金,纯钛,氧化锆陶瓷,Ceramage聚合瓷制成符合规格的试件.（2）将上颌第一前磨牙磨改,作为对照组.（3）将滑石瓷制做圆盘状,作为与试件及天然牙对磨的材料.（4）所有实验均在人工唾液环境中加载测试.（5）SPSS17.0软件进行统计学处理,对磨耗后的试件进行磨痕形貌的观察.结果：（1）纯钛的磨耗量与牙釉质最接近.钴铬合金与氧化锆陶瓷无统计学意义（P＞0.05）,其余各组之间均有统计学意义（P＞0.05）.磨耗后质量损失量的大小顺序为纯钛＞牙釉质＞ Ceramage聚合瓷＞氧化锆陶瓷＞钴铬合金.（2）钴铬合金：磨粒磨损,同时伴有粘着磨损.纯钛：以粘着磨耗为主,伴有磨粒磨耗.氧化锆陶瓷：磨粒磨损.Ceramage聚合瓷：主要是磨粒磨损和粘着磨损,伴有疲劳磨损.天然牙：粘着磨损和磨粒磨损.结论：（1）纯钛的耐磨性低于牙釉质但与牙釉质最为相近,是一种良好的修复材料.（2）钴铬合金与氧化锆陶瓷的耐磨性能接近,均可对天然牙釉质造成过度磨耗.（3）修复材料的耐磨性能受其微观结构的影响.     

喷砂粒度对激光快速成形纯钛与瓷结合强度的影响

目的 探讨不同喷砂粒度对激光快速成形(laser rapid forming,LRF)纯钛与瓷结合强度的影响,以期为LRF纯钛的临床应用提供参考.方法 利用LRF技术加工纯钛,测量LRF纯钛、铸钛和牙本质瓷试件的热膨胀系数(n=3).分别以0.5 MPa压力,50、120、250 μm的Al_2O_3对LRF纯钛表面进行喷砂处理(LRF纯钛-50μm组、LRF纯钛-120 μm组、LRF纯钛-250μm组),以0.5 MPa压力、50μm Al_2O_3喷砂处理铸钛试件作为对照(铸钛-50 μm组),测量4组钛试件的表面粗糙度(n=10)、表面接触角(n=10)并观察试件表面形貌,4组钛试件烤瓷后(n=5)测量钛-瓷结合强度.结果 LRF纯钛与铸钛的热膨胀系数[分别为(9.79±0.31)×10~(-6)和(9.84±0.42)× 10~(-6)/℃]与牙本质瓷[(8.93±0.36)×10~(-6)/℃]匹配.随着喷砂粒度的增大,LRF纯钛表面粗糙度增加,表面接触角增大.铸钛-50 μm组的钛-瓷结合强度[(26.42±1.65)MPa]略大于LRF纯钛-50μm组[(25.91±1.02)MPa],两组差异无统计学意义(P＞0.05);LRF纯钛-120 μm组钛-瓷结合强度[(21.86±1.64)MPa]与LRF纯钛-250μm组[(19.96 ±1.03)MPa]的差异无统计学意义(P＞0.05);其余各组间钛-瓷结合强度的差异均有统计学意义(P＜0.05).结论 经0.5 MPa、50 μm Al2O3喷砂处理后,LRF纯钛与瓷的结合强度可达到ISO 9693所要求的基本值(25 MPa).     

铸造纯钛和锻造纯钛与瓷的结合性能比较

目的 :了解铸钛表面反应层对钛瓷结合力的影响。方法 :采用铸造法制做 2 8mm× 3mm× 0 .5mm纯钛试条 ,用机器切割法制做 2 8mm× 3mm× 0 .5mm纯钛金属试条 ,于中分 8mm× 3mm处熔附VITATI TANKERAMIK钛专用瓷 ;采用铸造法制做 2 8mm× 3mm× 0 .5mmNi Cr合金试条 ,于中分 8mm× 3mm处熔附VITA 99常用瓷。采用三点弯曲法测试金瓷结合力 ,扫描电镜观察钛瓷界面。结果 :Ni Cr合金与瓷的结合力水平明显高于铸造纯钛与瓷的结合力和锻压纯钛与瓷的结合力 (P <0 .0 1) ;铸造纯钛与瓷的结合力和锻压纯钛与瓷的结合力之间无显著差异 (P >0 .0 5 )。结论 :采用机械磨除及喷沙的方法可以基本消除铸钛表面的反应层对铸钛与瓷结合性能的影响 ,提示铸造纯钛冠桥基底在附瓷以前应磨除表面厚约 10 0 μm的反应层 ,以利于钛瓷之间形成较强的结合力。     

