渗透树脂治疗早期龋的研究新进展

早期龋的发生是牙釉质脱矿与再矿化交替进行的动态过程,阻止脱矿的进展是治疗早期龋的关键。渗透树脂作为一种新型材料,具有粘性低,表面张力小的特点,可进入龋损的微小孔隙并堵塞封闭形成屏障,阻止龋损的进展。树脂渗透技术是近年来治疗早期龋的新技术,具有微创,无痛的优点,易于被患者接受。近年来国内外学者针对渗透树脂的渗透原理、临床效果做了大量研究,该文将对上述研究进展进行综述。     

Anesthetic efficacy of 1.8 mL versus 3.6 mL of 4% articaine with 1:100,000 epinephrine as a primary buccal infiltration of the mandibular first molar

Introduction

No study has compared 1.8 mL and 3.6 mL 4% articaine with 1:100,000 epinephrine in a mandibular buccal infiltration of the first molar. The authors conducted a prospective, randomized, single-blind, crossover study comparing the degree of pulpal anesthesia obtained with 1.8 mL and 3.6 mL 4% articaine with 1:100,000 epinephrine as a primary infiltration in the mandibular first molar.

Methods

Eighty-six asymptomatic adult subjects randomly received a primary mandibular buccal first molar infiltration of 1.8 mL or 3.6 mL 4% articaine with 1:100,000 epinephrine in two separate appointments. The authors used an electric pulp tester to test the first molar for anesthesia in 3-minute cycles for 90 minutes after the injections.

Results

Compared with the 1.8-mL volume of 4% articaine with 1:100,000 epinephrine, the 3.6-mL volume showed a statistically higher success rate (70% vs 50%).

Conclusions

The anesthetic efficacy of 3.6 mL 4% articaine with 1:100,000 epinephrine is better than 1.8 mL of the same anesthetic solution in a primary mandibular buccal infiltration of the first molar. However, the success rate of 70% is not high enough to support its use as a primary injection technique in the mandibular first molar.     

甲哌卡因在牙体牙髓病治疗中的应用

目的评价2%甲呱卡因在口腔临床局部麻醉应用中的有效性及安全性。方法将注射用2%甲呱卡因用于II例患者的深龋备洞或开髓治疗的局部浸润麻醉,观察麻醉时间、麻醉效果、对心血管的影响及其他不良反应,并与7例采用2%利多卡因麻醉作对照。结果试验组的麻醉起效时间短于对照组,而麻醉持续时间长于对照组,医生评价良好率达到90.91%。两组药物均不引起血压、心率的明显变化。结论2%甲呱卡因是一种安全可靠、麻效较好的口腔用局部麻醉剂。     

颊侧浸润麻醉对上颌磨牙麻醉效果的临床观察

目的：比较颊侧浸润麻醉与传统阻滞麻醉对上颌磨牙牙髓的麻醉效果。方法：选择因上颌磨牙深龋或牙髓炎患者,患牙在局麻下行去龋或开髓、拔髓操作。麻药为含1：80000肾上腺素的2%利多卡因。患者随机分为A、B、C三组,每组各100例。A组采用颊侧黏膜下浸润麻醉,剂量1.8ml;B组采用与A组相同的黏膜下浸润麻醉,剂量0.9ml;C组采用传统阻滞麻醉,剂量1.8ml。以视觉模拟评分法（VAS）对注射和操作的疼痛程度进行评分,以Kruskal-Wallis方法检验各组间差异。结果：①Kruskal-Wallis检验显示注射疼痛,组间有统计学差异（p〈0.05）,而操作疼痛,组间无统计学差异（p〉0.05）;②Nemenyi法进一步比较各组间注射疼痛的差异,A组与B组无显著性差异（p〉0.05）,而A组与C组、B组和C组之间存在显著性差异（p〈0.05）。结论：对于上颌磨牙的麻醉,颊侧浸润麻醉（1.8ml或0.9ml）与传统的阻滞麻醉在操作疼痛评分中无显著性差异,但是注射疼痛显著低于阻滞麻醉。提示0.9ml含1：80000肾上腺素的2%利多卡因颊侧浸润麻醉即可获得较好的上颌磨牙牙髓麻醉效果。     

