不同树脂充填材料边缘微渗漏的体外研究

目的:扫描电镜下观察比较三种充填树脂的冠方微渗漏的程度。方法:选择42颗离体恒磨牙预备牙合面洞型(4mm×4mm×4mm),随机分为三组,分别使用三种不同的树脂充填,Surfill Smart Dentin replacement(SDR)大体积树脂,3M ESPE~(TM)Filtek~(TM)P60 Poterior Restorative(P60)复合树脂,3M ESPE~(TM) Filtek~(TM) Z350XT Flowable Restorative(Z350XT)流动纳米复合树脂,所有样本在人工唾液中浸泡2个月,经冷热循环老化试验后,在扫描电镜下观察牙体与充填体之间发生微渗漏的程度。结果:SDR体积树脂组充填体与牙体组织间微缝隙最小,与P60复合树脂组和Z350XT流动纳米树脂组相比有统计学差异(P0.05)。结论:SDR树脂是边缘封闭效果比较好的树脂,适用于充填后牙窝洞。     

自酸蚀粘结剂对树脂充填体边缘封闭后微渗漏变化的体外实验研究

目的：探讨自酸蚀粘结剂对树脂充填体边缘封闭后微渗漏的影响。方法：将40颗完整无龋坏、无隐裂的新鲜离体磨牙随机分为4组，备洞并用3M Z350树脂充填。第1、2组使用3M Adper Easy One自酸蚀粘结剂，第3、4组使用Dentsply Xeno IV自酸蚀粘结剂。备洞充填抛光后，第1组和第3组为实验组，分别使用3M Adper Easy One 和 Dentsply Xeno IV自酸蚀粘结剂对充填体边缘涂布20s。第2组和第4组为对照组，不进行这项操作。然后，对1～4组充填体均进行光照，经温度循环后涂隔水剂，亚甲基蓝溶液染色，对牙齿长轴切片，在体视显微镜下观察修复体边缘染料渗漏情况。结果：3M Adper Easy One 和Dentsply Xeno IV自酸蚀粘结剂对树脂充填边缘处理后微渗漏均明显变小（P＜0.05），且染料渗入窝洞均明显减轻。结论：3M Adper Easy One和 Dentsply Xeno IV自酸蚀粘结剂对充填体边缘进一步处理后均起到明显边缘封闭作用。     

根管治疗术后树脂充填联合固位纤维冠外保护对上颌第一前磨牙牙齿抗折性能的影响

目的：探讨根管治疗术后树脂充填联合固位纤维冠外保护对上颌第一前磨牙牙齿抗折性能的影响。方法：选择2018年6月-2020年8月笔者医院因正畸拔除的60颗冠根完整的上颌第一前磨牙为研究对象，将60颗离体牙样本分为对照组（3M流体树脂填充），观察组（3M流体树脂填充联合固位纤维冠外保护），采用游标卡尺测量并比较两组第一前磨牙牙体标本解剖外形各项指标（牙全长、冠长、颈部颊舌径及近远中径），采用静态加载法和循环加载法对离体牙折裂载荷及离体牙折裂模式进行测定。结果：两组离体牙体标本解剖外形各项指标比较无统计学意义（P>0.05）。对照组平均折裂载荷为（627.96±91.42）N，观察组为（974.85±102.25）N，观察组折裂载荷值明显高于对照组；对照组可修复性牙折裂20颗（66.67%），观察组可修复性牙折裂27颗（90.00%），差异有统计学意义（P<0.05）。对照组中33.33%的离体牙样本表现为修复体和超过一半的牙体破坏或破坏涉及牙根，无法修补；观察组中10.00%的离体牙样本无法修补，差异有统计学意义（P<0.05）。结论：3M流体树脂充填辅以固位纤维冠外保护...     