载荷变化对口腔修复用纯钛摩擦磨损性能的影响

目的探讨载荷变化对纯钛与滑石瓷对磨时摩擦磨损性能的影响。方法使用MMV-1立式万能摩擦磨损试验机,以滑石瓷为对磨物,载荷设置为20、50、100N,在37℃人工唾液润滑的试验工况下,对口腔修复用纯钛进行二体摩擦磨损试验。记录动态摩擦系数。采用扫描电镜观察表面磨损形貌．X线衍射能谱仪分析磨屑成分．电子天平得出磨损量。结果纯钛与对磨物滑石瓷的磨损量及摩擦系数随载荷的增加而增大。载荷20N,纯钛的磨损机制主要为磨粒磨损：50N时,磨损机制是黏着磨损伴发磨粒磨损;100N时,纯钛磨损机制以黏着磨损为主。结论载荷增加可增大纯钛的磨损量．导致磨损机制改变,在高载荷条件下可发生严重黏着磨损．缩短纯钛修复体的使用寿命。     

两种不同氧化钇含量的牙科氧化锆瓷与牙釉质的摩擦磨损性能

目的：通过体外模拟实验考察两种不同氧化钇含量的牙科氧化锆瓷与天然牙釉质的摩擦磨损性能。方法：选择两种不同氧化钇含量的牙科氧化锆瓷UpceraST（3mo1％Y2O3-ZrO2）与Upcera TT（3mo1％Y20-ZrO2＋8mo1％Y2O3-ZrO2）在微摩擦磨损试验机上,人工唾液润滑下与天然牙釉质进行摩擦磨损实验。两种氧化锆瓷表面分别采用抛光和打磨处理。用激光共聚焦显微镜测量牙釉质磨斑宽度,扫描电子显微镜观察氧化锆瓷及牙釉质磨斑微观形貌。采用配对t检验进行统计学分析。结果：牙釉质与氧化钇含量相对较低的UpceraST对磨的磨斑宽度：抛光组474．2±18．0μm,打磨组581．5±32．7Win;牙釉质与氧化钇含量相对较高的UpceraTT对磨的磨斑宽度：抛光组476．8±33．7μm,打磨组591．3±55．7μm。不同氧化钇含量的氧化锆瓷采用相同的表面处理方式对牙釉质的磨耗无统计学差异（P〉0．05）。牙釉质磨斑宽度在不同表面处理组间差异有统计学意义（P〈0．01）：牙釉质与抛光氧化锆瓷对磨的磨斑宽度值小于打磨组。结论：两种不同氧化钇含量的氧化锆瓷摩擦磨损性能相似;氧化锆瓷表面抛光可避免牙釉质过度磨损。与抛光氧化锆瓷对磨,牙釉质的磨损类型主要是疲劳磨损;与打磨氧化锆瓷对磨,牙釉质的磨损类型主要是磨粒磨损。提示临床在对充填体或修复体调磨后应进行抛光处理,以避免造成对颌天然牙的过度磨损。     

氟磷灰石玻璃陶瓷、长石质饰瓷与天然牙摩擦磨损性能的研究

目的：研究牙科氟磷灰石玻璃陶瓷、长石质饰瓷与天然牙在干摩擦和唾液润滑条件下的摩擦磨损学性能。方法：制备涂覆IPS-emaxcream和Vita vm9 2种饰面瓷的氧化锆-饰面瓷双层材料试样,尺寸为20 mm×20 mm×4.5 mm,各20个。利用MMV-1摩擦磨损试验机,通过设置不同大小的垂直载荷和转速,分别在干摩擦和唾液润滑条件下,对2种氧化锆-饰面瓷试样进行摩擦磨损试验。采用SPSS 17.0软件包进行单因素方差分析和t检验,确定各组间摩擦系数和磨损量是否存在差异。结果：氟磷灰石玻璃陶瓷在唾液润滑条件下的动态摩擦系数和磨损量显著大于干摩擦条件下的数值;与氟磷灰石玻璃陶瓷相反,长石质饰瓷在干摩擦时的动态摩擦系数和磨损量显著大于在唾液润滑条件下的数值。在干摩擦和唾液润滑条件下,氟磷灰石玻璃陶瓷的磨损量均小于长石质饰瓷。扫描电镜显示,在唾液润滑条件下,氟磷灰石玻璃陶瓷及对应天然牙表现出比干摩擦更为严重的磨损表面。在干摩擦条件下,长石质饰瓷及对应天然牙较氟磷灰石玻璃陶瓷磨损更为严重,在唾液润滑条件下差异较小。结论：与长石质饰瓷相比,氟磷灰石玻璃陶瓷与天然牙在干摩擦条件下表现出更优越的耐磨损性能。加入唾液后,能减少2种饰瓷摩擦磨损性能之间的差异。     

