光固化复合树脂与污染底层树脂粘接的临床探讨

对３８例复合树脂修复体磨损、碎裂后，在存留于牙上的被唾液等污染的修复体部分基底上，用光固化复合树脂粘接技术进行再粘接修复，临床观察５～２４个月。结果３８例中有３例粘接修复后新旧材料界面分离。在污染的基底层树脂表面进行适当处理并应用偶联剂可有效地提高填加层光固化复合树脂与污染的基底层光固化复合树脂、化学固化复合树脂、塑料的粘接强度，短期临床效果比较。     

上颌第二前磨牙根管治疗后复合树脂直接粘接修复2．5年的效果

本文报道1例采用复合树脂直接粘接修复技术修复根管治疗后上颌第二前磨牙MOD洞的病例。患牙因慢性牙髓炎施行一疗次根管治疗．牙体缺损呈MOD洞．采用复合树脂直接粘接技术进行修复。临床操作中充分发挥牙本质粘接作用．利用髓腔固位,并以复合树脂覆盖颊舌牙尖。经1年和25年复查修复效果良好．患牙能正常行使咀嚼功能．修复体和剩余牙体组织均完好,没有边缘着色和继发龋形成。本病例提示复合树脂直接粘接技术是修复根管治疗后牙体缺损的一个有效方法。     

复合树脂美学直接粘接修复术的临床应用

复合树脂直接粘接修复术在前牙美学修复中的应用范围广泛, 因技术敏感性高, 其美学效果呈现和临床远期疗效是临床医师关注的重点。本文从材料、牙齿、技术三方面对复合树脂美学效果呈现的影响因素进行分析, 并从美学效果评价的角度, 对复合树脂美学直接粘接修复术的适应证、影响因素及临床应用效果进行梳理, 为其临床应用提供参考。     

基于循证实践的Ⅱ类洞复合树脂修复的操作要点

邻面龋是临床上的常见问题,对后牙邻面龋备洞后行Ⅱ类洞修复是临床日常性操作,复合树脂充填修复已成为Ⅱ类洞修复的首选方式。随着复合树脂、粘接技术和成形工具的发展,Ⅱ类洞复合树脂修复的理念与技术已出现很多新的进展,本文基于近期的文献证据,从受力分析、术区隔离、窝洞预备、护髓处理、成形系统的选择与放置、粘接方案、充填方案以及修形与抛光8个方面对Ⅱ类洞复合树脂修复操作要点进行阐述,为Ⅱ类洞复合树脂修复临床实践提供循证医学指导。     

牙列重度磨耗粘结复合树脂咬合面预增高咬合重建

目的:探讨牙列重度磨耗以粘接复合树脂预增高咬合,后行咬合重建修复的临床治疗新途径。方法:先采用粘接复合树脂直接修复牙列重度磨耗患者的咬合面,增高咬合,恢复垂直距离及正中关系,再以固定修复、固定-可摘局部义齿修复等方式行咬合重建。结果:4例牙列重度磨耗患者以粘接树脂预增高咬合均可有效升高咬合垂直距离,复合树脂粘接可靠,调简捷,患者对粘接复合树脂预增高咬合适应性好,永久性修复体完成后随访半年-1年,患者面部外形改善,咀嚼功能恢复良好。结论:牙列重度磨耗粘接树脂咬合面预增高咬合重建,可较为准确恢复咬合垂直距离,易于患者接受及配合,为固定式咬合重建创造了便利条件,作为咬合重建修复的新途径值得进一步研究。     

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复合树脂充填材料用于牙体修复已超过半个世纪的时间,随着科技的进步,粘接系统和复合树脂材料已达到既牢固又美观的临床使用要求,成为牙体直接修复中的首选技术。复合树脂直接粘接修复技术的适应证包括修复各种原因造成的前牙牙体缺损及色泽、形态的异常等,修复的最终目的是恢复患牙的形态和美观。对于牙釉质的粘接需使用磷酸酸蚀粘接系统,对于牙本质的粘接则使用全酸蚀或自酸蚀牙本质粘接系统,修复材料则应选择复合树脂材料。修复中可根据患者的要求及患牙的条件选择单色、双色和多色树脂修复技术,以满足不同的美学修复目标。唇舌侧贯通的牙体组织缺损,应在舌侧充填具有遮色效果的树脂以减小口腔暗背景对修复体色泽的影响。唇面缺损的修复应体现牙体组织的细节和个性化解剖特征。对于外伤冠折牙齿的美学修复,可以用粘接系统将断离牙冠与剩余牙体组织对位粘接,必要时还可以用纤维桩增强固位。复合树脂直接粘接修复技术有保守、隐形、快捷等优势,但不适用于牙体组织缺损过大、色泽等严重异常的患牙。     