不同脱敏剂对楔状缺损充填后微渗漏的影响

目的:比较不同脱敏剂对楔状缺损充填后的微渗漏的影响。方法:选取30颗前磨牙随机分成3组并制作楔状缺损洞型,分别用MEdental,Gluma脱敏剂对牙本质进行表面处理,流动树脂充填,对照组牙本质表面不做任何处理,经牙合力循环、热循环后,用2%亚甲基蓝染色,24h后将每个离体牙由颊舌向沿牙长轴连续切下3片。在体视显微镜下放大40倍观察充填体边缘染液微渗漏情况,然后在SEM下观察流动树脂与牙体组织之间的粘结情况。结果:3组间充填体微渗率差异均有统计学意义(P0.05),以MEdental材料的边缘微渗率最低(P0.01);扫描电镜下观察可见:Medental组树脂与牙体组织结合良好,Gluma组树脂与牙体组织结合处部分位置出现裂隙,对照组树脂与牙体组织结合处存在裂隙且较Gluma组明显。结论:MEdental脱敏剂和Gluma脱敏剂均能降低楔状缺损充填后的微渗率,MEdental脱敏剂影响较大,使用Gluma脱敏剂和MEdental脱敏剂可以获得较好的边缘封闭性。     

不同树脂嵌体材料边缘微渗漏的对比研究

目的：通过对比4种树脂嵌体材料的微渗漏大小,为临床树脂嵌体材料的选择提供参考.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Z350、P60、Ceramage、Solitaire 2制作嵌体后使用Adper Single Bond 2和Adper Rely X ARC进行粘结.经冷热循环500次品红染色后,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,在体式显微镜下测量染料渗入轴壁、龈壁的深度.结果：4组树脂嵌体材料轴壁和龈壁均出现微渗漏.经单因素方差分析,不同树脂嵌体材料之间的轴壁（F=0.131）及龈壁（F=0.385）微渗漏差异无统计学意义（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：从微渗漏深度大小来进行评价,4种树脂嵌体材料均是临床上制作树脂嵌体理想的材料;树脂嵌体与牙釉质粘结效果比牙本质好.     

大块充填复合树脂与传统复合树脂在后牙牙体缺损修复中的疗效对比

目的:比较大块充填复合树脂和传统复合树脂对后牙邻牙合面牙体缺损修复的临床效果。方法:选择60例患者,120颗患牙自身对照,将每位患者的两颗GV BlackⅡ类缺损患牙随机分为Ⅰ、Ⅱ两组。Ⅰ组:Tetric N-Ceram Bulk Fill充填树脂整层充填;Ⅱ组:Filtek~(TM)Z350传统复合树脂分层充填,临床随访观察2年,依据改良的美国公共卫生署的直接临床评价系统(USPHS),分别在修复体边缘着色、边缘密闭性、继发龋、表面形态、填充术后敏感及充填体脱落6个方面评价两种充填技术的临床效果。结果:随访2年内,两种树脂粘接修复后的临床效果接近,两组比较均无统计学差异(P0.05)。结论:大块充填复合树脂与传统复合树脂修复后牙GV BlackⅡ类洞缺损均显示出了很好的临床效果,2年的随访中,疗效相当。     

四种牙体充填材料牙冠微渗漏的比较

目的：本实验旨在评价4种牙体充填材料在冠部暂时性封闭窝洞能力。方法：选用4℃保存100颗新鲜离体前牙颈部截断并保证牙根长度不小于10mm。糊剂加牙胶尖侧压充填后,根管口处统一制备成2mm×2mm×3mm的洞形。随机分为5组,每组20颗牙,分别为松风玻璃离子组、磷酸锌水门汀组、聚羧酸水门汀组、国产玻璃离子组、空白组,并经温度循环。每组选15颗牙用细菌渗透法观察细菌渗透后无菌培养液的浑浊情况。每组另外5颗,除空白组外用日立S-570型扫描电子显微镜观察根管冠方充填材料与根管壁间的微缝隙。结果：①细菌渗透法：1个月后松风玻璃离子仅发生2例冠部细菌渗漏,其余充填材料均发生大量细菌渗漏,4种材料间均有显著性差异（P〈0.01）;②扫描电镜：磷酸锌水门汀和聚羧酸水门汀均颗粒较粗大,有较大微缝隙夹杂有空气泡;国产玻璃离子表面粗糙内部有许多裂隙;松风玻璃离子与牙本质小管完全密合粘结紧密,无微缝隙存在,4种材料间均有显著性差异（P〈0.05）。结论：①松风玻璃离子在暂时性窝洞充填过程中冠方抗渗透能力优于国产玻璃离子粘固剂,磷酸锌水门汀,聚羧酸锌水门汀;②本实验中细菌渗透法,扫描电镜所检测结果基本相一致。     

