牙科发光二极管光固化灯和普通卤光灯临床应用效果评价

目的：了解牙科发光二极管光固化灯应用于患牙备洞树脂充填固化后的临床效果.方法：按纳入标准选择门诊就诊患者患牙160颗,龋损和楔状缺损各80颗.随机分为试验组和对照组,使用牙科树脂材料充填后,实验组应用发光二极管光固化灯固化20sec,对照组应用普通卤光灯固化40sec,打磨抛光;12个月后复诊,评价.结果：楔状缺损实验组有1颗充填物脱落,1颗边缘密合度缺陷,1颗边缘着色,成功率92.1%;对照组有1颗充填物脱落,1颗边缘着色,成功率94.4%;无统计学意义上的差异（P＞0.05）.龋损实验组有3例边缘密合度缺陷,2颗边缘着色,成功率87.5%;对照组有2颗边缘密合度缺陷,1颗边缘着色,成功率91.7%;无统计学意义上的差异（P＞0.05）.结论：发光二极管光固化灯与普通卤光灯临床效果没有区别,但操作时间更短,使用更为轻巧.     

老年患者对牙洁治术的心理接受评价

洁治术是预防和治疗牙周病的重要手段之一,但有相当一部分人对口腔洁治认识不足甚至存在误区,尤其是老年人。此外,洁治术中的不适反应可能会引起老年患者的紧张、畏惧心理,从而在一定程度上影响洁治术的推广应用。本文对老年患者采用不同方案进行洁治,应用心理测试量表分析老年患者对洁治术的心理接受度。     

发光二极管光固化灯的研究进展

随着光固化树脂的广泛应用,人们对光固化技术的研究也有了进一步的发展.传统的卤光灯因固有的缺陷限制了发展.本文介绍了发光二极管新型光固化灯的基本工作原理、特点及其发展,分析对比了发光二极管新型光固化灯与传统卤光灯对树脂物理性能、机械性能及生物学性能的影响,提出这种新型光固化技术亟待解决的问题,为其临床应用提供一定的理论依据.     

长春市口腔临床应用光固化灯的功率密度调查

目的 调查长春市口腔临床应用光固化灯的功率密度及其影响因素。方法 调查长春市口腔专科医院、综合医院口腔科和私人口腔诊所共285盏光固化灯的功率密度,并进行相关信息的收集,包括光固化灯的品牌、类型、使用年限、光导棒数目及类型、光导棒玷污、破损情况、使用频率、装置的检测及维修情况。利用LED辐射仪检测光固化灯的输出功率密度。平均输出功率密度分为3类（<200 mW/cm²,200~399 mW/cm²和≥ 400 mW/cm²）。结果 所检查的285盏固化装置均为LED灯,检测功率密度的变化范围在121~1794 mW/cm²,平均功率密度为796 mW/cm²,其中只有3盏灯小于200 mW/cm²,不能充分聚合光固化复合树脂。结论 相比于2010年的调查结果,长春市现阶段临床使用光固化灯的类型已从大部分的卤光灯全部更新为LED光固化灯。此次调查过程中发现大多数医师对于光固化灯的重视程度有所提高,但部分医生依旧缺乏关于光固化灯需要定期检修和清洁等相关知识。     

口腔光固化灯临床应用进展

随着光固化材料的发展,光固化灯已成为口腔临床中必不可少的设备之一,但要正确且高效地应用并不简单。文章结合复合树脂的固化特性,就口腔光固化灯的临床应用做一综述,为口腔医生正确使用光固化灯提供参考依据。     

3种光固化灯照射不同颜色复合树脂的固化深度比较

目的探讨LED光固化灯与传统卤素灯对不同颜色复合树脂的固化深度的影响。方法选取FiltekTMZ350和Premisa两种树脂,FiltekTMZ350组选取A1B,A2B,A3B 3种颜色,Premisa组选取A1E,A2E,A3E 3种颜色,自制实验模具,将树脂填入模具。每种颜色树脂制作60例试件,分为3组,每组20例,分别用2种新型LED光固化灯Demi LED和Bluephase20i与传统卤素灯ALC-50在标准条件下照射试件,检测固化深度。结果 Demi LED光照10 s、Bluephase20i光照10 s树脂的固化深度均达到3 mm,与传统的卤素光固化灯ALC-50光照40 s有显著差异,但前两者之间无显著差异。Premisa树脂中2种LED照射组A1E,A2E和A3E 3种颜色之间固化深度有统计学差异。结论在相同条件下,Demi LED和Bluephase20i照射10 s树脂固化深度大于传统卤素灯ALC-50照射同一树脂40 s,适合临床应用。树脂颜色的加深对树脂固化深度有影响。     

