粘结修复前牙龋洞815颗临床疗效观察

本文采用粘结修复术修复前牙龋洞815颗。根据洪法廉教授提出的牙本质二层龋概念．作为去除龋坏的标准。操作时不制备洞型，去净崩坏层，保留软比层，进行临床疗效观察。采用材料为德国古莎与上海一拜耳齿科的酸蚀剂、釉质粘结剂、复合树脂。在前牙龋洞修复时若存在冷热激发痛明显者，使用氢氧化钙垫底，本组垫底50颗。分别于充填修复后3月、6月、1年观察结果。修复后一年成功780颗，失败35颗，成功率95．7％。从临床学上可说明：①前牙修复允许保留无基釉，操作时不制备洞型是可行的；②前牙粘结修复术去净外层龋，软化层可以保留；③酸蚀对牙髓组织不会造成损害；④减少细菌微渗漏的发生，可以减少继发龋的发生而提高修复术的成功率；⑤氢氧化钙在粘结修复中不是唯一刺激牙本质形成的因素。     

两种混合型粘结剂修复楔状缺损的临床评价

目的比较两种牙釉质牙本质混合型粘结剂和复合树脂修复楔状缺损的临床疗效.方法对16例患者共108颗牙髓活力正常的牙颈部楔状缺损分别进行充填治疗,随机分成配套粘结剂加复合树脂充填(A组)和新型混合型粘结剂super-bondC＆B加复合树脂充填(B组)两组.每组54颗牙,临床观察18个月后,用美国公共健康部制定的评定系统(USPHS)进行疗效评估.结果B组的固位效果、边缘密合性、牙髓反应明显优于A组,两者差异有显著性.两组在边缘着色,继发龋,牙龈反应方面差异不显著.结论新型混合型粘结剂 super-bondC＆B修复楔状缺损可提高修复充填体的固位率,有较高的实用性.     

两种复合树脂应用于前牙修复的临床疗效

目的 比较两种复合树脂用于前牙修复的临床疗效.方法 选取120颗患龋的上前牙,按就诊顺序随机分为2组,试验组60颗患牙用Z350纳米复合树脂充填修复,对照组60颗患牙用卡瑞斯玛复合树脂充填修复.修复完成后检查修复体边缘吻合、边缘着色及颜色匹配,评价修复体满意率.对刚完成修复时不满意的患者立即重新修复至满意.随访12个月后复查,评价修复体的满意率.结果 刚完成修复时试验组满意率96.7%,对照组为95.0%,差异无统计学意义(P＞0.05).1年后试验组满意率为95.0%,对照组为68.3%,差异有统计学意义(P＜0.01).结论 Z350纳米复合树脂是一种比较理想的前牙充填修复材料.     

2种自酸蚀粘接剂及复合树脂修复前牙的近期临床评价

目的 探讨2种白酸蚀粘接剂及复合树脂应用于前牙美观修复的可行性。方法 选择52例116颗前牙龋损或缺损,随机分为A组用AdheSE白酸蚀粘接剂及Tetric Ceram瓷化树脂充填修复35例68颗牙,B组用Clearfil(可乐丽菲露)SEBOND及AP—X树脂充填修复27例58颗,随访半年,观察其临床疗效。结果 2组疗效无显著性差异;其临床满意率A组为95．6％,B组为94．8％。结论 2种自酸蚀粘接剂及复合树脂应用于前牙美观修复操作简单易行、有较好的临床疗效。     

全酸蚀和自酸蚀粘结剂在前牙修复的临床比较研究

目的 比较全酸蚀粘结剂和自酸蚀粘结剂在前牙树脂粘结修复的临床效果。方法 将前牙近中切端缺损需要行纳米树脂修复的330颗活髓恒牙随机分为2组,分别用全酸蚀粘结剂和自酸蚀粘结剂结合纳米树脂进行充填修复。于术后3个月、1年、3年对患者进行回访,检查充填物和牙体牙髓情况,并用Spss软件进行分析比较。结果 2组患牙的充填效果无显著性差异(P＞0.05),对牙髓的刺激性自酸蚀粘结剂小于全酸蚀粘结剂,有显著性差异（P<0.05）。结论 全酸蚀粘结剂和自酸蚀粘结剂用于前牙粘结修复治疗中的疗效均不错,自酸蚀粘接剂更易操作。     

2种复合树脂修复前牙龋损的临床效果评估

目的 探讨2种复合树脂修复前牙龋损的临床效果。方法 选取100例前牙龋损患者,依据随机数字法将其分为实验组与对照组,每组各50例。实验组应用复合树脂多层充填技术和3 M-Z350（A2/A3）纳米复合树脂充填,对照组选用卡瑞斯玛光固化复合树脂充填, 1年后比较2组的修复成功率、不良反应及患者满意度。结果 实验组的美观满意度、治疗成功率均高于对照组（P<0.05） ;实验组不良反应发生率低于对照组（P<0.05）。结论 纳米复合树脂材料可大大提高前牙龋损患者美观满意度,提高修复成功率,减少不良反应的发生情况,值得临床推广应用。     