不同桩核和粘结材料与牙体微渗漏关系的研究

目的:比较两种桩核常用粘结材料复合树脂、玻璃离子粘结后的根向微渗漏的大小,并进行分析和评价。方法:采用40颗离体上颌前磨牙作桩核制备,随机分为4组,每组10颗牙。A组:纤维树脂桩核复合树脂粘结组;B组:纤维树脂桩核玻璃离子粘结组;C组:铸造镍铬合金桩核复合树脂粘结组;D组:铸造镍铬合金桩核玻璃离子粘结组。采用微渗漏染料渗入法,印度墨汁作染料染色1周后透明技术处理,观察样本染色深度。结果:纤维桩核与两种粘结剂出现微渗漏的现象少于铸造镍铬合金桩核与两种粘结剂。结论:树脂粘结剂与牙体组织面以及粘结剂与桩核组织界面有较强的化学结合,封闭效果更好。     

不同根充方法对牙根根尖封闭性及垂直向抗折性能影响的研究

目的:比较三种根管充填方法对根尖封闭性及牙根垂直向抗折性能的影响,为临床操作选择适宜的根充方法提供实验依据。方法:选取人单根前磨牙54颗,随机分为A、B、C三组(每组18颗)。用iRoot SP封闭剂配合牙胶尖对三组样本分别行冷牙胶侧压充填(A组)和热牙胶加压充填(B组)和单尖法充填(C组);从三组各选取9颗,制作透明牙标本,比较根尖微渗漏情况;将剩余的样本(各9颗)制作成标准试件,用万能材料试验机垂直加压直至牙根折裂,记录牙根折裂瞬间的压力值。结果:不同组的根尖微渗漏长度差异不具有统计学意义(P>0.05);单尖法充填组的牙根垂直向抗折力大于冷牙胶侧压充填组和热牙胶加压充填组(P<0.05)。结论:离体牙根管充填时三种根充方法对根尖封闭性的影响没有明显区别,单尖法填充后的牙根垂直向抗折性强于另外两种填充方法。     

伢典化学机械去龋法治疗牙科畏惧症患者龋齿的临床研究

目的：评估伢典化学机械去龋法治疗牙科畏惧症患者龋齿的效果与可行性。方法：选择牙科畏惧症患者45例（66颗患牙）,随机分为实验组和对照组,每组各33颗患牙,分别采用伢典凝胶去龋和局麻下常规磨牙去龋后用树脂充填。比较两组患者的疼痛感受,治疗所用时间及2年后的治疗效果。结果：实验组治疗时的疼痛程度、治疗时间均接近对照组（P〉0．05）。2年后实验组出现充填体边缘微隙、充填体脱落、继发龋的牙数分别为1颗、0颗、1颗,对照组分别为2颗、1颗、1颗,2组间差异无统计学意义（P〉0．05）。结论：伢典化学机械去龋治疗牙科畏惧症患者龋齿安全、无痛、有效,可推广应用。     

Apical microleakage of root-end cavities prepared by Er, Cr: YSGG laser

The aim of this study is to assess the apical microleakage of the composite filled root-end cavities prepared by an Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet laser. Fifty-five maxillary incisor teeth were enlarged and filled. Following the apical resection, root-end cavities were prepared using conventional methods: either using a bur (n?=?30) or an ultrasonic retrotip (n?=?15). Root-end cavities of the 15 teeth in the bur group were finished with the laser at 3.5 W. All root-end cavities were filled using two-step self-etching primer and composite resin. After 4 months of storage, apical microleakage was measured by a fluid filtration method. Microleakage of composite filled root-end cavities that were prepared by Er, Cr: YSGG was significantly larger than those made by conventional methods (p?<?0.05). In conclusion, using the Er, Cr: YSGG laser has no advantages over conventional root-end cavity preparation methods when a composite filling material is used to seal root-end cavities.     

