不同树脂黏结剂对纤维桩冠向微渗漏及黏结强度的影响

背景：目前国内外对全酸蚀、自酸蚀及自黏结树脂黏结剂对纤维桩的冠向微渗漏及黏结强度影响的研究仍存在差异。 目的：评价全酸蚀、自酸蚀及自黏结3种树脂黏结剂对纤维桩黏固后冠向微渗漏及黏结强度影响。 方法：将32颗人离体上前牙随机分成5组,其中3组为实验组,2组为对照组。实验组离体牙经根管预备后,选用全酸蚀、自酸蚀及自黏结3种树脂黏结剂分别黏结直径为1.4 mm的玻璃纤维桩。体视显微镜下观察试件各剖面的微渗漏情况,再将实验组试件沿垂直牙长轴方向切成厚度为2 mm的薄片,万能材料测试机进行微推出实验,并观察试件断裂方式。阳性对照组不进行根管预备,根部涂布指甲油,冠部直接暴露于染色剂中;阴性对照组不进行根管预备,树脂覆盖根管口,将牙体整体涂布指甲油后黏蜡包埋至截面下1 mm。 结果与结论：各种树脂黏结剂均存在微渗漏现象,其中全酸蚀树脂黏结剂的微渗漏程度最轻,自酸蚀树脂黏结剂的微渗漏程度最重。3种树脂黏结剂间的微渗漏程度差异有显著性意义(P < 0.05)。黏结剂间的黏结强度由高到低分别为全酸蚀树脂黏结剂、自酸蚀树脂黏结剂、自黏结树脂黏结剂,3种黏结剂的黏结强度差异有显著性意义(P < 0.05)。试件的主要断裂方式为黏结剂/纤维桩间断裂及混合破坏。说明全酸蚀树脂黏结剂与牙本质结合紧密,与自酸蚀树脂黏结剂、自黏结树脂黏结剂比较在微渗漏程度及黏结性能方面显示出优越性。     

草酸铁溶液处理牙本质后黏结界面的超微形态

背景：基于流体动力学说,选择良好的生物材料封闭暴露的牙本质小管口是国际上对治疗牙齿敏感研究的热点。草酸铁溶液可以在牙本质小管内形成结晶样结构。 目的：观察草酸铁溶液结合全酸蚀黏结系统处理牙本质后黏结界面的形态学变化。 方法：选择无龋人离体智齿12颗,去除牙冠牙釉质,暴露牙本质。随机均分为实验组和对照组, 32%磷酸酸蚀剂酸蚀牙本质黏结面,实验组用5.3%草酸铁溶液处理表面1 min后充分冲洗10 s,两组表面再充填树脂。平行牙长轴方向片切制备扫描电镜试样,在扫描电镜(SEM)下观察黏结界面的微观形态。 结果与结论：实验组草酸铁产生的结晶样结构几乎堵塞全部牙本质小管开口,树脂层伸出无数短小树脂突嵌于硬化的牙本质小孔内。对照组局部区域混合层与其下方未脱矿的牙本质间有明显的裂隙出现,树脂突较粗,但长短不均匀,可见树脂突的断裂。提示,5.3%草酸铁溶液能够在牙本质小管内形成结晶,使牙本质小管口封闭良好。对照组可见树脂突的断裂,牙本质小管暴露,封闭不严密。说明5.3%草酸铁溶液结合全酸蚀黏结系统治疗牙本质龋能够提高其临床治愈率。     