三种材料修复基牙环状龋的临床疗效观察

目的　探讨修复可摘局部义齿引起的后基牙环状龋的较理想材料。方法　选择由戴用可摘局部义齿引起后基牙环状龋的门诊病例 2 86例 ,共 3 5 4颗患牙 ,随机分成三组 ,分别采用光固化复合树脂、玻璃离子和银汞合金进行充填治疗 ,随访观察 3年。结果　银汞合金与玻璃离子两组材料修复的成功率有显著性差异 ,0 .0 5 >P >0 .0 1。银汞合金与光固化复合树脂两组材料修复的成功率有高度显著性差异 ,P <0 .0 1。玻璃离子和光固化复合树脂两组材料修复的成功率无显著性差异 ,P >0 .0 5。结论　银汞合金为修复可摘局部义齿引起的后基牙环状龋的较理想材料。     

复合树脂联合两种酸蚀粘结剂与乳牙釉质及牙本质的剪切粘结强度比较

目的:比较复合树脂联合全酸蚀和自酸蚀粘结剂与乳牙釉质及牙本质的剪切粘结强度。方法:收集新鲜拔除的滞留乳磨牙48个,随机分为4组,分别制备全酸蚀和自酸蚀粘结剂的釉质和牙本质试件,电子万能试验机测定各组剪切强度;体视显微镜下观察试件断面的破坏模式;扫描电镜观察粘结界面情况。结果:全酸蚀粘结剂组的釉质剪切强度明显高于牙本质剪切强度(P<0.05);自酸蚀粘结剂组釉质与牙本质剪切粘结强度无统计学差异(P>0.05);全酸蚀粘结剂组的釉质、牙本质剪切粘结强度均明显高于自酸蚀粘结剂组(P<0.05);体视显微镜及扫描电镜观察均显示,全酸蚀粘结剂与釉质和牙本质的粘结界面结合程度好于自酸蚀粘结剂。结论:全酸蚀粘结剂处理对乳牙釉质及牙本质的剪切粘结强度高于自酸蚀粘结剂。     

透明成形冠在大面积龋损乳前牙修复中的应用

目的探讨应用Strip crowns透明成形冠对大面积龋损的乳前牙进行复合树脂全冠修复的效果。方法 72例174颗大面积龋损的乳前牙分为试验组和对照组。试验组88颗,应用Strip crowns透明成形冠进行复合树脂全冠修复;对照组86颗,用光固化复合树脂直接充填修复。经6个月、18个月随访观察修复体状态。结果经6个月观察,修复体保存率试验组和对照组分别为100%、96.51%,两组间差异无统计学意义（P〉0.05）。经18个月观察,修复体保存率试验组和对照组分别为100%、67.44%,两组间差异有统计学意义（P〈0.01）。结论应用Strip crowns透明成形冠对大面积龋损的乳前牙进行复合树脂全冠修复,其疗效可靠,明显优于复合树脂直接充填修复,具有良好的应用前景。     

光谱级树脂作前牙美容修复和后牙充填的疗效比较

目的：比较光谱级树脂（Spectrum TPH)在前牙邻面Ⅲ、Ⅳ类洞及后牙邻He面Ⅰ、Ⅱ类洞充填治疗的疗效比较。方法：前牙Ⅲ类洞68例95个牙，Ⅳ类洞35例55个牙；后牙Ⅰ类洞53例82个牙，Ⅱ类洞48列67个牙，充填后2－2.5年随访观察。结果：前牙修复成功率，Ⅲ类洞89.5%，Ⅳ类洞83.6%。后牙修复成功率，Ⅰ类洞93.9%，Ⅱ类洞81.6%。结论：Spectrum TPH树脂是较好的通用型复合树脂。     

Grandio纳米树脂与可乐丽树脂充填治疗后牙深龋的疗效比较

目的 对比Grandio纳米树脂与可乐丽树脂充填治疗后牙深龋的临床效果.方法 选择后牙深龋患者276例398颗,随机分为2组.试验组138例197颗患牙使用Grandio纳米树脂充填,对照组138例201颗患牙使用可乐丽树脂充填.术后随访2年,对比两组充填体解剖形态、固位、边缘密合度及牙齿继发龋、牙髓、根尖周及牙周状况.结果 治疗后6个月试验组和对照组成功率分别为97.46％和97.01％,成功率差异无统计学意义(x2=0.074,P=0.786).治疗后2年试验组和对照组成功率分别为95.43％和88.06％,差异有统计学意义(x2 =7.110,P=0.008),其中Ⅰ类洞成功率差异无统计学意义,Ⅱ类洞成功率试验组高于对照组,差异有统计学意义(x2=8.728,P=0.003).结论 Grandio纳米树脂充填治疗后牙深龋Ⅱ类洞远期疗效较佳.     