Removal of organic debris with Er:YAG laser irradiation and microleakage of fissures sealants in vitro

The current study was conducted to improve fissure sealing by pre-treatment with Er:YAG laser irradiation in order to remove organic debris. The surface morphology, surface roughness of fissure cavities, and the degree of microleakage after laser treatment were compared with those after bristle brush treatment in vitro. Sixty extracted human teeth were used in this study. The teeth were randomly divided into two groups of 30 each. Artificial fissures were prepared in all teeth into which artificial organic debris was placed. The debris in 30 teeth of one group was removed by means of Er:YAG laser system and the remaining 30 teeth were cleaned using a bristle brush with prophylaxis paste. Surface morphology and surface roughness of were analyzed in ten samples from each group by color laser three-dimensional (3D) microscopy and by scanning electron microscopic examination. The remaining samples were then filled with sealant and subjected to a microleakage test under thermocycling. Statistical analysis was performed using the Mann-Whitney U test; a value of p?相似文献   

牙隐裂伴牙髓急性病变98例疗效观察

目的：探讨牙隐裂伴牙髓急性病变的临床治疗方法及观察修复后1年疗效。方法：对98例隐裂牙伴牙髓急性病变患牙在有效防裂措施下,随机分为2组,A组一次法根管治疗患牙46例,观察1周后冠修复。B组常规法根管治疗52例,观察1周后冠修复。对根管治疗后1周进行疼痛评价,修复1年后进行的临床疗效评价。结果：A组、B组隐裂牙根管治疗术后疼痛患者分别为9例（19．6％）、6例（11．5％）,无统计学差异。两组修复后1年成功例数分别为39例（84．8％）、43例（82．7％）,差异无统计学意义。结论：牙隐裂伴牙髓急性病变经根管治疗后冠修复,,J缶床效果良好,一次法根管治疗、常规根管治疗对牙隐裂伴牙髓病的治疗无统计学差异。     

Sealing ability of retrofilling materials following various root-end cavity preparation techniques

The aim of this study is to compare the sealing efficacy of the retrograde cavity preparations prepared and filled with different equipment and materials. In the study, low speed burs, ultrasonic or Er, Cr:YSGG laser devices were used for cavity preparations and ProRoot MTA and MTA-Angelus as filling materials. Seventy-eight single-rooted teeth were instrumented, root filled, and grouped. Root-end cavities were prepared and filled by using the following: Group 1: Low-speed carbide bur + ProRoot MTA; Group 2: Low-speed bur + MTA-Angelus; Group 3: Ultrasonic retrotips + ProRoot MTA; Group 4: Ultrasonic retrotips + MTA-Angelus; Group 5: Er, Cr:YSGG laser tips + ProRoot MTA; Group 6: Er, Cr:YSGG laser tips + MTA-Angelus. Microleakage was measured using a fluid filtration technique. Differences in the fluid movement among groups were analyzed with a two-way analysis of variance (ANOVA) and LSD test. The results showed a significant difference between the groups prepared with laser and carbide bur (p < 0.05). No difference was found between root-end filling materials (p > 0.05). According to the results of the study, the cavities prepared with Er, Cr:YSGG laser demonstrated significantly lower microleakage in all the filling materials considered.     