FL-BOND粘接系统在楔状缺损修复中的临床观察

目的:对比研究FL-BOND自酸蚀粘接系统和全酸蚀粘接系统与光固化复合树脂修复牙颈部楔状缺损的临床疗效。方法:对218例楔状缺损患者420个患牙随机分成2组,分别采用FL-BOND自酸蚀粘接系统与全酸蚀粘接系统对牙颈部楔状缺损进行光固化复合树脂修复,治疗后6,12,24月复查,对2组病例的治疗效果进行比较分析。结果:两组病例一次成功率比较,无统计学差异。但FL-BOND系统在防止牙本质过敏方面明显优于全酸蚀粘接系统。结论:FL-BOND系统与光固化复合树脂修复楔状缺损有良好的防止牙本质过敏作用。     

不同合金烤瓷基底冠与树脂修复材料粘接强度的对比实验

,模拟口内喷砂后,采用PanaviaTM F崩瓷修复系统粘接修复,测定金属试件与复合树脂之间剪切粘接强度,进行统计分析。结果　Ni-Cr合金与复合树脂间剪切粘接强度为5 .4 9±1 .2 3MPa ,金合金与复合树脂间剪切粘接强度为4 .73±0 .96MPa ,二者间无统计学差异(P >0 .0 5 )。2 0倍OPTON体视显微镜下观察到金属与复合树脂的剪切断面均位于金属-复合树脂粘接界面,未发生复合树脂内聚断裂。结论　采用PanaviaTM F进行崩瓷树脂修复,Ni-Cr合金与金合金的金属基底,对金属—复合树脂间剪切粘接强度无影响。     

复合树脂直接粘接修复Ⅱ.粘接系统类型及临床选择

复合树脂直接粘接修复成功的关键之一是获得有效可靠的牙齿一修复材料粘接界面,其中粘接剂必不可少.本讲将择要介绍目前使用的牙齿粘接系统的基本分类、粘接机制,以及临床选择和使用要点.     

复合树脂充填材料的研发策略和进展

复合树脂充填材料是牙体直接粘接修复的首选材料,其良好的性能可以满足临床牙体修复治疗的要求,恢复结构和功能并兼具微创和美观。为进一步提高临床疗效,改善复合树脂材料性能的局限性是根本的解决策略。本文总结目前的研究进展,重点阐述改良复合树脂材料的性能,研发新型复合树脂包括抗菌复合树脂、再矿化生物活性树脂和自修复复合树脂的进展,为新型复合树脂充填材料的研究趋势提供新思路。     

Direct resin-based composites: current recommendations for optimal clinical results

Composite resins are increasingly used for the restoration of anterior and posterior teeth. Although adhesives and composites have become easier to use than earlier generations of these materials, the use of composite resins is still technique-sensitive. This article reviews the current recommendations for the use of direct composite resins and summarizes the technique for both anterior and posterior restorations.     

Quantitative evaluation by measuring affected area for cytotoxicity of dental materials

The agar overlay method was modified and employed in this study to quantitatively evaluate the cytotoxicity of dental materials. The area of fibroblasts affected by the release of toxic substances from tested materials was determined with an image analysis system in order to compare the relative cytotoxicity of amalgams and composite resins. The cytotoxicity of amalgams decreased by 50% or more with aging time. Zinc appeared to be the major contributor to the cytotoxicity of amalgams. The cytotoxicity of chemically cured composite resins was also reduced with hardening time. However, even after 24 hours, the cytotoxicity of all chemically cured composite resins was still apparent. The cytotoxicity of light cured composite resins was dramatically reduced after illumination with the light source. The cytotoxicity of both amalgams and composite resins was strongly dependent upon their hardening process, since aging and curing produced a more stable material which was less likely to release toxic substances into the culture medium. The technique developed in the present study for measuring the area of affected cells to quantitatively evaluate the cytotoxicity of dental materials is simple and reproducible.     

Composite resins with a condensable inorganic phase

Reinforcing filler particles with open porosity can be prepared in three-dimensional networks made from extremely fine sintered glass fibers. Such fillers can be impregnated with a monomer, used for a putty type of composite, or packed into close particle contact by the use of a condensation technique similar to that used with dental amalgam. The condensation technique allows the use of high viscosity liquid resins and need not be accompanied by an increased amount of internal air voids. Condensed composite resins can be made which have a high finishability after curing.     