玻璃离子水门汀与纳米树脂充填乳牙邻面龋的效果比较

目的 比较玻璃离子水门汀与纳米树脂充填乳牙邻面龋的效果.方法 选择来我科就诊的年龄为5～8岁的乳磨牙邻面龋102例,共320颗患牙,其中深龋组204颗,中、浅龋组116颗,每组随机分为富士Ⅸ玻璃离子水门汀充填(A组)和光固化纳米树脂充填(B组).深龋A组采用氢氧化钙盖髓玻璃离子水门汀充填,深龋B组采用氢氧化钙盖髓,玻璃离子水门汀垫底后纳米树脂充填;中浅龋A组直接玻璃离子水门汀充填,B组中龋玻璃离子水门汀垫底后纳米树脂充填,浅龋直接纳米树脂充填.分别在3个月、6个月、1年时复查充填效果,比较两组成功率.结果 深龋组2种材料在各个时间段成功率均无统计学差异(P＞0.05),中、浅龋组2种材料在3个月时两组成功率无统计学差异(P＞0.05),但在6个月和1年时纳米树脂充填组成功率优于玻璃离子水门汀充填组(P＜0.05).结论 光固化纳米树脂是临床上充填乳牙易脱落之邻面龋较好的选择.     

Effect of interchanging two composite resin system with a dentine adhesive

There is a tendency to interchange dentine adhesives and composite resins when using composite resins for restorations. This study used marginal contraction gaps to test the effect of changing composite resins with a dentine adhesive. Cylindrical butt-joint cavities were prepared entirely in dentine using extracted human teeth. Two groups of control cavities (30 cavities per group) were restored with Prisma-Bond/Prisma-Fil and Heliobond/Heliomolar respectively. Two groups of test cavities (30 cavities per group) were restored using the dentine adhesive. Prisma Universal Bond with Prisma-Fil on one group and Prisma Universal Bond and Heliomolar in the other. Following thermocycling the marginal contraction gaps were measured and assessed. The results showed a significant reduction in marginal contraction gaps when using either composite resin with Prisma Universal Bond. This indicates a compatibility of both resins with the adhesive in this instance.     

Class IV preparations for fractured anterior teeth restored with composite resin restorations

Pediatric dentists play a major role in treating most of the anterior teeth fractures due to the fact that most patients who suffer such traumatic injuries are between the ages of seven and fourteen. Several techniques has been developed to restore the fractured incisors to the original shape and color, these include full-coverage of the traumatized tooth, or restoring the incisors with a resin. The purpose of this study is to find the ideal combination of tooth preparation and restorative material, namely, to determine if stair step chamfer preparations provide more retention in class IV restorations than the plain chamfer preparation technique when restored with a combination of a hybrid composite resin and a microfilled composite resin. This was done by comparing the shear strength values between the buccal stair-step chamfer preparation, and a modification on it (buccal and lingual stair-step chamfer preparation) and the plain chamfer preparation techniques in class IV restorations on anterior incisors using different composite resin materials. The Instron machine was used to test shear strength. One hundred and two bovine incisor teeth were freshly harvested from the slaughterhouse. The teeth were prepared and restored according to the following six groups; Plain Chamfer preparation with Tetric Ceram Composite, Plain Chamfer preparation with Renamel Composite, buccal stair-step chamfer preparation with Tetric Ceram composite, buccal stair-step chamfer preparation with Renamel composite, Buccal and lingual stair-step preparation with Tetric Ceram Composite, Buccal and lingual stair-step chamfer preparation with renamel composite. All samples were fractured using the Instron testing machine then the surface area were measured using Image-J software. Shear strength for every sample was calculated using the load numeric result from the Instron machine and the measured surface area. The Two-Factorial (AB) Analysis of Variance For Independent Samples showed that the buccal stair-step chamfer preparation showed significantly higher shear strength and fracture resistance than plain chamfer or the buccal and lingual stair-step chamfer preparation. The combination of Renamel Hybrid and Renamel Microfill composite materials showed better results than the Tetric Ceram composite when used with all three preparation techniques, but did not show a statistical significance. It was concluded that buccal stair-step preparation technique provided the ideal preparation technique with bonded composite resins in fractured anterior teeth. Only 7% of the entire sample size had an adhesion failure versus 93% that had cohesion failure. There was no significant difference in shear strength, between the restorative materials used, in conjunction with all the preparation techniques.