Nanoleakage in primary teeth prepared by laser irradiation or bur

The aim of this in vitro study was to analyze hybrid layer and nanoleakage of composite resin restorations in cavities prepared by either Er,Cr:YSGG laser or bur, followed by acid etching in primary teeth. Ten extracted primary molar teeth were randomly allocated into two groups consisting of ten cavities according to surface treatment regimen: Er,Cr:YSGG laser + acid etching(group 1) and bur + acid etching(group 2). Restorations of all samples were completed. Then, teeth were sectioned and immersed to ammoniacal silver nitrate solution. After polishing, hybrid layer thicknesses were examined under scanning electron microscopy (SEM) and ion analysis was carried out with SEM/energy dispersive X-ray spectroscopy preparation in terms of nanoleakage. Hybrid layer thickness and the amount of silver ions were assessed for the acid-etched groups. The collected data were analyzed with independent sample t test and Spearman’s rank correlation. In groups 1 and 2, the mean hybrid layer thicknesses were 4.25?±?1.41 and 5.24?±?1.07 μm and the silver ion percentages were 10.97?±?13.81 and 22.79?±?21.62 %, respectively. Although no significant correlation was observed between the increase of hybrid layer thickness and the amount of silver ions, more silver ions were observed in group 2 (p?<?0.05). According to the results of this study, acid-etched cavities prepared with laser promoted better results when compared to the acid-etched cavities prepared with bur.     

光固化树脂修复前牙各类洞型2年疗效评估

目的:研究3M-Z350树脂在前牙美容修复术中的2年期临床应用效果,评估其应用前景。方法:对125人,193颗前牙的各类洞型进行复合树脂充填修复,分别于治疗后的6个月、1年、2年对修复体的完整性、色泽匹配,边缘脱色,继发龋,解剖形态,边缘适合度,表面光滑度及术后敏感情况等指标进行系统评估。结果:3M-Z350树脂在2年的观察期内成功率达到93.9%,各类洞型修复后的色泽匹配度,边缘脱色,表面光滑度、解剖形态、继发龋、边缘适合度成功率分别为100%、100%、100%、100%、93.4%和98.9%,1年与2年的修复体完整率存在显著差异(P<0.05)。但各洞型间的修复体保存率及临床疗效无显著差异。结论:3M-Z350纳米树脂在前牙美容修复治疗中具有良好的应用效果。     

Microleakage of Er:YAG laser and dental bur prepared cavities in primary teeth restored with different adhesive restorative materials

The purpose of this study was to evaluate and compare the effect of erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation and conventional dental bur cavity preparation on in vitro microleakage of class V cavities restored with different adhesive restorative materials and two types of self-etching adhesives in primary teeth. Standard class V cavities were prepared on 80 extracted primary, and the teeth were randomly divided into eight subgroups prepared either by dental bur or Er:YAG laser irradiation and then restored with self-cured glass ionomer (GI), resin-modified glass ionomer (RMGI), resin composite and Clearfil SE Bond (two-step self-etching adhesive), and resin composite and Clearfil S3 Bond (one-step self-etching adhesive). Restorations were finished and stored in distilled water at 37 °C for 24 h and then subjected to thermocycling. All the teeth were sealed with nail varnish, placed in a silver nitrate solution, and then vertically cut in a buccolingually direction. Subsequently, the specimens were evaluated for gingival and occlusal microleakage using a stereomicroscope. Data were analyzed using Kruskal–Wallis test followed by Mann–Whitney test. Wilcoxon test was used for comparing occlusal microleakage with gingival microleakage at p?<?0.05. A higher degree of occlusal and gingival microleakage values for the teeth restored with GI or RMGI was obtained by both preparation methods compared with that of resin composites and the two self-etching primers. Er:YAG laser irradiation resulted in a significantly higher degree of microleakage only at the gingival margins for teeth restored with GI or RMGI, or composite and Clearfil S3 Bond compared with the bur preparation. The Er:YAG laser-prepared teeth restored with composite and Clearfil SE Bond demonstrated a better marginal seal on occlusal and gingival margins compared with that of bur-prepared cavities. The degree of microleakage in class V cavities was affected by the type of adhesive restorative materials, type of self-etching adhesive, cavity margin location, and tooth preparation method either by Er:YAG laser or dental bur.     