FiltekTM Z 350纳米流动树脂微创修复细小窝沟龋

背景：传统的细小窝沟龋修复需要按Ⅰ类洞形进行预备,对牙体组织破坏较多。 目的：评价流动纳米树脂微创修复细小窝沟龋的临床效果。 方法：选择14~30岁磨牙有窝沟龋且对侧同名牙或邻牙也有窝沟龋患者167例,在一侧磨牙牙合面窝沟龋去除龋坏牙体组织后,采用Adper Single Bond 2全酸蚀黏结技术,用Filtek ^TM Z350流动纳米树脂充填整个微创窝洞作为实验组,对侧同名牙或邻牙窝沟龋用同一公司生产的Filtek ^TM Z350纳米树脂充填作对照。 结果与结论：随访2年后发现实验组Z350流动纳米树脂填充体保留率高,边缘完整性好,边缘着色率低,树脂保留率、边缘完整性及边缘着色率高于对照组(P < 0.05)。提示Filtek ^TM Z350流动纳米树脂微创窝沟充填可有效修复细小窝沟龋。     

常用3种光固化复合树脂材料修复楔状缺损离体牙的组织学评价

背景：延长口腔生物材料的使用寿命,是当今口腔治疗学与材料学的关注点。 目的：评价3种光固化复合树脂修复牙体楔状缺损的效果。 方法：在体外模型中对离体牙进行统一造模,扫描电子显微镜观察3MZ350树脂、3M流体树脂及P90树脂3种修复材料充填后材料与牙体的结合界面。 结果与结论：3种材料都显示了与牙体组织基本良好的结合性能,3MZ350树脂微裂隙多出现在粘接剂层,可有空泡出现;P90组树脂材料侧有断裂纹;流体树脂微裂隙很小,这与其流动性有关系。说明3种材料都可以直接充填,良好的边缘封闭性能的粘接剂可有效减少复合树脂-牙齿界面的微渗漏,增加树脂修复的成功率。关键词：复合树脂;楔状缺损;光固化;结合界面;扫描电子显微镜 doi:10.3969/j.issn.1673-8225.2012.16.023     

光固化和双重固化玻璃离子水门汀修复牙体的效果比较

背景：玻璃离子水门汀作为新型齿科修复材料,具有与牙体粘接性强,对牙体刺激性小,可有效防龋等优点,目前被广泛应用于临床牙齿充填、黏结、洞基衬,牙本质过敏治疗及暂封等。 目的：比较光固化玻璃离子水门汀与双重固化玻璃离子水门汀修复牙体的效果。 方法：选择48例龋齿患者,以随机数字表方法分为2组,分别采用光固化玻璃离子水门汀与双重固化玻璃离子水门汀修复牙体,随访6个月-2年,通过修复体完整程度、边缘密闭性、继发龋发生与牙周及牙髓病变等对比分析两组修复效果。 结果与结论：修复6个月复查,光固化玻璃离子水门汀组修复成功率为97%,双重固化离子水门汀组修复成功率为99%,两组比较差异无显著性意义(P > 0.05)。修复2年后复查,光固化玻璃离子水门汀组修复成功率为74%,双重固化离子水门汀组修复成功率为92%,两组比较差异有显著性意义(P < 0.05)。表明双重固化玻璃离子水门汀材料修复体保持完整时间更长,边缘密闭性更好,继发龋和牙髓及牙周病变发生率更低,更适用于临床应用。     

不同洞径I类洞修复后牙体的应力分析

我们旨在研究不同洞径I类洞复合树脂修复后牙体的应力分布情况.采用CT扫描获取健康成人上颌牙的二维图像,通过计算机重建技术建立三维立体图像,并获得其有限元数据模型,在相同垂直载荷下对5种不同洞径I类洞修复前后的牙体应力状态进行数据分析.结果显示,在所设计的圆三角形I类洞受到50N相同作用力后,洞底切面直径从3.3 mm逐步长到3.7 mm时,其应力峰值依次为14.873、16.682、17.589、17.307和17.912 MPa,各值间无明显差异,但应力峰值为正常牙的3倍.提示后牙树脂充填时,I类洞洞径的改变对牙体的应力峰值无显著影响,但牙体的承载能力较正常牙明显下降.     