In vitro wear assessment of titanium alloy teeth

PURPOSE: Wear of commercially pure (CP) titanium prosthetic teeth has frequently been observed. The greatest wear has been found when the same grades of CP titanium are used for both maxillary and mandibular teeth. This study examined the wear behavior of teeth made with cast titanium alloy and compared these results with those for CP titanium and gold alloy teeth. MATERIALS AND METHODS: All tooth specimens were cast with grade 3 alpha titanium, 3 metastable beta alloys [Ti-15Mo-2.8Nb-0.2Si (Timetal 21 SRx), Ti-13Nb-13Zr, and Ti-15V-3Cr-3Sn-3Al], and 2 alpha+beta alloys (Ti-6Al-7Nb and Ti-6Al-4V). As a control, Type IV gold alloy was also cast conventionally. All teeth (both maxillary and mandibular) were secured in an in vitro 2-body wear testing apparatus that simulated chewing function (60 strokes/min; grinding distance, 2 mm under flowing water). Wear resistance was assessed as volume loss (mm(3)) at 5 kgf (grinding force) after 50,000 strokes. The results (n = 5) were analyzed using analysis of variance or Fisher's exact test (alpha = 0.05). RESULTS: Of the titanium teeth, the wear of 2 of the metastable beta alloys (Timetal 21 SRx and Ti-15V-3Cr-3Sn-3Al) was found to be significantly (p <0.05) higher than that of CP titanium and the 2 alpha+beta alloys. The Type IV gold alloy exhibited better wear resistance than all of the titanium teeth tested. No correlation was found between wear loss and hardness among all the metals tested. CONCLUSIONS: Among the titanium teeth examined, the alpha+beta alloys exhibited significantly less wear than the other types of titanium. The dental casting gold alloy tested exhibited the best wear resistance among all of the metals tested.     

The measurement and prevention of erosion and abrasion

OBJECTIVES: To develop a reproducible method to measure tooth wear and assess the protection given by dentine bonding agents in an erosive/abrasive wear regime. METHODS: Seal and Protect (Dentsply, UK) and Optibond Solo (Kerr, UK) were each applied to 20 extracted teeth and subjected to 3000 cycles in a reciprocating erosion/abrasion wear machine. A further 20 teeth, without protection, were subjected to the same wear regime and were either brushed in water or immersed in acid. Impressions were taken by a standardised technique and were scanned with a non-contacting laser profilometer. The amount of erosion was measured at the same co-ordinates before and after erosion using 2mm diameter metal discs as reference points. RESULTS: The amount of wear on Seal and Protect had a mean 24.8 microm (SD 57.4 microm) and for Solo it was 1.4 microm (24.5 microm), and this difference was statistically significant (p=0.02). There was no statistically significant difference in the wear measured on the teeth brushed in water or immersed in acid. The wear measured on the unprotected teeth was 243 microm (SD 120 microm) and was statistically significantly different to the protected surfaces (p=0.001). CONCLUSION: Both Seal and Protect and Solo protected the teeth in this wear regime and the technique could be used clinically for patients with uncontrolled dental erosion.     

Prevalence of dental caries and tooth wear in a Byzantine population (13th c. A.D.) from northwest Turkey

Dental caries and wear are important conditions to record in archaeological collections. Reconstruction of the life of ancient peoples can be accomplished by studying their dental remains. The aim of the present paper was to determine the frequency, distribution, and characteristics of dental caries, dental wear and related diet in the mediaeval Byzantine population of Iznik in northwest Turkey. The analysed sample consisted of the dental remains of 56 individuals with the total of 280 teeth. The majority (261 or 93.2%) of the teeth belonged to the permanent dentition. The frequency of antemortem tooth loss in the sample was 6.5% and the frequency of caries was 6.8%. The most frequent recorded caries were mesial (3.3%), followed by buccal (3%). The frequency of dental wear was rather high (84.2%) exhibiting presence of dentin clusters mostly. This finding is consistent with the hypothesis of caries attrition competition based on the assumption that a beneficial effect of tooth wear is to avoid development of caries. High wear in the archaeological population can be linked to the fact that the cumulative effects of attrition as a result of the Byzantine diet.     

加热氟化钠对髓腔内温度变化影响的离体牙实验观察

目的:体外实验观察器械加热后放置于不同磨损牙面上所涂的氟化钠糊剂上不同时间髓腔内温度的变化。为临床使用加热氟化钠导入法治疗牙本质过敏症提供实验依据。方法:收集成人完整离体磨牙,根据SmithBGN对牙齿磨损分类,将牙合面制成轻、中、重度磨损,用加热不同时间的金属器械放置在不同磨损程度的牙面上不同时间,观察髓腔内温度变化,以所测温度最高值减测量前基础温度值,所得出髓腔温度上升绝对值进行比较分析。结果:加热器械5和10s,放置牙面不同时间,髓腔温度上升值不同,在最初10~20s内,髓腔温度随器械放置时间延长而上升。在相同时间内,磨损程度越重,髓腔温度上升值越高。结论:器械加热导入氟化钠过程中,器械温度一定时,器械放置时间和牙齿磨损程度是影响髓腔温度的主要因素。     