不同洁牙方式对老年患者临床疗效的对比评价

目的:对比观察SATELEC P5超声洁牙机与SONICflex 2003气动声波洁牙机对老年患者牙周的治疗效果,以及老年患者对其心理接受的评价。方法:按纳入标准随机选择门诊就诊的老年患者40例,随机分为实验组20例和对照组20例,分别采用SONICflex 2003气动声波洁牙机和和SATELEC P5超声洁牙机进行洁治,并观察菌斑指数、探诊出血指数的变化,所有患者在接受治疗后完成心理试量表,量化对这两种不同洁牙机治疗的主观感受,并对结果进行统计学分析。结果:两种洁牙方式均使即刻菌斑指数减少,探诊出血指数降低。Corah计分SONICflex 2003组总分187,平均9.35,SATELEC P5组总分226,平均11.30,P<0.05,有统计学意义上的差异。结论:两种洁牙机均有利于控制牙龈炎症维持牙周治疗效果。和SATELEC P5超声洁牙机相比,老年患者对SONICflex 2003气动声波洁牙机心理接受度较高。     

长春市口腔临床应用光固化灯的调查

目的调查长春市临床应用光固化灯的功率密度及其相关信息,为临床医师正确维护使用光固化灯提供参考。方法调查对象为长春市口腔专科医院、综合医院口腔科、民营诊所,采用简单随机抽样的方法,共检测270盏光固化灯的功率密度及相关信息,包括光固化灯的品牌、类型、使用年限、光导头数目及类型,光导头玷污、破损情况,使用频率,装置的检测及维修情况,灯数目/牙椅数。结果270盏光固化灯中,卤光灯174盏,发光二极管灯96盏,检测功率密度变化范围在0～1702 mW/cm2,平均功率密度为413.2 mW/cm2,73盏灯小于200 mW/cm2,不能充分聚合光固化复合树脂。光固化灯的平均使用年限为4.7年。大多数医师未检测过光固化灯的功率密度,84％(227/270)的光导头表面有树脂的玷污和破损。结论 长春市大部分光固化灯为卤光灯,部分灯老化明显,需要更新,大多数医师没有注意光固化灯需要定期检测和维修。     

固化光源光照方向和角度对微渗漏影响的研究

目的：研究固化光源光照方向及角度对复合树脂固化后微渗漏的影响。方法：选择63颗离体前磨牙,在颊面牙颈部以釉牙骨质界为中心制备圆形V类洞,常规酸蚀粘结,充填复合树脂,将所有实验牙以光源不同朝向随机分为A组：光源方向朝向龈壁;B组：光源方向朝向牙合壁;C组：光源方向朝向近中壁。再将A、B、C每组按固化光源与充填材料表面所成的角度不同随机分1组：成30°光照;2组：成60°光照;3组：成90°光照。所有实验牙均光照40s。分别浸泡于0.1%罗丹明B荧光染色剂中24h。然后经修复体中央,沿牙体长轴沿颊舌向纵向剖成两半,在激光扫描共聚焦显微镜（Laser Scanning Confocal Microscopy,LSCM）下分别观察检测微渗漏大小。结果：龈壁处的微渗漏情况：在光源的不同朝向下,不同的光照角度对龈壁处微渗漏的影响均具有统计学意义,光照角度均为90°时微渗漏值最小（P〈0.05）;牙合壁处的微渗漏情况：当光源朝向牙合壁及近中壁照射时,牙合壁处3组之间微渗漏有明显差异（P〈0.05）,光照角度90°时微渗漏最小;当光源朝向龈壁时,牙合壁处微渗漏之间没有明显的差异。结论：固化光源的光照方朝向及光照角度对微渗漏有影响。     