光固化修复楔状缺损的失败原因分析

牙齿颈部楔状缺损是一种非龋性牙体硬组织疾病 ,是临床上多见的一种牙体病。临床上多采用复合树脂和玻璃离子充填 ,但复合树脂要酸蚀 ,对牙髓刺激性大 ;玻璃离子虽不用酸蚀 ,但楔状缺损的部位及形态的特殊 ,充填后不易固位 ,临床上易补物脱落。本文利用光固化复合体的优点对 78例13 8个楔状缺损临床资料进行修复总结如下 :1　材料和方法1.1　临床资料本组 78例 ,男性 53例 91个 ;女性 2 5例 47个 ;年龄 2 5-63岁。前牙 51个 ,前磨牙 69个 ,磨牙 18个。选择的 13 8颗牙均诊断为楔状缺损的活髓牙 ,无急慢性牙髓炎 ,无急慢性根尖周炎等病史。1.…     

不同复合树脂材料硬度及黏结强度的比较

背景：与传统复合树脂材料相比,大块充填复合树脂材料具有增加光固化深度、降低聚合收缩率、简化临床操作程序等特点,但不同类型大块充填复合树脂材料的性能各异。 目的：分析4种复合树脂材料的硬度及黏结强度。 方法：取大块填充复合树脂Tetric EvoCeram BulkFill、SDR,以及传统复合树脂P60、Z350,检测4种复合树脂材料分别在2,3,4,5 mm光固化深度下的维氏显微硬度,以及4种复合树脂材料与牙本质间的剪切黏结强度。 结果与结论：不同光固化深度下的硬度顺序为：P60复合树脂>Z350复合树脂>Tetric EvoCeram BulkFill复合树脂> SDR复合树脂,4组间比较差异有显著性意义(P < 0.05);Tetric EvoCeram BulkFilll和SDR复合树脂光固化后的硬度未随着固化深度的增加而明显减小。Tetric EvoCream BulkFil和SDR复合树脂的剪切黏结强度显著高于P60和Z350复合树脂(P < 0.05)。表明大块充填树脂材料Tetric EvoCeram BulkFill和SDR的综合机械性能较高,并且具有较高的剪切黏结强度。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

不同纤维桩修复方式影响重度楔状缺损前磨牙的抗折性能

背景：以往的观点认为桩可以增强根管治疗牙的抗折裂强度,但近年来这种观念已引起争议,许多学者认为,根管的预备削弱了牙根,桩进一步增加了折裂的危险。 目的：评价侧向加载条件下,采用不同纤维桩修复方法对重度楔状缺损前磨牙抗折性能的影响。 方法：将50颗正畸拔除的人上颌前磨牙随机分为5组,每组10颗。A组为正常前磨牙;B-E组40颗牙均制备深达颊舌径1/3深度的重度楔状缺损,B组不做任何处理;C组经根管治疗,保留楔状缺损上方颊侧悬突牙体组织,颊、舌根管内采用LuxaPost高强度玻璃纤维桩、LuxaCore双固化冠核复合树脂修复缺损牙体组织;D组经根管治疗,保留楔状缺损上方颊侧悬突牙体组织,颊、舌根管内采用LuxaPost高强度玻璃纤维桩、LuxaCore双固化冠核复合树脂及金属全冠修复缺损牙体组织;E组经根管治疗,去除楔状缺损上方颊侧悬突牙体组织,颊、舌根管内采用 LuxaPost高强度玻璃纤维桩、LuxaCore双固化冠核复合树脂及金属全冠修复缺损牙体组织。检测各组样本折裂强度。 结果与结论：A-E组抗折载荷分别为(1 002.69±147.62),(439.28±66.34),(958.30±101.23),(1 207.09± 143.48),(1 056.44±139.30) N。D组抗折载荷最高(P < 0.01),B组最低(P < 0.01),A、C、E三组间抗折载荷比较差异无显著性意义。表明纤维桩能增强重度楔状缺损牙的抗折能力,并且保留牙体组织有助于提高修复体的抗折性。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

