口腔陶瓷及类陶瓷修复材料的分类和临床应用

口腔陶瓷材料具有良好的色泽稳定性、耐磨性、生物相容性,以及出色的光学性能和美观性,在口腔修复临床上占据越来越重要的地位.本文根据微观构成对目前主流的口腔陶瓷及类陶瓷修复材料进行了分类,从材料性能、主要产品、临床适应证、表面处理和粘接等方面进行综述.     

渗透陶瓷性能的研究进展

渗透陶瓷是一种新型口腔全瓷修复材料,在国外应用已日趋广泛,而国内学者也对其进行了研制、测试和临床试用。本文综述了目前国外对渗透陶瓷的研究进展,较系统地介绍其材料性能、表面处理及粘接技术等方面的情况,为渗透陶瓷更广泛的应用于临床提供理论依据。     

玻璃陶瓷粘接面预处理的研究进展

玻璃陶瓷具有优良的美学特性和生物相容性,现已成为全瓷修复常用材料。修复体与树脂界面的粘接强度对远期修复效果有重要影响,而粘接强度的影响要素是修复体的表面处理。常用方式包括：酸蚀、喷砂、激光、表面处理剂等。学者们就不同表面处理方式的应用原理、最佳处理方案以及过度处理造成的损伤进行研究,并比较单一处理方式和联合处理方式对粘接强度的增强效果,以期为口腔医生临床工作提供参考。该文就玻璃陶瓷的粘接面预处理对粘接强度的影响方面的研究进展作一综述。     

渗透陶瓷性能的研究进展

渗透陶瓷是一种新型口腔全瓷修复材料，在国外应用已日趋广泛，而国内学者也对其进行了研制、测试和临床试用。本文综述了目前国外对渗透陶瓷的研究进展，较系统地介绍其材料性能、表面处理及粘接技术等方面的情况，为渗透陶瓷更广泛的应用于临床提供理论依据。     

经冷常压等离子体处理的纯钛与氧化锆陶瓷粘接强度的实验研究

目的　研究冷常压等离子体处理纯钛,对纯钛微观结构及纯钛与氧化锆陶瓷粘接强度的影响。方法　冷常压等离子体处理纯钛试件不同时间的组均为实验组,不使用冷常压等离子体处理的纯钛试件组作为对照组。分别用接触角测量仪、扫描电子显微镜（SEM）、激光扫描共聚焦显微镜（LSCM）、X射线能谱仪（EDS）、电子万能试验机、体式光学显微镜对纯钛试件表面接触角、表面形貌、元素含量、纯钛与氧化锆陶瓷粘接强度以及粘接断面的断裂模式等进行分析。采用SPSS18.0软件对测量数据进行统计学分析。结果　经冷常压等离子处理的各实验组纯钛与氧化锆陶瓷粘接强度均大于对照组,差异有统计学意义（P < 0.05）;冷常压等离子体处理后的纯钛表面接触角变小,氧元素含量升高,表面粗糙度与形态无明显变化。结论　冷常压等离子体处理纯钛试件能在不改变其表面粗糙度及形貌的情况下,增强表面亲水性,提高表面氧元素含量,从而增强纯钛试件与氧化锆陶瓷试件粘接的强度。这为临床上使用冷常压等离子体处理种植体钛基台后,增强钛基台与氧化锆陶瓷牙冠的粘接强度方面提供了新思路。     

树脂基陶瓷材料不同表面处理的研究进展

近年树脂基陶瓷产品大量出现,做为一种新型的计算机辅助设计/计算机辅助制造(computer aided design/computer aided manufacturing,CAD/CAM)修复材料,具有良好的生物相容性、机械加工性能、粘接性能、美学特性及与天然牙体组织相近的物理特性。越来越多树脂基陶瓷材料被应用于口腔修复学，对于其远期修复效果很大程度取决于修复体的粘接强度,其中影响修复体与牙体粘接强度的主要因素就是修复体的表面处理,本文将结合文献就树脂基陶瓷在喷砂、酸蚀、硅烷化、激光和大气压冷等离子体不同表面处理方面展开综述，以期为临床上树脂基陶瓷材料的应用提供有价值参考意义。     