氧化铝玻璃复合体颜色的初步筛选

目的：研究渗透用玻璃料中氧化铈、氧化铁的添加量对牙科CAD／CAM氧化铝玻璃复合体颜色的影响。方法：制备渗透用无色玻璃粉、含4％氧化铈及含0．5％氧化铁的着色基础玻璃粉,分别按0．1g间隔变动含氧化铈和氧化铁的玻璃粉量,制备出9种混合着色玻璃粉,再制备分别按0．1g间隔变动着色玻璃粉和无色玻璃粉的含量,最终得到81种不同颜色的渗透用玻璃粉,在1250℃下渗透2h后进行测色与评价。结果：比色片的Yxy色度范围在185、0．378、0．340和121、0．443、0．341之间,81种试件的Yxy色度范围在227、0．352、0．343和102、0．489、0．364之间。试件Yxy数值落在比色片色度范围的共计37种。不同着色玻璃含量的试件组间色度值分布近似等差排列。结论：基于3种玻璃粉以不同比例进行混合可配制出不同颜色的渗透用玻璃料,其色度范围基本涵盖了VITAPAN-3D—MASTER比色片的色度值。     

Esthetic improvements of postorthodontic white-spot lesions treated with resin infiltration and microabrasion: A split-mouth,randomized clinical trial

Objective:To compare the esthetic improvement between postorthodontic white-spot lesions (WSLs) treated by resin infiltration and microabrasion for 12 months.Materials and Methods:A total of 20 patients with 128 teeth with postorthodontic WSLs were recruited. A simple randomized, split-mouth, positive controlled design was used to allocate patients to resin infiltration or microabrasion groups. The lesion area ratio (R value) was calculated between the area of a WSL and the labial surface of the corresponding tooth based on standardized clinical photographs. The color change (ΔE) of each tooth was measured with a Crystaleye spectrophotometer (Olympus, Tokyo, Japan). Every measurement was taken before treatment (T0) and at different time points after treatment: 1 week (T1), 6 months (T6), and 12 months (T12).Results:A total of 16 patients with 108 trial teeth were available at T12. Each group had 54 trial teeth. In both groups, there was a significant decrease in R value and ΔE between T1 and T0 (P < .0001). In the infiltration group, the R value and ΔE had no significant changes over time from T1 to T12. In the microabrasion group, the R value and ΔE decreased significantly from T1 to T6. The R value of resin infiltration was lower when compared with microabrasion at every recall point (P < .001). The ΔE had no significant differences between the two groups at any timepoint.Conclusions:Resin infiltration and microabrasion improved the esthetic appearance of WSLs and showed sufficient durability for 12 months. Resin infiltration showed a better esthetic improvement effect when compared with microabrasion at 12 months.     

氧化铝预烧结前后及玻璃渗透后渗透陶瓷的扫描电镜观察

目的：渗透陶瓷是一种新型的高强度全瓷冠桥修复材料,本实验研究了渗透陶瓷在氧化铝预烧结前后及四种玻璃料渗透后陶瓷样本的ＳＥＭ表现,旨在探讨高强度的可能原因,以及微观结构与强度的关系。方法制取氧化铝预烧结前、后及ＧＩ－Ⅰ型、ＧＩ－Ⅱ型镧系、ＧＩ－Ⅱ型铈系、Ｖｉｔｚ Ｉｎ－ｃｅｒａｍ玻璃渗透后的样本各１个,进行ＳＥＭ观察,结果Ｖｉｔａ Ｉｎ－ｃｅｒａｍ氧化铝粉的颗粒大小具有多相性,其中大颗粒粒度为３－５μｍ,小颗粒粒度为０．１－０．５μｍ,烧结以的小颗粒的数目略减小,氧化铝基体的致肖增加;４种玻璃渗透以后样本的断面ＳＥＭ相似,渗透后氧化铝颗粒稍长大,形态有向氧化铝的天然晶型斜方型转化的趋势。结论玻璃渗透过程中,可能发生了小颗粒氧化铝的溶解再晶化过程,强度相同的四种渗透陶瓷ＳＥＭ表现也相似。     