不同洞径Ⅰ类洞修复后牙体的应力分析

我们旨在研究不同洞径Ⅰ类洞复合树脂修复后牙体的应力分布情况。采用CT扫描获取健康成人上颌牙的二维图像，通过计算机重建技术建立三维立体图像，并获得其有限元数据模型，在相同垂直载荷下对5种不同洞径Ⅰ类洞修复前后的牙体应力状态进行数据分析。结果显示，在所设计的圆三角形Ⅰ类洞受到50N相同作用力后，洞底切面直径从3．3nm逐步长到3．7nm时，其应力峰值依次为14．873、16．682、17．589、17．307和17．912MPa，各值间无明显差异，但应力峰值为正常牙的3倍。提示后牙树脂充填时，Ⅰ类洞洞径的改变对牙体的应力峰值无显著影响，但牙体的承载能力较正常牙明显下降。     

两种嵌体加工技术对树脂嵌体机械性能的影响

背景：复合树脂作为一种既美观又实用的嵌体修复材料,其机械性能的改进成为研发的热点。 目的：用CERAMAGE与TESCERA两种嵌体固化机制作树脂试件,比较两种加工技术对嵌体材料机械性能的影响。 方法：选取两种机器的配套树脂,与两种机器进行交叉配对,分成4组：A、B两组用Tescera树脂分别与TESCERA嵌体机和CERAMAGE嵌体机配对;C、D两组用Ceramage树脂分别与CERAMAGE嵌体机和TESCERA嵌体机配对,分别制作标准试件,测试试件的表面硬度,抗压强度和挠曲强度。 结果与结论：在表面硬度,抗压强度上,A组高于其他3组;B组高于C、D两组(P <0.05)。在挠曲强度上,C、D两组高于A、B两组(P < 0.05),C、D组间及A、B组间差异无显著性意义。结果表明,用TESCERA嵌体机加工其配套树脂,所得试件的机械性能最佳。     

栓道预处理对自粘接树脂水门汀粘接纤维桩粘接强度的影响

BACKGROUND: The bonding interface of resin cements with dentin is unstables, therefore, improvement on the bonding strength is of great significance. OBJECTIVE: To evaluate the effects of different pretreatments to post space on bonding strength of the self-adhesive resin cement EmbraceCoreTM Resin Cement to fiber posts after phosphoric acid etching or self-etching. METHODS:Twenty-five human mandible canines or premolars with single-rooted canal were selected. After conventional root canal treatment and post space preparation, they were randomly divided into five groups (n=5 per group): group I (control group): 0.9% normal saline irrigation; group II: etching with 35% phosphoric acid for 15 seconds; group III: self-etching with CLEARFILTM SE BOND binder for 20 seconds; group IV: etching with 35% phosphoric acid for 15 seconds and bonding with single bong 2; group V: self-etching with CLEARFILTM SE BOND binder for 20 seconds and bonding with CLEARFILTM SE BOND binder. Fiber posts were edusing self-adhesive resin cement EmbraceCoreTM Resin Cement. The thin-slice push-out test was performed to record the bonding strengths, and the failure modes of fiber posts were observed by stereomicroscope. RESULTS AND CONCLUSION: The bond strength of groups I-V were as follows: (8.66±2.43), (7.05±3.0), (7.37±2.83), (9.88±2.9), and (10.04±2.86) MPa. Groups II, IV and V showed significantly different bond strength from the group I (P < 0.05), but there were no significant differences between groups III and I (P > 0.05). The main failure models in the groups I, II and III were A1 and A2, and less B1 and B2 appeared. The failure modes in the groups IV and V also focused on the A1 and A2, but B1 and B2 increased gradually. These results indicate that neither the pretreatments by phosphoric acid etching nor by self-etching in root canal dentin can improve the bonding strength of EmbraceCoreTM Resin Cement to fiber posts, but the use of binder relative to phosphoric acid etching or self-ctching is helpful.      