硅基陶瓷的临床应用现状与展望

硅基陶瓷是现代口腔美学临床修复的首选材料之一,近年来应用广泛。硅基陶瓷以玻璃相为主,具有良好的美观性、粘接性及生物相容性等诸多优势,但是其机械性能略差,可以根据材料组分与加工方式制作不同种类的修复体以满足不同的临床需求。课题组在PubMed、中国知网(CNKI)、万方等数据库中以“硅基陶瓷、玻璃陶瓷、物理性质、剪切强度、粘接表现、临床操作、表面处理”为中英文关键词检索相关文献。按照纳入与排除标准筛选后,对最终纳入的45篇文献进行归纳总结。通过查阅文献分析总结硅基陶瓷的种类与特点、硅基陶瓷修复体的临床应用以及硅基陶瓷的粘接技术,在此基础上对硅基陶瓷未来发展趋势进行展望,同时结合现在技术从中得到新启迪。硅基陶瓷具有理想的应用前景,但对于硅基陶瓷技术更多拓展应用的可行性还有待科学实验验证与临床实践观察。     

氧化锆表面硅处理的进展

全瓷修复材料逐渐成为主要的口腔修复材料,其中氧化锆陶瓷具有更为优异的机械性能和生物相容性,但氧化锆陶瓷因其特殊结构,较难获得足够的粘接强度。因此在粘接前需要对氧化锆进行表面处理,该文将对氧化锆表面制备含硅成分处理技术的进展作一综述。     

低温等离子体改性基托树脂表面粘结性能的研究

目的：使用低温等离子体表面处理技术处理树脂基托材料,观察材料表面化学成份及润湿性、粘接性的变化。方法：将试件置于低温等离子体装置中处理20min,并对等离子体处理前后的标本进行X射线光电子能谱分析和接触角的测量,进行剪切实验以测量粘接力。结果：等离子体处理后,树脂表面碳氧原子比例从1∶0.30升至1∶0.46;材料表面接触角明显下降;粘接强度比未处理前提高了1.6倍。结论：低温等离子体处理树脂材料表面可提高其润湿性及粘接性。     

新型树脂-陶瓷复合材料粘接性能的研究进展

CAD/CAM技术在口腔修复临床的应用越来越广泛,传统的CAD/CAM材料是玻璃陶瓷或树脂,而近年来出现了一种新型树脂-陶瓷复合材料。它结合了树脂和陶瓷的优势,成为间接修复体一种新的材料选择。修复材料的粘接性能是评价其能否满足临床需要的一项重要指标,间接修复体的粘接成功对修复体的使用寿命有着举足轻重的影响。本文将根据现有文献对树脂-陶瓷复合材料的粘接性能作一综述。     

Surface modification of pure titanium by plasma exposure and its bonding to resin

The purpose of this study was to investigate the effects on shear bond strength to resin after pure titanium (Ti) was exposed to plasma under different kinds of gas atmosphere. Polished Ti samples were treated using a plasma exposure apparatus in gas atmospheres of air, CO2, and C3F8. Surface analysis of Ti exposed to plasma was achieved through surface free energy and XPS measurements. The Ti sample was bonded with adhesive resin (4-META, MAC-10, HEMA, MDP, VBATDT) to a stainless steel piece. After which, shearing adhesion test was done. It was observed that plasma exposure in a specific gas atmosphere in regulated the bonding strength of titanium surface to resin. Based on the results of this study, we concluded that plasma exposure was a useful surface treatment method for dental practices.     

Effect of plasma treatment on adhesion of self-curing repair resin to acrylic denture base

Plasma irradiation on surface of heat-cured acrylic resin prior to processing self-curing acrylic resin is likely to effectively increase the adhesive strength between these materials for short-term period. However, long-term reliability of adhesive strength between these materials has not been clarified yet. In the present study, these materials were stored in water for a long period (100 days), and the effect on their shear bond strength was investigated. Forty-four test specimens with flat bonding test surface were made with heat-cured acrylic resin. They were divided into four groups according to treatment procedures for bonding surface: plasma treatment, adhesive primer application, adhesive primer application after plasma treatment, and no treatment (for control). Self-curing acrylic resin was processed against all bonding surfaces. After storage in water for 100 days, shear bond strength values between heat-cured and self-cured acrylic resins were measured. Specimens in plasma treatment group exhibited higher shear bond strength value than those in control, although the difference was not significant.     

