不同频率铒激光对氧化锆陶瓷粘接性能的影响

目的: 评价不同频率铒钇铝石榴石（erbium-doped yttrium aluminum garnet,Er:YAG）激光对氧化锆陶瓷粘接性能的影响。方法: 制作3 mm×3 mm×2 mm的钇稳定四方多晶氧化锆（yttrium-stabilized tetragonal zirconia polycrystals,Y-TZP）试件,随机分为6组,即空白对照组（C组）、喷砂组（SB组）和Er:YAG激光蚀刻组（A1-A4组）,频率分别为5、10、15和20 Hz,IPS e.max Press压铸陶瓷为B组,记录各组扫描电镜图像。将陶瓷试件粘接到牙试件上,37 ℃恒温水浴,保存24 h后进行剪切实验,随后在体视显微镜下观察各个试件的断裂模式。采用SPSS 26.0软件包对实验数据进行统计学分析。结果: 扫描电镜显示,不同频率的Er:YAG激光照射Y-TZP陶瓷后,与C组相比,Y-TZP陶瓷表面变得粗糙。剪切实验结果显示,B组剪切强度值最高,为（13.15±2.97） MPa;其次为SB组[（7.78±0.97） MPa]和A2组[（7.13±0.75） MPa],SB组与A2组相比无统计学差异（P>0.05）。断裂模式结果显示,C组断裂模式以Y-TZP陶瓷与树脂粘接剂界面断裂为主,A1-A4组和SB组断裂模式大多为Y-TZP陶瓷与树脂粘接剂界面断裂,少部分为混合断裂和树脂粘接剂内聚断裂,B组断裂模式全部为混合断裂。结论: 10 Hz Er:YAG激光照射Y-TZP陶瓷可替代110 μm直径的Al₂O₃颗粒喷砂,用于Y-TZP陶瓷的表面改性,增加了Y-TZP陶瓷与树脂粘接剂的粘接强度。     

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目的探讨氧化锆陶瓷表面不同粒径Al2O3颗粒喷砂及牙本质表面Er：YAG激光处理对树脂黏结强度的影响。方法2011年2—10月在山西医科大学口腔医院选取25颗完整人前磨牙,制作50个牙块,暴露牙本质。其中10个牙块表面用35％磷酸酸蚀处理,40个牙块表面用Er：YAG激光蚀刻处理。制作氧化锆陶瓷片50个,20个不做处理,其余30个（每组10个）在0．4MPa压力下分别接受120、80、40μm粒径Al2O3颗粒喷砂20s。试件分为5组（每组10个）：A、B组分别由35％磷酸酸蚀和Er：YAG激光蚀刻的牙块与未做处理的陶瓷片黏结;C、D和E组分别由120、80、40μm粒径Al2O3颗粒喷砂的陶瓷片与Er：YAG激光蚀刻的牙块黏结。各组分别进行黏结强度测试？结果A组的黏结强度[（8．71±0．86）MPa]低于B组[（10．94±0．93）MPa],两组差异有统计学意义（P〈0．05）;C、D和E组的黏结强度[（13．49±1．53）、（13．97±0．83）、（17．11±1．51）MPa]均高于B组,差异有统计学意义（P〈0．01）;C、D组的黏结强度低于E组,差异有统计学意义（P〈0．01）;但C与D组间差异无统计学意义（P〉0．05）。结论氧化锆陶瓷片表面Al2O3颗粒喷砂和牙本质表面Er：YAG激光蚀刻处理可增加氧化锆陶瓷与牙本质间的树脂黏结强度。     

Effects of surface treatment,hydration and application method on the bond strength of a silorane adhesive and resin system to dentine

Objectives

To evaluate the effects of surface treatment, surface hydration (SH) and application method (AM) on the tensile bond strength of the Silorane Adhesive System (SAS) to dentine.