GI-Ⅱ型着色渗透玻璃的研制

目的:探讨GI- Ⅱ型着色渗透玻璃的制作工艺,并对着色渗透玻璃的相关性能进行测定。方法:优选法确定玻璃配方,测定热膨胀曲线,计算热膨胀系数、玻璃转化和软化温度;用三点弯曲法测挠曲强度和弹性模量,显微压痕法测断裂韧性和维氏硬度;用棱镜折光仪测定玻璃的折射率;用差热分析和X 衍射的方法测定玻璃渗透烧烤前后的稳定性。结果:GI- Ⅱ型着色渗透玻璃的热膨胀系数为61997 ×10-6 ℃-1 (25～500 ℃) ,玻璃转化和软化温度分别为635 ℃和650 ℃,主折射率为1164 ,三点弯曲强度为96127 MPa ,弹性模量为31116 GPa ,维氏硬度为51534 GPa ,显微断裂韧性为1105 MPa·m1P2 ,密度为31214 gPcm3 。GI- Ⅱ型着色渗透玻璃在特定条件下有乳浊产生,但在渗透烧烤程序下具有良好的稳定性。结论:GI- Ⅱ型着色渗透玻璃具有良好的机械物理性能和热稳定性。     

Comparative study of local anesthetic efficacy of 5% tramadol versus 2 %Lignocaine with 1:100,000 adrenaline for extraction of fully erupted maxillary 3rd molars using infiltration anesthesia

IntroductionThe majority of dental procedures need local anesthesia for pain control, and lidocaine/ lignocaine is the most commonly used anesthetic agent in dentistry. Although effective and safest, the anesthetic agent still has some complications. To overcome these many alternatives have been used. Tramadol has been shown to have some local anesthetic (LA) effects when used for infiltration anesthesia in dentistry.MethodsIn the present study, the local anesthetic efficacy of tramadol was compared with 2% lignocaine containing 1: 100,000 adrenaline for the extraction of maxillary fully erupted 3rd molar teeth. The parameters recorded included the onset of action, duration of action, intraoperative pain, post-operative analgesic effect, and incidence of an allergic reaction. A total of 200 patients were randomly divided into two groups. In group A -Each patient received 0.6 ml of 5% tramadol (Tramataj- 50 mg prepared by Taj pharma company) 0.4 ml buccally and 0.2 ml palatally for extraction of maxillary 3rd molar as local infiltration following strict aseptic precaution. In Group B- patients received 0.6 ml of 2% lignocaine containing 1: 100,000 adrenaline buccally and 0.2 ml palatally as infiltrations.ResultsIt was found that 5% tramadol has a local anesthetic efficacy similar to 2% lignocaine with adrenaline but was found to be a comparatively weaker agent.Conclusiontramadol is a valid alternative for performing extractions in normal patients or patients allergic to lidocaine.     