Does plasma irradiation improve shear bond strength of acrylic resin to cobalt-chromium alloy?

OBJECTIVES: Plasma treatment leads to surface modification such as the improved wettability of dental materials. Studies have suggested that plasma treatment may bring about an improvement in the shear bond strength between cobalt-chromium alloy and self-curing acrylic resin. METHODS: Forty-eight cobalt-chromium alloy specimens were randomly divided into four groups (each of the groups consisted of 12 specimens); air abrasion, adhesive primer, adhesive primer after air abrasion, or after plasma irradiation. A self-curing acrylic resin, 2 mm thick and 3.6 mm in diameter, was processed on all specimens before storage in distilled water at 37 degrees C for 24 h. Shear bond strength values were determined at a crosshead speed of 0.5 mm/min. Data was statistically analyzed using Scheffé's test. RESULTS: Adhesive primer clearly increased the shear bond strength compared with air abrasion (p < 0.05). The synergy of air abrasion and adhesive primer greatly increased the shear bond strength, showing a five-fold increase over air abrasion, or one and a half-fold over adhesive primer. A similar tendency in increase was observed in the adhesive primer after plasma treatment, but to a lower degree. Adhesive primer after plasma treatment showed half the shear bond strength of the treatment of adhesive primer after air abrasion (p < 0.05). Moreover, adhesive primer after plasma treatment showed a lower shear bond strength than adhesive primer alone although the difference was not statistically significant. SIGNIFICANCE: Plasma treatment does not improve adhesion between cobalt-chromium alloy and self-curing acrylic resin.     

Improved resin‐to‐dentin bond strength and durability via non‐thermal atmospheric pressure plasma drying of etched dentin

This study aimed to evaluate the improvement in strength and durability of the bond between dentin and composite resins following plasma drying of the etched dentin surface using non‐thermal atmospheric pressure plasma. Plasma drying was applied to the etched dentin before applying adhesive. Conventional wet‐bonding and helium (He) gas‐dried bonding schemes were used as control groups. The bond strength of the composite resin to dentin was measured as the microtensile bond strength at 24 h after bonding and after 10,000 cycles of thermocycling. Hybrid layer formation was observed using micro‐Raman spectroscopy and scanning electron microscopy. Although the bond‐strength values were not statistically different either at 24 h after bonding or after thermocycling, the bond strength of the plasma‐dried bonding group was significantly higher than the conventional wet‐bonding group and He gas‐dried bonding group. Micro‐Raman spectral analysis revealed effective penetration of the adhesive and an improved polymerization rate of the adhesive after plasma drying. Plasma drying increased the penetration of hydrophobic resin into the collagen mesh structure, which improved mechanical bonding and long‐term durability between dentin and composite resin.     

可乐丽菲露AP-X复合树脂对人牙髓细胞毒性的研究

目的 通过细胞毒性试验，探讨可乐丽菲露AP-X复合树脂及其SEBOND粘接系统在临床上用于活髓牙窝洞直接修复术的安全性。方法选用年轻健康人新鲜离体牙髓，以组织块培养法及酶消化法进行原代培养。同时制备各材料样品，浸入DMEM培养基制取材料浸渍液。分别将各材料的浸渍液与第五代人牙髓细胞共同培养，以MTT法评价材料的细胞毒性。结果可乐丽菲露AP-X复合树脂的细胞毒性小于双组份玻璃离子水门汀Vitremer及复合树脂Z100，其差别具有统计学意义，与复合体F2000的细胞毒性无统计学意义的差别。可乐丽菲露的细胞毒性小于复合体F2000和复合树脂Z100对应粘接剂，且其差别具有统计学意义（P〈0．05）。结论可乐丽菲露AP-X复合树脂及其粘接剂的细胞毒性小于临床上现在常用的其他牙色类材料。     

Effects of energy and sports drinks on tooth structures and restorative materials

