3种脱敏剂对牙本质粘结强度的比较研究

目的:探讨GLUMA、Bi f l uor i dT12和MS COAT 3种脱敏剂处理牙本质,对牙本质粘结界面粘结强度的影响。方法:人离体前磨牙20颗,去除咬合面釉质,随机分成4组(n=5):A组(GLUMA)、B组(Bi fl uori dT12)、C组(MS COAT)、D组(空白)。A、B、C组分别使用相应脱敏剂在牙本质表面处理,D组不处理。全部样本3M ESPE Adper TM自酸蚀树脂粘结剂粘结,复合树脂修复厚约4～5mm,硬组织切片机制成1.0mm×1.0mm×8.0mm长方体试样,微拉伸测试仪测试粘结强度并进行统计学分析。结果:A组微伸拉强度高于对照组,但无统计学意义(P>0.05);B和C组低于对照组,有统计学意义(P<0.05)。结论:GLUMA脱敏剂预处理牙本质的粘结强度最强。     

不同脱敏剂与蜂胶对牙本质小管封闭性的实验研究

目的：比较不同脱敏剂与蜂胶对牙本质小管的封闭性。方法：选取因正畸治疗而拔出的48颗牙,制备成为牙本质过敏模型,随机分为4组（3组为实验组,1组为空白对照组）,分别用Bifluorid12（双氟剂）脱敏剂（A组）、Gluma脱敏剂（B组）、蜂胶（C组）三种试剂对实验组暴露的牙本质表面进行处理并做刷牙实验,然后用扫描电镜观察牙本质小管的封闭情况。结果：两种脱敏剂与蜂胶均在牙本质表面形成封闭。A、B、C组在牙本质小管内形成“树脂突”样结构,其中A组和C组渗入较深,B组较浅。结论：两种脱敏剂和蜂胶都能取得封闭牙本质小管的效能,其中Bifluorid12（双氟剂）脱敏剂的封闭性、耐久性较佳。     

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.     

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。     

桩腔预备的不同时机对两种根管封闭剂根尖封闭性的影响

目的：通过比较根尖微渗漏的长度来观察即刻桩腔预备和延迟桩腔预备对两种根管封闭剂根尖封闭性的影响。方法：将120颗上颌单根管牙齿以ProTaper手用镍钛根管锉逐步深入法根管预备,随机分为A、B两组,每组60颗。分别用AHplus糊剂、Cortisomol糊剂加牙胶尖热侧向加压法进行根管充填。根充后根据桩腔预备情况将A、B两组随机再分为A1、A2、A3和B1、B2、B3 3个亚组,每组20颗。A1、B1组即刻行桩腔预备,A2、B2组1周后行桩腔预备,A3、B3组为对照组未行桩腔预备。染料渗透法测量微渗漏距离并进行统计学分析。结果：两组牙齿根尖部均有微渗漏产生。采用单因素方差分析各实验组间微渗漏差异有统计学意义（F=19.2033,P＜0.01）,LSD-t检验对组间进行两两比较：两种根管封闭剂根充后延迟桩腔预备组和即刻桩腔预备组、对照组微渗漏差异有统计学意义（P＜0.01）。延迟桩腔预备不同封闭剂充填组之间微渗漏差异有统计学意义（P＜0.01）。其余各组之间微渗漏差异无统计学意义。结论：即刻桩腔预备对两种根管封闭剂的根尖封闭能力没有影响,延迟桩腔预备降低了根管封闭剂的根尖封闭能力;延迟桩腔预备中AHplus的根尖封闭性比Cortisomol好。     

极固宁脱敏剂与蜂胶联合运用于活髓牙制备后的脱敏效果观察

牙本质敏感症是指暴露的牙本质受到（机械、化学、温度及渗透压等）外界刺激而产生的异常酸软疼痛的感觉[1]。活髓牙在做固定桥基牙时因需要磨除一定的牙体组织而极易产生牙本质过敏症状。目前临床上治疗牙本质敏感症的方法很多圈,但疗效不一。治疗活髓牙制备后牙本质过敏症报道很少。笔者用极固宁脱敏剂与3％蜂胶醇溶液联合运用来治疗取得较好的临床效果。现报道如下。     