Comparative study of local anesthetic efficacy of 5% tramadol versus 2 %Lignocaine with 1:100,000 adrenaline for extraction of fully erupted maxillary 3rd molars using infiltration anesthesia

IntroductionThe majority of dental procedures need local anesthesia for pain control, and lidocaine/ lignocaine is the most commonly used anesthetic agent in dentistry. Although effective and safest, the anesthetic agent still has some complications. To overcome these many alternatives have been used. Tramadol has been shown to have some local anesthetic (LA) effects when used for infiltration anesthesia in dentistry.MethodsIn the present study, the local anesthetic efficacy of tramadol was compared with 2% lignocaine containing 1: 100,000 adrenaline for the extraction of maxillary fully erupted 3rd molar teeth. The parameters recorded included the onset of action, duration of action, intraoperative pain, post-operative analgesic effect, and incidence of an allergic reaction. A total of 200 patients were randomly divided into two groups. In group A -Each patient received 0.6 ml of 5% tramadol (Tramataj- 50 mg prepared by Taj pharma company) 0.4 ml buccally and 0.2 ml palatally for extraction of maxillary 3rd molar as local infiltration following strict aseptic precaution. In Group B- patients received 0.6 ml of 2% lignocaine containing 1: 100,000 adrenaline buccally and 0.2 ml palatally as infiltrations.ResultsIt was found that 5% tramadol has a local anesthetic efficacy similar to 2% lignocaine with adrenaline but was found to be a comparatively weaker agent.Conclusiontramadol is a valid alternative for performing extractions in normal patients or patients allergic to lidocaine.     

Comparison of Maxillary Lateral Incisor Infiltration Pain Using the Dentapen and a Traditional Syringe: A Prospective Randomized Study

IntroductionThe anterior maxillary infiltration is one of the more painful dental injections. The Dentapen is an electronic syringe that uses computer-controlled delivery technology to administer dental local anesthesia at a slow controlled rate. The purpose of this prospective, randomized, single-blind study was to evaluate solution deposition pain of a maxillary lateral incisor infiltration using the Dentapen with the slow flow rate (1.8 mL/162 sec) and ramp-up setting compared with a traditional syringe infiltration at a flow rate of 1.8 mL/60 sec.MethodsOne hundred thirty adults were administered a maxillary lateral incisor infiltration with the Dentapen and a traditional syringe at 2 separate appointments in a single-blind manner. The infiltrations of 2% lidocaine with 1:100,000 epinephrine were given at a rate of 1.8 mL/162 sec with the ramp-up feature for the Dentapen and 1.8 mL/60 sec for the traditional infiltration. The pain of solution deposition was recorded on a visual analogue scale. At the conclusion of the study, subjects selected their preferred injection technique. The data were analyzed statistically using paired t tests, a mixed-effect model, and odds ratio.ResultsThe pain of solution deposition was significantly less for the Dentapen injection than the traditional injection (P < .001). With the Dentapen device, 16% experienced moderate pain, and for the traditional syringe, 39% experienced moderate pain. Overall, 75% of subjects preferred the Dentapen injection over the traditional injection.ConclusionsThe Dentapen, using the slow flow rate and ramp-up mode, significantly reduced the pain of solution deposition for maxillary lateral incisor infiltrations.     

Bond Strength and Degree of Infiltration between Acrylic Resin Denture Liner after Immersion in Effervescent Denture Cleanser

Purpose: The purpose of this study was to investigate the effect of sodium perborate on the bond strength and degree of infiltration between acrylic resin/resilient denture liners. Materials and Methods: Three denture liners (Elite Soft, Mucopren Soft, Kooliner) were investigated. Twenty specimens (83 × 10 × 10 mm³) of each material were made by processing the denture liners against two polymerized PMMA blocks. Ten specimens for each material were stored in artificial saliva at 37°C (control group: TBS1), and the other ten specimens were stored in artificial saliva at 37°C combined with sodium perborate (experimental group: TBS2). All specimens were placed under tension until failure in a Universal Testing Machine at a crosshead speed of 5 mm/min after 7 (T7) and 60 (T60) days (n = 5). Failure strength (MPa) was recorded, and mode of failure was characterized as cohesive, adhesive, or cohesive/adhesive. For the infiltration tests, ten circular specimens (14‐mm diameter × 2‐mm thick) of each material were stored in artificial saliva and 0.5% methylene blue at 37°C (control group: I1), and ten specimens were stored in artificial saliva and 0.5% methylene blue at 37°C combined with daily immersions for 5 minutes in an effervescent solution of sodium perborate (experimental group: I2). The degree of infiltration was obtained through photographs and using Software Image Tool after 120 days. Results: For Kooliner, the statistical test did not show a significant difference in the bond strength due to the influence of the immersion period or to the use of sodium perborate. Elite Soft presented a significant increase in the average tension in T7 and in T60 in both TBS1 and TBS2. Inversely, the Mucopren suffered a significant decrease in the tension value in the same period as the TBS1 group as well as in the TBS2. The infiltration percentage was analyzed with the Kruskal–Wallis test (26.18; p < 0.05), which indicated significant differences between the compared averages for the groups. Comparing the averages of materials, the statistical test did not show significant differences between the control (I1) and experimental (I2) groups after 120 days. Conclusions: The use of sodium perborate did not promote significant alterations in the evaluated properties. Kooliner presented the best results.     