Relationship among visible light source, composite resin polymerization shrinkage, and hygroscopic expansion

Composite resins contract during polymerization, and studies have shown that light-cured composite resins shrink toward the polymerizing light source. The purpose of this study was to investigate differences in the adaptation of composite resin to the axial wall in Class V restorations following light curing from the lingual or facial aspects. Polymerization contraction in relation to hygroscopic expansion of the restoration was also investigated. Results showed no statistically significant differences (P less than .05) in the adaptation of composite resin to the axial wall, regardless of the polymerization technique, the composite resin, or the effects of hygroscopic expansion.     

Color stability of three composite resins used in the inlay/onlay technique

The color stability of three composite resins used in the inlay/onlay technique was determined by means of irradiation with UV-light and by water storage. Generally, water storage resulted in greater changes in color than did UV-light, but no correlation was found between the results of the two chromogenic procedures. The microfilled composite resin was the least color stable material, but none of the resins had alarmingly low color stability.     

Finishing and polishing of composite resins. The experimentally designed silicone cup hards and their polishing ability

To establish the most efficient polishing technique for composite resins, four kinds of silicone cup hards were experimentally designed, and the surface texture of two semihybrid composite resins polished with these experimental polishing tools were examined using a surface roughness recorder and by SEM. The individual silicone cup hard consisted of a hard rubber and silicone carbide abrasive particles being sized into #180 (P0), #360 (P2), #600 (P3), and #2500 (P4), respectively. Combination polishing with both P3 and P4, as well as from P0 through P4 in this order, efficiently created the smoothest surfaces for the semihybrid composite resins, which are generally considered to be hard to polish in the routine clinic.     

Color stability of three composite resins used in the inlay/onlay technique

Abstract – The color stability of three composite resins used in the inlay/onlay technique was determined by means of irradiation with UV-light and by water storage. Generally, water storage resulted in greater changes in color than did UV-light, but no correlation was found between the results of the two chromogenic procedures. The microfilled composite resin was the least color stable material, but none of the resins had alarmingly low color stability.     

Bond strength of etched enamel to direct composite resins, to indirect composite resins and to etched and silanized porcelain

The adhesion to enamel of composite resin inlays are not documented as much as porcelain inlays and direct composite resins. This study evaluates the adhesion of a light cured composite resin (P-50) used in an indirect technique and secondarily polymerized by heat. No significant differences were found between adhesion of P-50 used with an indirect technique and adhesion of porcelain (Mirage). P-50 used with the direct technique yield adhesion values significantly lower than the indirect techniques.     

Diametral tensile strength of composite resins submitted to different activation techniques

The aim of this study was to evaluate the diametral tensile strength (DTS) of composite resins submitted to different curing techniques. Four composite resins were tested in this study: Targis (Ivoclar), Solidex (Shofu), Charisma (Heraeus-Kulzer) and Filtek Z250 (3M Espe). Sixty-four cylindrical specimens were prepared and divided into eight groups according to each polymerization technique (n = 8). The indirect composite resins (Targis and Solidex) were polymerized with their respective curing systems (Targis Power and EDG-lux); Charisma and Filtek Z250 were light-cured with conventional polymerization (halogen light) and additionally, with post-curing systems. Specimens were stored in artificial saliva at 37 degrees C for one week. DTS tests were performed in a Universal Testing Machine (0.5 mm/min). The data were statistically analyzed by ANOVA and Duncan tests. The results were (MPa): Z250/EDG-lux: 69.04 feminine; Z250/Targis Power: 68.57 feminine; Z250/conventional polymerization: 60.75b; Charisma/Targis Power: 52.34c; Charisma/conventional polymerization: 49.17c; Charisma/EDG-lux: 47.98c; Solidex: 36.62d; Targis: 32.86d. The results reveal that the post-cured Z250 composite resin showed the highest DTS means. Charisma composite presented no significant differences when activation techniques were compared. Direct composite resins presented higher DTS values than indirect resins.     

Techniques for achieving realistic color distribution in large composite resin restorations

A technique of using macrofilled and microfilled composite resins in conjunction with tints and opaquers has been described. The technique achieves a more realistic color distribution in large composite resin restorations, such as Class IV restorations, diastema closures, veneers, and large Class III restorations. In placing more natural distributions of color in composite resin restorations, a more pleasing appearance can be achieved.