Methods

Ninety bovine teeth were used. For the control group (n = 10), each dentine surface was treated according to the manufacturer's instructions of the SAS. The remaining teeth were randomly distributed into two groups (n = 40), according to the type of dentine surface treatment (ST)—37% phosphoric acid or Er:YAG Laser prior to the application of the SAS. Each group was further divided into 2 subgroups (n = 20), according to the SH status: dry (D) or wet (W). Each subgroup was further divided into 2 subgroups (n = 10), according to the application method [AM: Active (AC) mode or Passive (PA) mode]. A coat of resin composite (Filtek P90) was applied on the surface. Artificial ageing was performed with a thermo-mechanical cycling machine. The specimens were sectioned into 1 mm × 1 mm × 10 mm sticks and stressed to failure using a universal testing machine. The remaining teeth in each group were used for Scanning Electron Microscopy to examine the fractured area. Data were subjected to a three-way ANOVA, Tukey's test and Dunnet's test (α = 0.05).

Results

The ANOVA showed significant differences for SH and AM, but not for ST. For SH, the results of Tukey's test were (in MPa): D – 14.9(±3.8)^a, W – 17.1(±4.3)^b; and for AM: PA – 14. 9(±4.2)^a, AC – 17.1(±3.9)^b.

Conclusions

Acid etching, when combined with a moist dentine surface and the use of primer agitation, improves the bond strength of the SAS to dentine.

Clinical Significance

According to the results of the present in vitro study, modification of the application protocols for the silorane-based adhesive system may improve its clinical performance.     

Er:YAG激光预处理对牙本质-全瓷粘结剪切强度影响的体外研究

目的研究Er:YAG激光预处理牙本质对牙本质与全瓷粘结剪切强度的影响,以期为Er:YAG激光在临床的应用提供参考。方法选择新鲜拔除的完整第三磨牙80颗,根据表面处理方法不同随机分为5组,每组颊面标记为ABCDE,舌面标记为abcde。A/a:Er:YAG激光光照+Optibond Versa/Adper Easy One组;B/b:Er:YAG激光光照+35%磷酸酸蚀+Optibond Solo Plus/Adper Single Bond 2组;C/c:Er:YAG光照能量密度15.73 J/cm~2/31.46 J/cm~2组;D/d:Optibond Versa/Adper Easy One粘结剂组;E/e:35%磷酸酸蚀+Optibond Solo Plus/Adper Single Bond 2组。计算机设计制作牙制作直径3 mm厚2 mm IPS e.max PressⅡ瓷块,常规粘结后制作剪切试件并测剪切粘结强度,电子显微镜下观察断裂类型。SPSS20.0统计学分析软件分别对实验数据进行单因素方差分析和χ~2检验,对实验数据进行两两比较。结果 Er:YAG激光光照与全酸蚀粘结剂联合组剪切强度(23.01±4.41/25.37±3.96)MPa,显著高于其他组,差异有统计学意义(P<0.05)。结论不同厂家的全酸蚀粘结剂联合Er:YAG激光预处理牙面均能够有效提高牙本质与全瓷的粘接强度。     

Influence of Er:YAG laser irradiation distance on the bond strength of a restorative system to enamel

OBJECTIVES: The aim of the present study was to investigate in vitro the effect of Er:YAG laser on bonding to enamel, varying the irradiation distance. METHOD: Tensile bond strength of an adhesive restorative system to non-irradiated and irradiated enamel surfaces was evaluated. Thirty caries-free human third molars were sectioned in mesio-distal direction and embedded in acrylic resin. Enamel was flattened, and a 3-mm-diameter bonding area was demarcated. Specimens were randomly assigned into six groups: groups I-V were treated with the Er:YAG laser (80 mJ/2 Hz), varying the irradiation distance (11, 12 mm-focused, 14, 16 and 17 mm, respectively), followed by 35% phosphoric acid etching. Control group (VI) received treatment with phosphoric acid alone. Single Bond adhesive system was applied on the conditioned enamel, and composite resin cones, bonded to enamel, were fabricated with Z250. After storage, samples were tested in tensile to failure (50 kgf and 0.5 mm/min). RESULTS: Means in MPa were: I-9.67 (+/-3.44); II-13.29 (+/-2.65); III-13.33 (+/-2.22); IV-14.87 (+/-3.58); V-16.43 (+/-4.52); VI-22.90 (+/-3.03). ANOVA and Tukey test revealed statistically significant decrease of bond strength in group I (P < 0.05). Groups II-IV presented similar results, as did groups IV and V. Control group (VI) yielded the best overall performance (P < 0.05). CONCLUSION: Er:YAG laser irradiation adversely affected adhesion to enamel. However, bond strength was influenced by the irradiation distance, thus being stronger with the increase of distance to the target tissue.     