In vivo effects of two acidic soft drinks on shear bond strength of metal orthodontic brackets with and without resin infiltration treatment

Objectives:To evaluate the in vivo effects of two acidic soft drinks (Coca-Cola and Sprite) on the shear bond strength of metal orthodontic brackets with and without resin infiltration treatment. In addition, the enamel surface was evaluated, after debonding, using a scanning electron microscope.Materials and Methods:Sixty noncarious maxillary premolars, scheduled for extraction in 30 orthodontic patients, were used. Patients were randomly divided into two groups according to the soft drink tested (Coca-Cola or Sprite). In each group, application of resin infiltration (Icon. DMG, Hamburg, Germany) was done on one side only before bonding of brackets. Patients were told to rinse their mouth with their respective soft drink at room temperature for 5minutes, three times a day for 3months. Shear bond strength was tested with a universal testing machine. After shearing test, a scanning electron microscope was used to evaluate enamel erosion. Statistical analysis was performed by twoway analysis of variance followed by the least significant difference test.Results:The Coca-Cola group without resin infiltration showed the lowest resistance to shearing forces. Scanning electron micrographs of both groups after resin application showed a significant improvement compared with results without resin use, as the enamel appeared smoother and less erosive.Conclusion:Pretreatment with the infiltrating resin has proved to result in a significant improvement in shear bond strength, regardless of the type of soft drink consumed.     

渗透树脂治疗对釉质白斑样病损颜色的影响

目的 研究渗透树脂治疗对釉质白斑样病损颜色的影响。方法 选择人磨牙60颗,树脂包埋,以牙尖方向作为观察面,每个样本打磨出2个釉质小平面,随机分为A、B点。60颗样本牙随机分为第1、2、3组,每组20颗,经人工龋脱矿液分别脱矿24、48、72 h;对各样本的A点进行渗透树脂处理,B点行0.1%氟化钠涂氟处理30 d,B点涂氟处理后再行渗透树脂处理。应用电子分光光度比色仪测量A、B点脱矿及处理前后的L*值。结果 各组A、B点脱矿前L*值没有明显差异,脱矿后均明显增加;经渗透树脂处理后,各组A点的L*值均较脱矿后降低,第1、2组的L*值恢复到脱矿前水平,第3组L*值与第1、2组存在差异（P<0.05）;经涂氟处理后,各组B点的L*值变化不明显;涂氟再经渗透树脂处理后,B点L*值明显降低,但仍高于A点和脱矿前（P<0.05）。结论 渗透树脂能够有效改善釉质白斑样病损的颜色,即刻效果优于传统涂氟治疗;其治疗效果与釉质脱矿程度及龋损活动性有关。     