A study on surface roughness and microleakage test in cavities prepared by Er:YAG laser irradiation and etched bur cavities

 The purposes of this study were to investigate the surface morphology, suface roughness of cavities prepared by Er:YAG laser irradiation, and compared the microleakage degree after composite resin restoration with etched bur cavities, in vitro. In each of the 30 human extracted teeth, two shallow cavities were prepared; one prepared with the Er:YAG laser system on the buccal surface, and one produced on the lingual (palatal) surface with a high-speed turbine. Five cavities from each group were investigated by scanning electron microscopy (SEM), and five were subjected to surface roughness analysis by a colour laser three-dimensional (3D) microscope. The remaining cavities were filled with a composite resin and subjected to a microleakage test under thermocycling. Only bur cavities were acid-etched before filling. Statistical analysis was performed using the Mann-Whitney U test; a value of p <0.01 was considered significant. Morphologically, the prepared cavities showed an irregular surface with the absence of a debris-like smear layer; enamel prisms and opening of dentinal tubules were recognised. Surface roughness was significantly increased with the laser system. Microleakage test revealed no significant differences between the laser and bur cavities. Crosscut sections of the cavities with no microleakage showed no gap at the interface. Laser cavity may facilitate good adaptation of composite resin with enamel and dentine, because an increase of surface roughness and the openings of dentinal tubules may facilitate the formation of a hybrid zone, since a primer and an adhesive can penetrate the surface better when the smear layer is removed. It can be concluded that shallow cavity prepared by Er:YAG laser is capable of decreasing microleakage of composite resin restorations, and its efficiency is similar to etched bur cavities. Received: 16 July 2001 / Accepted: 5 June 2002     

The effect of erbium family laser on tensile bond strength of composite to dentin in comparison with conventional method

The purpose of this study was to evaluate the effect of Er:YAG and Er,Cr:YSGG laser on tensile bond strength of composite resin to dentine in comparison with bur-prepared cavities. Fifteen extracted caries-free human third molars were selected. The teeth were cut at a level below the occlusal pit and fissure plan and randomly divided into three groups. Five cavities were prepared by diamond bur, five cavities prepared by Er:YAG laser, and the other group prepared by Er,Cr:YSGG laser. Then, all the cavities were restored by composite resin. The teeth were sectioned longitudinally with Isomet and the specimens prepared in dumbbelled shape (n?=?36). The samples were attached to special jigs, and the tensile bond strength of the three groups was measured by universal testing machine at a speed of 0.5 mm/min. The results of the three groups were analyzed with one-way ANOVA and Tamhane test. The means and standard deviations of tensile bond strength of bur-cut, Er:YAG laser-ablated, and Er,Cr:YSGG laser-ablated dentine were 5.04?±?0.93, 13.37?±?3.87, and 4.85?±?0.93 MPa, respectively. There is little difference in tensile bond strength of composite resin in Er,Cr:YSGG lased-prepared cavities in comparison with bur-prepared cavities, but the Er:YAG laser group showed higher bond strength than the other groups.     

Super bond C&B,Fuji Ⅱ,MTA粘结离体牙纵裂牙根的力学研究

目的:比较Super bond C&B,Fuji Ⅱ,MTA三种材料粘结离体单根管前牙纵裂牙根的粘结强度。方法:选取离体单根管前牙75颗制备成纵裂牙根模型后按数字随机表分成6组。1～3为压力组(每组15颗牙):1组,MTA充填裂缝;2组,Super bond C&B充填裂缝;3组,则用Fuji Ⅱ行裂缝充填。4～6为拉力组(每组10颗牙):4组,MTA充填裂缝;5组,Super C&B充填裂缝;6组,则用Fuji Ⅱ行裂缝充填。用万能力学测试机测定各试件数值,用SPSS 10.0软件包对检测结果进行统计学分析。结果:压力测试显示:Superbond C&B充填纵裂牙根,其抗压能力明显高于MTA组和FujiⅡ组,而后两组之间无明显差异;拉力测试表明:MTA组抗拉能力最差,Fuji Ⅱ组明显高于MTA组但明显低于Super bondC&B组。结论:Super bond C&B粘结离体纵裂牙根的强度最强,抗压和抗拉能力优于FujiⅡ和MTA。