Effect of different provisional cement remnant cleaning procedures including Er:YAG laser on shear bond strength of ceramics

PURPOSE

The purpose of this study was to evaluate the effect of provisional cement removal by different dentin cleaning protocols (dental explorer, pumice, cleaning bur, Er:YAG laser) on the shear bond strength between ceramic and dentin.

MATERIALS AND METHODS

In total, 36 caries-free unrestored human third molars were selected as tooth specimens. Provisional restorations were fabricated and cemented with eugenol-free provisional cement. Then, disc-shaped ceramic specimens were fabricated and randomly assigned to four groups of dentin cleaning protocols (n = 9). Group 1 (control): Provisional cements were mechanically removed with a dental explorer. Group 2: The dentin surfaces were treated with a cleaning brush with pumice Group 3: The dentin surfaces were treated with a cleaning bur. Group 4: The provisional cements were removed by an Er:YAG laser. Self-adhesive luting cement was used to bond ceramic discs to dentin surfaces. Shear bond strength (SBS) was measured using a universal testing machine at a 0.05 mm/min crosshead speed. The data were analyzed using a Kolmogorov Smirnov, One-way ANOVA and Tukey HSD tests to perform multiple comparisons (α=0.05).

RESULTS

The dentin cleaning methods did not significantly affect the SBS of ceramic discs to dentin as follows: dental explorer, pumice, cleaning bur, and Er:YAG laser.

CONCLUSION

The use of different cleaning protocols did not affect the SBS between dentin and ceramic surfaces.     

铒激光备洞对牙体与充填体间纳米渗漏和粘结强度的影响

目的评价铒(Er:YAG)激光和高速涡轮手机备洞,对复合树脂充填后牙体与充填体间纳米渗漏和粘结强度的影响。方法选32颗离体前磨牙平均分成两组,对照组用高速涡轮手机备洞;实验组用Er:YAG激光备洞,随后进行光固化复合树脂充填。两组各取8颗,进行纳米渗漏测试,扫描电镜(scanning electron micrographic,SEM)观察渗漏情况。其余样本检测微拉伸强度。使用SPSS 20.0统计软件对各组微拉伸强度进行独立样本t检验。结果在牙体与充填体间,实验组几乎没有纳米渗漏产生,对照组则产生纳米渗漏带。微拉伸强度:对照组(16.10±4.91)MPa,实验组(26.53±3.61)MPa,实验组微拉伸强度大于对照组,两组间差别有统计学意义(P<0.05)。结论与涡轮手机相比,Er:YAG激光备洞的纳米渗漏程度更低,粘结强度更好。     

Er:YAG激光照射对牙本质粘结强度的影响

目的探讨Er:YAG激光照射对牙本质粘结强度的影响。方法选取离体磨牙或前磨牙40颗,随机分为4组:A:酸蚀(35%磷酸)组;B:Er:YAG激光组;C:Er:YAG激光+磷酸酸蚀组;D:空白对照组。每组随机选取2颗制备成3 mm厚的牙本质盘,相应预处理后扫描电镜观察;每组剩余8颗牙制备统一标准粘结面,相应预处理后与树脂粘结测量剪切粘结强度。结果扫描电镜结果显示牙本质面经相应预处理后发生明显改变;统计分析结果显示A组剪切粘结强度最大(16.03±6.56)MPa,其次为C组(13.21±6.08)MPa,两组间差异无统计学意义(P>0.05);D组剪切粘结强度最低(4.52±1.02)MPa,与B组(7.91±4.56)MPa比较差异无统计学意义(P>0.05),与A、C组比较差异有统计学意义(P<0.05)。结论 Er:YAG激光照射联合磷酸酸蚀较单纯Er:YAG激光照射可提高牙本质剪切粘结强度。     