老年患者牙科焦虑症的调查分析

目的调查老年患者牙科焦虑症存在的情况及影响因素。方法利用柯氏牙科焦虑症量表用简单随机法对100例门诊就诊的老年患者进行横断面调查和统计分析。结果56％的老年人有牙科焦虑症。焦虑的原因主要是害怕疼痛（占70％）；担心医生技术（占12％）；担心治疗复杂、收费高（占10％）；其他原因包括担心被拔牙、留下后遗症等（占8％）。结论56％的老年人有牙科焦虑症，焦虑的主要原因是害怕疼痛。     

Effect of LED and halogen light curing on polymerization of resin-based composites

The clinical performance of light polymerized resin-based composites (RBCs) is greatly influenced by the quality of the light curing unit (LCU). A commonly used unit for polymerization of RBC material is the halogen LCUs. However, they have some drawbacks. Development of new blue superbright light emitting diodes (LED LCU) of 470 nm wavelengths with high light irradiance offers an alternative to standard halogen LCU. The aim of this study is compared the effectiveness of LED LCU and halogen LCU on the degree of conversion (DC) of different resin composites [two hybrid (Esthet-X, Filtek Z 250), four packable (Filtek P60, Prodigy Condensable, Surefil, Solitaire), one ormocer-based resin composite (Admira)]. The DC values of RBCs polymerized by LED LCU and halogen LCU ranged approximately from 61.1 +/- 0.4 to 50.6 +/- 0.6% and from 55.6 +/- 0.7 to 47.4 +/- 0.5%, respectively. Significantly higher DC of RBCs except Surefil and Filtek Z 250 was obtained for LED LCU compared with halogen LCU (P < 0.05). Surefil and Filtek Z 250 exhibited no statistically significant difference values between LED LCU and halogen LCU (P > 0.05). As a result, it was observed that the performance of LED LCU used in the study was satisfactory clinically and had sufficient irradiance to polymerize RBCs (hybrid, packable and ormocer based) at 2 mm depth with a curing time of 40 s.     

Effects of light-emitting diode and halogen light curing techniques on ceramic brackets bonded to porcelain surfaces

The objectives of this study were to test the efficiency of LED curing devices in bonding ceramic brackets to porcelain surfaces and to compare the effects of LED and halogen curing techniques on shear bond strength of ceramic brackets. A total of 20 glazed porcelain facets were randomly divided into two groups of 10. Porcelain surfaces were etched with 9.6% hydrofluoric acid for 2 minutes, and silane was applied on the etched porcelain surface. Ceramic brackets were bonded with an LC composite resin cured with soft start mode LED and a halogen light. Bond strengths, as determined in the shear mode, were higher in the LED group (P < .001). LED curing units with the soft start polymerization mode were more effective than halogen curing units in bonding ceramic brackets on porcelain surfaces. The type of curing light must be considered as an important factor affecting bond strength of ceramic brackets on porcelain surfaces.     

Influence of light intensity from different curing units upon composite temperature rise

The unavoidable consequence of composite resin photopolymerization is temperature rise in tooth tissue. The temperature rise depends not only on the illumination time, but also on light intensity, distance of light guide tip from composite resin surface, composition and shade of composite resin and composite thickness. The most commonly used units for polymerization today are halogen curing units, which emit a large spectrum of wavelengths. A proportion of the spectrum has no influence on degree of conversion and therefore causes unnecessary temperature rise. Units based on light source - blue light emitting diodes (LED), as an alternative for halogen curing units, have been introduced in clinical practice. The aim of this study was to show the influence of the light intensity of curing units Elipar Trilight, Astralis 7 and Lux-o-Max unit on temperature rise in composite resin sample of Tetric Ceram. The temperature was measurement with Metex M-3850 D multimeter with the tip of temperature probe put into unpolymerized composite resin sample 1 mm depth. The highest temperature rise was recorded with standard curing mode for Elipar Trilight halogen curing unit (13.3 +/- 1.21 degrees C after 40 s illumination), while the lowest temperature rise was recorded for the Lux-o-Max unit based on LED technology (5.2 +/- 1.92 degrees C after 40 s illumination).     