两种树脂填充方法对微渗漏影响的实验研究

目的：通过两种树脂充填方式微渗漏的比较，为临床找到一种能有效防止微渗漏且操作简便的充填方式。方法：选择新近拔除的60颗人恒牙在唇、颊侧备V类洞。随机分为两组，每组30颗牙。用3M自酸蚀粘结剂及3M树脂分别按分层及分割增量两种方式充填，经恒温保存、染色、纵剖牙体，在体视显微镜下观测充填物边缘微渗漏的情况。结果：分层充填的微渗漏大于分割增量充填。结论：两种充填方式微渗漏之间有显著性差异，分层充填的微渗漏大于分割增量充填。     

粘接剂对充填材料封闭性的影响

目的:比较采用粘接剂对充填材料封闭的方法来修复受损后的牙齿与常规充填物修复后的差异.方法:选择两年内可回访复修患者,共290颗牙齿,随机分两组,一组常规填充,一组涂粘接剂后填充,进行比较.结果:粘接剂的应用大大降低了克填物的微渗漏及临床上深龋牙本质过敏的症状.     

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。     

2种光固化树脂材料修复牙体颈部楔状缺损的疗效比较

目的:观察使用Spectrum TPH-3和3M FiltekTM Z350 2种纳米光固化复合树脂修复楔状缺损的的存留率比较。方法:将58例186颗有牙体颈部楔状缺损的患牙随机分为Spectrum TPH-3组30例(96颗)和3M FiltekTM Z350组28例(90颗),修复后2年复查评价2组疗效。结果:Spectrum TPH-3组的成功率为86.53%,3M FiltekTM Z350组的成功率为89.67%。两组成功率差异无统计学意义(P0.05)。结论:纳米树脂Spectrum TPH-3和3M FiltekTM Z350是修复楔状缺损的理想材料,值得临床推广使用。     

Effect of surface pretreatment with two desensitizer techniques on the microleakage of resin composite restorations

This study evaluated the effect of two desensitizing procedures on the marginal microleakage of composite restorations bonded by a two-step etch-and-rinse adhesive. Class V cavities were prepared on the buccal surfaces of 42 extracted premolars at the cementoenamel junction and randomly divided into three groups of 14 each. In group 1 (control), an adhesive (Excite) was applied according to manufacturer's instructions. In group 2, after the application of oxalate desensitizer (BisBlock) to the cavities, the specimens were etched, and Excite was applied and light cured. In group 3, the cavities were treated with CO₂ laser irradiation (1 W power output in a continuous wave mode, 10 s), and then, the specimens were etched and bonded by Excite. All the cavities were restored with a resin composite. After water storage and thermocycling, the specimens were placed in 1 % basic fuchsin blue dye solution. The dye penetration was evaluated using a stereomicroscope. The data were analyzed by using Kruskal–Wallis and Mann–Whitney statistical tests (α?=?0.05). There was a significant difference among three groups at the gingival and occlusal margins (P?<?0.05). The specimens treated with BisBlock exhibited higher microleakage at both margins than those of the control and laser-treated groups (P?<?0.001). There was no significant difference between the control group and group treated with CO₂ laser at both margins (P?>?0.05). CO₂ laser did not show a detrimental effect on the marginal sealing ability of the adhesive system used in resin composite restorations. However, oxalate desensitizer adversely influenced the sealing ability of the restorations.     