Effect of a desensitizing agent containing glutaraldehyde and HEMA on bond strength to Er:YAG laser-irradiated dentine

OBJECTIVES: The aim of this study was to investigate whether a desensitizing agent (GLUMA Desensitizer) containing glutaraldehyde and HEMA improved the bond strength and bonding durability of a self-etching primer adhesive to Er:YAG-irradiated dentine. METHOD: Dentine of 120 human molars was exposed by wet grinding on SiC paper for bond strength testing. Thirty specimens each were allocated to the following treatment groups: (1) control; (2) Er:YAG laser irradiation; (3) Er:YAG laser irradiation followed by application of GLUMA Desensitizer; (4) Er:YAG laser irradiation followed by application of GLUMA Desensitizer and 10s rinsing with water. Composite cylinders were bonded to the dentine surfaces with a self-etching priming adhesive system. Tensile bond strengths (TBS) of 10 specimens of each treatment group were measured after 24-h water storage, 6 months water storage and 12 months water storage, respectively, and the failure modes were analyzed. TBS data were statistically treated by two-way ANOVA and Fisher's PLSD test at a significance level of p<0.05. RESULTS: TBSs for the GLUMA-non rinse and GLUMA-rinse groups were significantly higher than for the laser group at 24 h and 12 months. Specimens from the Er:YAG-irradiated dentine group had significantly lower bond strengths than the control group at each storage time. All control specimens showed cohesive fractures in resin close to the bonding interface whereas the Er:YAG laser-irradiated groups showed both dentine cohesive, resin cohesive and dentine-resin mixed failures. CONCLUSION: Application of GLUMA Desensitizer to Er:YAG-irradiated dentine increases the bond strength and durability of the self-etching priming adhesive used.     

Morphology, chemical structure and diffusion processes of root surface after Er:YAG and Nd:YAG laser irradiation

OBJECTIVES: The aim of this in vitro study was to evaluate the effects of Er:YAG and Nd:YAG lasers on morphology, chemical structure and diffusion processes of the root surface. MATERIAL AND METHODS: 60 root samples were irradiated for 1 min each either with 60 mJ/p, 80 mJ/p and 100 mJ/p using Er:YAG laser or with 0.5W, 1.0W and 1.5W using Nd:YAG laser. Scanning electron microscopy (SEM) was used to determine the morphology, infrared (IR) spectroscopy to assess the alterations in chemical structure and one dimensional electron paramagnetic resonance imaging (1-D EPRI) was used to estimate the diffusion coefficients in dental root samples. RESULTS: Er:YAG laser treatment resulted in deep crater formation with exposed dentin. Morphological alterations of root surface after Nd:YAG laser irradiation included cracks, crater formation, meltdown of the root mineral and resolidified porous globules formation. Er:YAG laser failed to alter the intensity of Amide peaks I, II or III. In contrast, treatment with Nd:YAG laser, using the highest power setting of 1.5W, reduced the intensity of Amide peak II and III in comparison to the control. The diffusion coefficients were increased significantly in all Er:YAG and Nd:YAG treated root samples. CONCLUSION: This study demonstrated that Er:YAG laser influences only on morphology and diffusion processes of root surfaces, while Nd:YAG laser also alters the chemical structure of root proteins.     