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光固化复合树脂通过光聚合进行固化,已有多种光固化灯用于口腔材料的光固化。随着发光二极管（LED）技术的迅速发展,LED光固化灯已逐渐成为多数临床应用的标准设备。本文就LED光固化灯的物理学特性、口腔临床应用发展、导光管及其消毒作一综述,分析未来发展趋势,为其在口腔临床应用提供参考依据。     

In-vitro pulpal temperature increases when photo-curing bulk-fill resin-based composites using laser or light-emitting diode light curing units

Objective

To evaluate the in vitro pulpal temperature rise (ΔT) within the pulp chamber when low- and high-viscosity bulk-fill resin composites are photo-cured using laser or contemporary light curing units (LCUs).

Materials and Methods

The light output from five LCUs was measured. Non-retentive Class I and V cavities were prepared in one upper molar. Two T-type thermocouples were inserted into the pulp chamber. After the PT values reached 32°C under simulated pulp flow (0.026 mL/min), both cavities were restored with: Filtek One Bulk Fill (3 M), Filtek Bulk Fill Flow (3 M), Tetric PowerFill (Ivoclar Vivadent), or Tetric PowerFlow (Ivoclar Vivadent). The tooth was exposed as follows: Monet Laser (1 and 3 s), PowerCure (3 and 20 s), PinkWave (3 and 20 s), Valo X (5 and 20 s) and SmartLite Pro (20 s). The ΔT data were subjected to one-way ANOVA followed by Scheffe's post hoc test.

Results

Monet 1 s (1.9 J) and PinkWave 20 s (30.1 J) delivered the least and the highest amount of energy, respectively. Valo X and PinkWave used for 20 s produced the highest ΔT values (3.4–4.1°C). Monet 1 s, PinkWave 3 s, PowerCure 3 s (except FB-Flow) and Monet 3 s for FB-One and TP-Fill produced the lowest ΔT values (0.9–1.7°C). No significant differences were found among composites.

Conclusions

Short 1- to 3-s exposures produced acceptable temperature rises, regardless of the composite.

Clinical Significance

The energy delivered to the tooth by the LCUs affects the temperature rise inside the pulp. The short 1–3 s exposure times used in this study delivered the least amount of energy and produced a lower temperature rise. However, the RBC may not have received sufficient energy to be adequately photo-cured.     

Effect of light-emitting diode photopolymerization modes on the push-out bond strength of a methacrylate-based sealer

Introduction

The objective of this study was to investigate and compare the effect of different light-emitting diode (LED) polymerization modes on the bond strength of a methacrylate-based sealer used with Resilon or gutta-percha.

Methods

Forty extracted single-rooted teeth were sectioned off below the cementoenamel junction, and the root canals were instrumented by using rotary instruments to ISO #30/0.06 taper. The roots were randomly assigned into 1 of the following groups for root canal obturation: (1) RealSeal + Resilon and (2) RealSeal + gutta-percha. In each group, specimens were further subgrouped according to the LED polymerization mode used to cure RealSeal: (1) standard (20 seconds of maximum intensity) and (2) exponential (5 seconds of exponential power increase, followed by 15 seconds of maximum intensity). Specimens were stored in 100% humidity for 1 week at 37°C. Push-out test was performed at a crosshead speed of 1 mm/min on 2-mm-thick root slices obtained from coronal to apical direction. Multivariate analysis of variance and Tukey tests were used for statistical analysis of the data (P = .05). Failure modes were examined under the scanning electron microscope.

Results

The tested polymerization modes had no significant effect on the bond strength values (P > .05). RealSeal + gutta-percha yielded significantly greater bond strength than RealSeal + Resilon (P < .05). In all groups, the bond strength values decreased significantly from coronal to apical direction (P < .05). Adhesive failure at the sealer-dentin interface was the predominant fracture mode.

Conclusions

The exponential photopolymerization mode had no significant advantage over the standard regimen in terms of dentin bond strength.