Sports and energy drinks are consumed by more people than ever. Sports and energy drinks may enhance physical resistance, stimulate metabolism, prevent rehydration and replace electrolytes during high activity efforts. However, these drinks often have a low pH and are acidic, which can erode enamel and dentin, and increase dentine hypersensitivity. In addition to the adverse effects of sports and energy drinks on tooth structures, they often have the potential to damage restorative materials. These drinks often contain artificial colors which have potential to discolor resin composite materials and glass ionomers. The acidic nature of these drinks could also lead to a degradation, increase in wear, and roughening of the surface of the restorative materials. Many of the negative consequences of sport and energy drinks can be related to their over-consumption among children and teenagers. Patients should be advised to have a healthy diet, and consume soft and energy drinks in moderation, to avoid any negative dental or health consequences. The over-consumption of sports and energy drinks which are high in sugar and have the lowest pH are most likely to cause avoidable dental problems.     

Maximum bond strength of dental luting cement to amalgam alloy

Although dental amalgam is used frequently under artificial crowns for restoration of severely damaged teeth, there is little information available on the bond between luting cements and this alloy. This study was designed for determination of the strength of the bond between a dental amalgam alloy and three crown-luting cements. Cylinders of dental amalgam were joined in pairs, with use of a zinc-phosphate, a glass-ionomer, and an acrylic-adhesive resin cement. The tensile-fracture stress of 45 samples of each cement was measured with a universal testing machine, and subjected to a Weibull analysis. The fractured surfaces were examined under low magnification with use of a light microscope, and at low and high magnifications with use of a scanning electron microscope, for evaluation of the appearance of the fractured joints. The Weibull analysis demonstrated that the adhesive resin cement provided a stronger and more predictable bond than either the zinc-phosphate or the glass-ionomer cement. The appearance of the fractured surfaces gave no indication of the strength of the joints, a feature that is common to brittle materials. The results suggest that crowns placed on teeth offering a large amalgam-alloy surface could be retained more predictably with an adhesive resin cement.     

唾液获得性膜对不同桥体材料表面自由能的影响

目的：评价唾液获得性膜对不同桥体材料表面自由能的影响。方法：采用接触角测量仪检测4种桥体材料(Co—Cr合金、Au—Pt合金、纯Ti以及Vita95瓷)表面形成唾液获得性膜前后试件的接触角并计算表面能。结果：制备唾液获得性膜后所有受测材料的表面自由能极性分量升高，自由能总量趋于一致。结论：唾液获得性膜会改变修复材料的表面属性，使不同材料表面自由能之间的差异减小。     

Influence of chemo-mechanical caries removal on the surface topography of dental composite resin and glass-ionomer materials: an in vitro study

The aim of the present study was to investigate the influence of a chemo-mechanical caries removal system, Carisolv gel, on the surface topography of dental filling materials. Thirty specimens of a composite resin (Spectrum) and a compomer (Dyract AP) and 60 specimens of a glass-ionomer (Ketac-Fil Plus) were prepared. The surface topography was investigated with an optical interferometer before and after chemical exposure for 5, 10, or 20 min. Each specimen acted as its own control. The topographical part of the glass-ionomer materials was performed in two series with different drying procedures, since this material exhibits a higher sensitivity to dehydration than the other materials. The surface topographical investigations were complemented with contact angle measurements. After Carisolv gel exposure the density of summits and the developed surface area ratio (3D/2D) were slightly smaller for the composite resin and the compomer. For the minimally dried glass-ionomer material, the results indicated a reduction of the height of the surface structures, as well as a surface area enlargement, after Carisolv gel exposure. No statistically significant changes of contact angles due to Carisolv gel exposure could be detected for any material investigated. If dental filling materials of composite resin or glass-ionomer materials are exposed to Carisolv gel, no or only minor surface topographical changes can be expected. n     

Adaptation of a visible light-cured denture base material

The Triad light-cured resin system appears to have potential for making processed record bases for special patients. The close adaptation of this material to the dental cast often results in internal voids and defects. These defects are greatly reduced when a dry cast is used instead of one with a high moisture content. Vacuum-assisted adaptation using a sheet of rubber dam in connection with a vacuum adaptor also results in an improved internal surface. Finger pressure alone is not a dependable method of adaptation.