自酸蚀粘结剂Adper Easy One修复牙体颈部楔状缺损的临床观察

目的:观察自酸蚀粘结剂Adper Easy One和全酸蚀粘结剂PrimeBond NT在修复牙体颈部楔状缺损的临床效果。方法:选取75例患者需要行牙体颈部楔状缺损树脂修复的共93颗活髓患牙随机分为2组,实验组使用自酸蚀粘结剂结合树脂充填修复,对照组使用全酸蚀粘结剂结合树脂充填修复。于充填术后1年对患者进行临床复查,根据Ryge的改良USPHS评分系统评估充填体情况。结果:两组充填修复1年后临床效果比较无显著性差异(P0.05),自酸蚀粘结剂充填修复术后敏感率小于全酸蚀粘结剂差异显著(P0.05)。结论:自酸蚀粘结剂用于牙体颈部楔状缺损粘结修复治疗后牙髓敏感率低可达到较好的临床效果。     

Three-level anterior cervical discectomy and fusion in elderly patients with wedge shaped tricortical autologous graft: A consecutive prospective series

Background:

Treatment of multilevel cervical spondylotic myelopathy/radiculopathy is a matter of debate, more so in elderly patients due to compromised physiology. We evaluated the clinical and radiological results of cervical fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy in elderly patients.

Materials and Methods:

Twelve elderly patients with mean age of 69.7 years (65–76 years) were treated between April 2000 and March 2005, for three-level anterior cervical discectomy and fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate. Outcome was recorded clinically according to Odom''s criteria and radiologically in terms of correction of lordosis angle and intervertebral disc height span at the time of bony union. The mean follow-up was 29.8 months (12–58 months).

Results:

All the patients had a complete recovery of clinical symptoms after surgery. Postoperative score according to Odom''s criteria was excellent in six patients and good in remaining six. Bony union was achieved in all the patients with average union time of 12 weeks (8–20 weeks). The mean of sum of three segment graft height collapse was 2.50 mm (SD = 2.47). The average angle of lordosis was corrected from 18.2° (SD = 2.59°) preoperatively to 24.9° (SD = 4.54°) at the final follow-up. This improvement in the radiological findings is statistically significant (P < 0.05).

Conclusion:

Cervical fusion with wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy is an acceptable technique in elderly patients. It gives satisfactory results in terms of clinical outcome, predictable early solid bony union, and maintenance of disc space height along with restoration of cervical lordosis.     

颏下岛状皮瓣修复口腔癌术后缺损13例效果观察

目的回顾颏下岛状皮瓣修复口腔癌术后缺损的效果。方法 13例口腔癌根治术后组织缺损,采用颏下岛状皮瓣进行同期修复。结果颏下岛状皮瓣全部成活,患者的形态、功能基本正常。结论颏下岛状皮瓣操作简单,成活率高,损伤小,适合中小型口腔癌缺损的修复。     

“U”形耳廓软骨在鼻翼缺损修复中的应用

目的:观察应用"U"形耳廓软骨支架修复鼻翼软骨缺损的临床疗效,总结其优越性。方法:本组35例鼻翼缺损患者,采取单侧或双侧耳甲腔、耳屏间切迹和耳屏区域的"U"形耳廓软骨,将其游离移植修复鼻翼支架缺损,并对其疗效进行评估。结果:应用耳甲腔、耳屏间切迹和耳屏区域的"U"形耳廓软骨修复鼻翼缺损,效果良好、可靠,不易遗留供区缺损、畸形。结论:采取的耳甲腔、耳屏间切迹、耳屏区域的"U"形耳廓软骨的局部解剖形态与鼻翼软骨较为相似,应用其修复鼻翼缺损,手术效果可靠,疗效满意,值得推广。     

自酸蚀粘结剂联合流体树脂修复楔状缺损的疗效观察

目的：探讨自酸蚀粘结剂联合流体树脂修复楔状缺损的疗效。方法：对21例患者共126颗牙髓活力正常的牙颈部楔状缺损分别进行充填治疗,随机分成实验组和对照组,每组63颗牙。实验组使用CLEARFIL S3 BONDTM自酸蚀粘结剂和流体树脂进行充填;对照组常规酸蚀,涂布粘结剂和复合树脂充填。评价两组6个月、1年、2年的保留成功率。结果：两组在治疗后6个月,成功率差异无统计学意义;治疗后2年,自酸蚀粘结剂联合流体树脂充填成功率为95%,对照组为76.6%,两组差异有统计学意义（P＜0.01）。结论：自酸蚀粘结剂和流体树脂充填楔状缺损牙髓刺激性小,可明显提高修复充填体的固位率,值得推广应用。