Er:YAG激光不同能量预处理对自粘结树脂水门汀剪切粘结强度的影响

目的探讨Er:YAG激光不同能量预处理对自粘结树脂水门汀剪切粘结强度的影响。方法按照纳入标准收集人离体磨牙70颗,根据对牙本质表面Er:YAG激光预处理能量的不同随机分为7组:A组(空白对照)、B组(50 m J,10 Hz)、C组(100 m J,10 Hz)、D组(150 m J,10 Hz)、E组(200 m J,10 Hz)、F组(250 m J,10 Hz)、G组(300 m J,10 Hz)。每组10颗牙中随机取2颗切取3 mm厚的牙本质片,按相应分组用不同激光能量预处理后扫描电镜观察;每组剩余8颗牙包埋后,制备一致标准牙本质表面,按相应分组要求预处理后,用自粘结树脂水门汀Rely XTMUnicem将其与Everest ZS氧化锆瓷片粘结,24 h后测试各组剪切粘结强度并进行统计学分析。结果扫描电镜观察显示Er:YAG激光预处理后牙本质表面形态改变明显,变得粗糙不平,牙本质小管开放,无玷污层,管周和管间牙本质脱矿,一定能量范围内呈现较好的粘结表面;剪切粘结强度结果显示Er:YAG激光预处理可增强自粘结树脂水门汀Rely XTMUnicem的剪切粘结强度(P<0.01);C、D、E组的剪切粘结强度与A组有显著性差异(P<0.05)。结论粘结强度与牙本质的粘结表面密切相关,合适能量下的Er:YAG激光预处理能获得较好的牙本质粘结表面,提高自粘结树脂与牙本质和氧化锆瓷的剪切粘结强度。     

Effect of different adhesive systems and laser treatment on the shear bond strength of bleached enamel

Purpose

This study determined the shear bond strength of a nanohybrid composite resin to bleached enamel immediately or 15 days later using different adhesive systems and laser application.

Methods

One hundred and forty enamel specimens were prepared from human molar teeth and bleached either with 16% carbamide peroxide (CP) or 30% CP according to the manufacturer's (Vivastyle/Vivadent) recommendations. After bleaching treatments specimens were divided into two groups according to the treatment time of the adhesive procedures: immediately or 15 days after the bleaching treatments. The four groups were then divided into five subgroups due to the surface treatments: using a two-step self-etching adhesive (AdheSe, Ivoclar Vivadent G, Schaan, Liechtenstein) or a two-step etch and rinse adhesive (Excite, Ivoclar Vivadent G, Schaan, Liechtenstein) and application of laser prior to adhesive procedures or not. After adhesive procedures nanohybrid composite resin cylinders of 4 mm × 2 mm (Tetric Evo Ceram/Vivadent) were bonded to the enamel surfaces. All specimens were subjected to shear bond strength test after thermocycling and 24 h of storage in water. Data were analyzed statistically.

Results

Mann–Whitney U-test analysis showed no significant difference in the mean bond strength values of enamel bleached with either 16% CP or 30% CP (p > 0.05). There was no difference between the groups bonded immediately or 15 days after bleaching (p > 0.05). Application of the etch and rinse adhesive after 15 days showed the highest bond strength values, whereas self-etching adhesive and laser application showed the lowest values in both bleaching treatments.

Conclusions

The results suggested that following the bleaching treatments, the use of etch and rinse adhesive system may provide higher bond strengths than self-etching adhesive and laser application.     

Enamel demineralization and bracket bond strength when etching with acid and /or Er:YAG laser

Background:  Enamel etching for brackets is usually done with phosphoric acid. Er:YAG lasers have been recently used for this purpose with conflicting results. The effects of lasers on tooth demineralization and the effects of different combinations of laser treatments and bonding agents were evaluated in this study. Methods:  The enamel contents of fluorine, calcium oxide and phosphorus pentoxide (P₂O₅) were analysed using acid etching, laser treatment or both. The tensile bond strength of metallic and ceramic brackets using Transbond^® XT and Fuji Ortho^® LC were also tested, using acid etching, laser treatment or a combination of both. Results:  All treatments reduced the contents of fluorine, P₂O₅ and calcium oxide, and acid reduced P₂O₅ levels more than laser. The bond strength with laser was weaker than with acid, and stronger when combining both. When using laser, the best adhesive was the Fuji Ortho^® LC. The combination of laser and acid produced the best results when using Transbond^® XT. Conclusions:  The demineralization promoted by laser was lower than the one produced with acid. Laser treatment produced lower tensile stress strength than acid, but still enough to produce clinically efficient retention. The combination of laser and acid produced the best retention results.     