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??Objective??To study the anesthetic effect of infiltration anesthesia and block anesthesia in the treatment for irreversible pulpitis. Methods??Seven electronic databases were searched including Pubmed??Cochrane Library and CNKI??which were updated until April 1st??2017. Two researchers finished the screenings??data extraction and bias risk evaluation separately. RevMan 5.2 was utilized to finish the data processing and statistical analysis. Results??There was no significant difference in the success rate of anesthesia in the treatment of irreversible pulpitis ??RR = 0.96??95% CI = 0.85??1.09??P =0.56?? comparing infiltration anesthesia with block anesthesia. Infiltration anesthesia was less painful at the time of injection ??RR = 0.41??95% CI = 0.19??0.88??P = 0.02??. Conclusion??There is no significant difference in anesthesia effect between infiltration anesthesia and block anesthesia in the treatment of irreversible pulpitis. Infiltration anesthesia is less painful than block anesthesia at injection.     

不同温度下牙科CAD/CAM用氧化铝玻璃渗透速率的测定

目的：探讨不同温度下玻璃渗透氧化铝厚度与时间的关系。方法：微米α-氧化铝粉经250MPa冷等静压成型，经高速率升温至1450℃烧结，制备成的预烧结氧化铝块分别通过1150℃、1200℃和1250℃的镧硼硅玻璃渗透，获得氧化铝玻璃复合体，测试不同渗透温度下玻璃渗透氧化铝厚度与时间的数值。结果：随着温度的增高，熔融玻璃的黏度下降，而相同渗透时间下的渗透厚度增加。渗透1mm的氧化铝在1150℃下需要95min，而在1200℃和1250℃下分别需要22min和8min。结论：选用1200℃的渗透温度可以缩短渗透时间，具有较高的临床应用意义。     

GI-Ⅱ型着色玻璃渗透后渗透陶瓷的性能测试

目的 :探讨用GIⅡ型着色渗透玻璃渗透后的渗透陶瓷底层材料的热膨胀性能、机械力学性能和密度 ,为材料性能的改进和临床应用奠定基础。方法 :选用GIⅡ型着色渗透玻璃的IG2色玻璃料及GIⅡ型氧化铝粉体 ,制作氧化铝基体及渗透陶瓷样本 ,在TMA2940型热分析仪上绘制样本的热膨胀曲线 ,计算热膨胀系数 ;三点弯曲法测定渗透陶瓷材料的挠曲强度和弹性模量 ,显微压痕法测量断裂韧性和维氏硬度 ;重量体积法测定其密度。结果 :渗透陶瓷的热膨胀系数为 7.620×10(6)℃(-1)（2 5～ 5 0 0℃ ） ,略高于Vitaduralpha饰面瓷的热膨胀系数。材料的三点挠曲强度、弹性模量、维氏硬度、显微断裂韧性和密度分别为 389.6MPa、92GPa、9.409GPa、3.2425MNm3/2和3.662g/cm3 。结论 :用GIⅡ型着色渗透玻璃渗透后的渗透陶瓷底层材料 ,其热膨胀性能与Vitaduralpha饰面瓷匹配 ,机械强度也达到了临床应用的要求。     

不可逆性牙髓炎治疗中浸润麻醉与阻滞麻醉效果Meta分析

目的　研究在不可逆性牙髓炎治疗中浸润麻醉与阻滞麻醉的效果。方法　检索PubMed、Cochrane Library和CNKI等7个数据库,时间截止于2017年4月,由2位作者独立完成文献筛选、数据提取和偏倚风险评估。使用RevMan5.2软件进行资料的提取和统计学分析。结果　在不可逆性牙髓炎的治疗中,浸润麻醉与阻滞麻醉相比,成功率差异无统计学意义（RR = 0.96,95% CI = 0.85～1.09,P = 0.56）;浸润麻醉较阻滞麻醉在注射时产生的疼痛更小（RR = 0.41,95% CI = 0.19～0.88,P = 0.02）。结论　在不可逆性牙髓炎的治疗中,浸润麻醉与阻滞麻醉的效果无显著差异;浸润麻醉较阻滞麻醉在注射时产生的疼痛反应更小。