Improved photochemical bonding of composites to dentin using 4-methacryloxyethyl trimellitate anhydride

The main objective was to evaluate the use of 4-methacryloxyethyl trimellitate anhydride (4-META) to improve bonding of composite materials to dentin. Bowen's resin, containing camphoroquinone, was polymerized by exposure to visible light. In composites, made with a silanated silicate, inclusion of 4-META (3%) had little effect in increasing mechanical strength or adhesion to bovine teeth. However, direct application of 4-META via acetone solution was found to be an effective way of increasing tensile adhesive strength; by 240% to dentin (to 7.2 MPa) and by 160% to enamel (to 10.8 MPa). Applying the experience mentioned above, 4-META was used to bond a proprietary photocuring microfilled composite material to Class V cavities in freshly extracted human teeth. After thermal cycling between water baths held at 5 degrees C and 60 degrees C, all dentin restorations without 4-META failed, as judged by marginal leakage of a dyestuff. In contrast, using 4-META there was no leakage in 9 out of 10 cases. In restorations involving enamel, 4-META failed to prevent marginal leakage at the enamel margins but did prevent penetration along the dentin/composite interface. It is concluded that 4-META shows great promise for preventing marginal leakage at dentin/composite interfaces.     

Panavia F遮色树脂黏结剂对Cerinate瓷贴面修复不同染色程度模拟四环素牙遮色效果研究

背景：关于四环素牙的美学修复大多局限于临床上的观察,而基础的实验研究相对较少。 目的：观察Cerinate瓷贴面修复轻度(黄色)、中度(黑灰色)、重度(黄-灰色)、极重度(灰褐色)4种不同染色程度模拟四环素牙的颜色变化。 方法：将模拟四环素牙试件按轻、中、重、极重度4种不同染色程度分为4组,每组10个试件,用Cerinate瓷贴面进行修复,Panavia F遮色树脂黏结剂黏结,用电子测色仪测定修复体黏结前及黏结后的L*、a*、b*值及变化。 结果与结论：瓷贴面黏结前与黏结后的表面的L*、a*、b*值之间差异有显著性意义(P < 0.05)。轻度四环素牙选用未含有遮色剂的树脂黏结剂黏结会较小,中、重度四环素牙在用含有遮色剂的遮色树脂黏结剂黏结后对修复体的颜色遮色效果较好,而对极重度四环素牙遮色效果不好,最好选用其他修复体修复。     

不同树脂核材料影响纤维桩核整体抗折强度的比较

背景：纤维桩修复中树脂核材料的选择可能影响桩核的整体强度。 目的：比较5种树脂核材料分别与玻璃纤维桩结合后的整体抗折强度。 方法：将50个viva玻璃纤维桩随机分为5组,分别与MEDENTAL双重固化树脂水门汀、伊蒂娜双重固化树脂水门汀、Bisco BisCem树脂水门汀、3M光固化纳米复合树脂P60及PULPDENT双重固化树脂水门汀黏结,将5组桩核的根管部分分别用自凝塑料包埋,固化后固定于万能试验机上并与牙体长轴成135°角加载于核部,加载速度为1.0 mm/min,直至断裂,测得断裂时受力情况。 结果与结论：MEDENTAL双重固化树脂水门汀组、伊蒂娜双重固化树脂水门汀组、Bisco BisCem树脂水门汀组、3M光固化纳米复合树脂P60组及PULPDENT双重固化树脂水门汀组的抗折强度分别为(83.248±7.857),(89.230±4.326),(95.188±5.147),(76.646±6.463),(83.064±3.964) N。除MEDENTAL双重固化树脂水门汀组与PULPDENT双重固化树脂水门汀组抗折强度无差异外,其余各组间两两比较差异均有显著性意义(P < 0.05)。结果表明Bisco BisCem树脂水门汀与纤维桩结合后具有较高的抗折强度。中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程全文链接：     

Improvement of the bond strength of 4-META/MMA-TBB resin to collagen-depleted dentin