Er：YAG激光在龋病治疗时消除疼痛疗效观察

目的：探讨Er:YAG激光在龋病治疗中的止痛效果。方法：使用Er:YAG激光治疗9例龋齿、观察临床效果及疼痛情况。结果：治疗过程中实验组患者疼痛得分平均为0．22且均未麻醉,而牙钻组疼痛得分平均为1．6,且2例进行麻醉。结论Er:YAG激光可以较好地解决龋齿治疗中的疼痛问题。     

不同表面处理及老化对氧化锆陶瓷抗折强度的影响

［摘要］ 目的 研究打磨、抛光、上釉及老化对氧化锆陶瓷抗折强度的影响。方法 将36片氧化锆陶瓷分成打磨组、抛光组、上釉组3组,每组试件按不同的老化时间分为0 h组（对照组）和10 h组（n=6）。将10 h组瓷块置于134 ℃,0.2 MPa 的水热环境下,进行10 h的老化试验。每组各取一个试件,用 X 线衍射 ( X-ray diffraction,XRD ) 仪测定单斜相含量,万能力学试验机测试所有试件抗折强度。结果 XRD分析显示老化前的所有试件均未显示单斜相。老化后所有组均出现单斜相,打磨组单斜相含量最高,上釉组最低。抗折强度所有组均无统计学意义（P>0.05）。结论 老化后所有试件单斜相含量均有所增加,但打磨、抛光、上釉及老化处理对氧化锆陶瓷抗折强度未产生影响。     

Er:YAG激光和酸蚀作用于牙釉质表面后剪切强度的比较研究

目的 探讨Er:YAG激光照射对牙釉质表面的蚀刻效果,并与酸蚀效果进行比较研究.方法 2010年4-7月在山西医科大学选取40颗完整的人离体双尖牙,随机分为4组(每组各10颗牙),即酸蚀组(35%的磷酸),Er:YAG激光组(5Hz,100 mJ,0.5W),酸蚀加Er:YAG激光组,Er:YAG激光加酸蚀组.分别在牙...     

激光法治疗种植体周围炎的短期临床效果评估

目的 探讨Er:YAG激光法治疗种植体周围炎临床效果,以期对今后种植体周围炎的临床治疗有所帮助。方法 20名种植体周围炎患者,满足纳入标准和排除标准后随机分为两组,试验组采用Er:YAG激光法治疗,对照组采用碳纤维刮治器和0.2% 洗必泰抗菌治疗。分别记录治疗前（基线水平）、治疗后3个月和6个月时相关的牙周临床指标,包括菌斑指数、探诊后出血指数、龈沟出血指数、探诊深度、临床附着水平。所有的检查均使用牙周探诊器(PCP12)。结果 基线时试验组和对照组间各项临床牙周指标的差异无统计学意义(P＞0.05)。治疗后3个月,与基线水平相比,各项临床牙周指标均有所降低,激光治疗比刮治治疗的降低幅度大,并且这种降低是具有统计学意义的(P＜0.05)。治疗后6个月时,总体来说牙周各项临床指标仍是低于基线水平的,但与3个月时相比,除了出血指数仍然降低以外,其他牙周指数都有略微反弹的趋势。结论 手工刮治和激光治疗都可以改善种植体周围炎患者的各项临床牙周指标,激光治疗可能疗效更为显著,但稳定性稍显不足。这种改善可能只是短期的,长期的疗效还需要依赖大样本长时间的观察随访。