Tactile sensibility of single-tooth implants and natural teeth

AIM: The purpose of this randomized split-mouth clinical trial was to determine the active tactile sensibility between single-tooth implants and opposing natural teeth and to compare it with the tactile sensibility of pairs of natural teeth on the contralateral side in the same mouth (intraindividual comparison). MATERIAL AND METHODS: The hypothesis was that the active tactile sensibilities of the implant side and control side are equivalent. Sixty two subjects (n=36 from Bonn, n=26 from Bern) with single-tooth implants (22 anterior and 40 posterior dental implants) were asked to bite on narrow copper foil strips varying in thickness (5-200 microm) and to decide whether or not they were able to identify a foreign body between their teeth. Active tactile sensibility was defined as the 50% threshold of correct answers estimated by means of the Weibull distribution. RESULTS: The results obtained for the interocclusal perception sensibility differed between subjects far more than they differed between natural teeth and implants in the same individual [implant/natural tooth: 16.7+/-11.3 microm (0.6-53.1 microm); natural tooth/natural tooth: 14.3+/-10.6 microm (0.5-68.2 microm)]. The intraindividual differences only amounted to a mean value of 2.4+/-9.4 microm (-15.1 to 27.5 microm). The result of our statistical calculations showed that the active tactile sensibility of single-tooth implants, both in the anterior and posterior region of the mouth, in combination with a natural opposing tooth is similar to that of pairs of opposing natural teeth (double t-test, equivalence margin: +/-8 microm, P<0.001, power >80%). Hence, the implants could be integrated in the stomatognathic control circuit.     

In Vitro Wear of Nano-Composite Denture Teeth

PURPOSE: Few laboratory tests have been able to substantiate and quantify the wear resistances of polymeric denture teeth. This study evaluated the relative wear resistance of several types of denture teeth using an in vitro wear testing device. MATERIAL AND METHODS: Four different types of denture teeth [nano-filled (Veracia) and micro-filled composites (SR-Orthosit, Endura, Duradent, Surpass), cross-linked acrylic (SR-Postaris, Genios-P, Creapearl, Vitapan Physiodens, Premium 8, Integral), and a conventional acrylic (Biotone)] were used. The flattened buccal surface of each denture tooth was subjected to the evaluation of Knoop hardness (n=5) and localized wear for 100,000 cycles (n=10). Wear values were determined in micrometers using a profilometer. The data for the hardness, wear depth, and worn surface areas were individually analyzed by one-way ANOVA. RESULTS: Knoop hardness values (KHN) ranged from 28.2 to 29.8 for micro-filled composite, 18.9 to 21.6 for cross-linked acrylic, 22.7 for nano-composite, and 18.6 for conventional acrylic teeth. All micro-filled composite teeth were significantly harder than other teeth (p <0.0001). The wear depth values were 90.5 microm for the nano-composite, 69.8 to 93.0 microm for the micro-filled composite, 80.8 to 104.0 microm for the cross-linked acrylic, and 162.5 microm for conventional acrylic teeth. The worn surface areas were 5.1 mm2 for the nano-composite, 2.6 to 3.6 mm2 for the micro-filled composite, 4.4 to 5.7 mm2 for the cross-linked acrylic, and 10.1 mm2 for conventional acrylic teeth. The wear values of the acrylic control were significantly different from all other denture teeth (p <0.001). CONCLUSION: The nano-composite tooth was harder and more wear resistant than the acrylic teeth but not significantly different from most of the cross-linked and micro-filled composite teeth tested.     

Microcomputerised tomography evaluation of 10% carbamide peroxide applied to enamel

OBJECTIVES: There is still some controversy in the dental literature whether carbamide peroxide bleaching causes demineralization of teeth. One of the reasons for this controversy is that there is as yet no reliable, non-destructive in vitro method for assessing mineral loss in bleached teeth. The objective of this study was to investigate the possible demineralization effect of 10% carbamide peroxide bleaching agent on enamel and dentine non-destructively. METHODS: microCT images were obtained of 12 human molar tooth sections. These sections had 10% carbamide peroxide applied for eight hours a day over a period of 15 days. Further tomographic images were obtained and the mineral content prior to and post bleaching assessed. RESULTS: A total of 144 regions were evaluated using the image processing language available in the work station. The application of 10% carbamide peroxide was found to cause demineralization of the enamel extended to a depth of 50 microm below the enamel surface (Paired t-test, p<0.05). CONCLUSIONS: This study confirmed that microCT was indeed a highly suitable method for assessing mineral content of dental enamel after bleach application. It is recommended that application of bleaching agents should be carefully considered in patients susceptible to caries and tooth wear.