It has been reported that the tensile bond strength between the 4-META/MMA-TBB resin and dentin pretreated with 10% citric/3% ferric chloride solution decreased after immersion in water for 2 years. The current study investigated the effect of an experimental dentin conditioner on the bonding of 4-META/MMA-TBB resin to dentin after thermocycling. The experimental conditioner was an aqueous solution of 10% ascorbic acid and 5% ferric chloride (Exp). Human teeth were prepared to expose flat dentin surfaces. These were treated sequentially with 40% phosphoric acid, 10% sodium hypochlorite, and the experimental conditioner. A commercially available dentin conditioner, an aqueous solution of 10% citric/3% ferric chloride (10-3) was used for a control group. Stainless steel rods were bonded to the pretreated dentin surfaces with the use of the 4-META/MMA-TBB resin. Tensile bond strengths were determined after 0, 5,000, 10,000, 20,000 themocycles. All data were analyzed by ANOVA, and differences among groups were analyzed by Duncan's new multiple range test (n = 10, p < 0.05). The experimental group showed no significant decrease in bond strength through 20,000 thermocycles, while the control group exhibited significant decrease after 10,000 thermocycles. Mean bond strength of the experimental groups were significantly higher than those of the control group at both 10,000 and 20,000 thermocycles. A hybrid layer could not be identified in SEM micrographs of the experimental groups. 10-3-conditioned specimen SEMs displayed crack formation between the adhesive resin and a hybrid layer. The experimental dentin pretreatment improved the bond strength of a 4-META/MMA-TBB resin to human dentin compared to 10-3 treatment after thermocycling.     

The effects of three different desensitizing agents on the shear bond strength of composite resin bonding agents

The aim of this study was to evaluate the effects of three desensitizing agents on the shear bond strengths of four different bonding agents used to bond composite resin to dentin.A total of 160 extracted human molars were sectioned parallel to the occlusal plane under water cooling, polished and randomly divided into 4 groups of 40. Each group was treated with a different desensitizing agent (Tooth Mousse, Ultra-EZ, Cervitec Plus), except for an untreated control group. Each group was then randomly subdivided into 4 groups of 10, and a different dentin bonding agent (XP Bond, AdheSE, Adper Prompt L-pop, GBond) was applied to each group in order to bond the specimens to a resin composite (Gradia Direct) built up using a plastic apparatus. A Universal Testing Machine was used to measure the shear bond strength of each specimen. Statistical analysis was performed using one-way ANOVA and Tukey’s tests.With the exception of the Control/AdheSE and Ultra-EZ/XP Bond groups, no statistically significant differences were found in the shear bond strength values of the groups tested. These findings suggest that the use of different desensitizing agents does not affect the shear bond strength of various adhesive systems used to bond resin composite to dentin.     

不同粘接系统对纤维桩粘接强度的影响

背景：粘接界面尤其是根管壁-粘接剂间是纤维桩修复后接构的薄弱环节,加强粘接剂与根管壁间粘接对提高纤维桩的修复成功率,有重要临床指导意义。 目的：比较自酸蚀粘接系统和全酸蚀粘接系统对纤维桩粘接强度的影响。 方法：选用30颗单根管前牙用于纤维桩粘接实验,每颗牙选用逐步后退法进行预备并进行根管充填。样本分为3组,自酸蚀粘接组、全酸蚀粘接组和空白对照组分别应用自酸蚀粘接系统、全酸蚀粘接系统、传统磷酸酸蚀法处理根管内壁。 结果与结论：自酸蚀粘接组、全酸蚀粘接组和空白对照组的粘接强度分别为(3.24±0.76),(4.09±0.54),(2.85±0.89) MPa。两两相比,不同粘接方法对纤维桩的粘接强度差异均有显著性意义(P < 0.05);扫描电镜观察发现全酸蚀粘接组混合层与牙本质和纤维桩粘接紧密,自酸蚀粘接组混合层只与纤维桩粘接紧密,与牙本质未形成有效连接。提示全酸蚀粘接系统的粘接强度优于自酸蚀粘接系统,具有良好的纤维桩固位性能。