学龄儿童恒牙非创伤性充填远期疗效的临床观察

目的　评价非创伤性充填 (ART)治疗恒牙龋的长期效果。方法　采用ART标准器械和步骤 ,用高强度玻璃离子材料对 197名 12～ 13岁儿童完成充填。连续 6年进行临床评价 ,用美国公共卫生服务标准 (USPHS)同时验证。并用标准Rheinberger测量器评价充填的磨损程度。 结果第 6年小Ⅰ类洞充填的保留率为 75 % ,大Ⅰ类洞充填保留率为 6 1% ,差异有统计学意义 (P <0 0 1)。USPHS评价结果表明大、小Ⅰ类洞充填的边缘完整性的满意度各占 80 %和 93%。充填后第 1年Ⅰ类洞磨损值为 4 8μm ,明显高于以后每年的磨损值 2 0～ 2 5 μm(P <0 0 5 )。 结论　ART充填恒牙龋是适合、有效和可接受的 ,其保留率与洞型大小有关 ,是一种有前途的治疗方法 ,但应注意掌握适应证     

六种玻璃离子粘固剂断裂模式的比较

目的采用赫兹压痕实验,研究不同类型玻璃离子粘固剂的断裂模式。方法选取6种玻璃离子粘固剂材料(A~D为酸反应固化型,其中A、B无加强成分,C为银粉加强,D为陶瓷加强;E、F为树脂改良型)制作圆盘形试件各10个,直径为10mm,厚度为2mm。置于玻璃纤维加强尼龙6,6基底上,通过直径为20mm的加载头进行静态加载,记录初始断裂载荷,扫描电镜观察试件断裂模式。结果材料A、B、C、D均表现为相似的脆性断裂模式,材料E、F多数试件为局部不完全断裂。材料A~F的初始断裂载荷分别为(258.86±10.49)、(230.88±21.66)、(281.90±25.39)、(282.11±9.60)、(756.67±83.50)和(1148.00±147.78)N,前4种与后2种间差异有统计学意义(P<0.05)。结论玻璃离子粘固剂的固化类型决定其断裂模式;金属或陶瓷加强成分增加试件承受载荷能力的效果不大。     

六种牙齿充填修复材料的释氟与再充氟性能研究

目的 评价6种牙齿充填修复材料的释氟和再充氟性能,以期为临床选择和应用提供参考.方法 选择材料A(FujiⅦ玻璃离子水门汀)、材料B(FujiⅡLC光固化玻璃离子水门汀)、材料C(Beautifil离子体复合树脂)、材料D(Compoglass F复合体)、材料E(Charisma普通复合树脂)及材料F(实验Ⅰ型释氟性复合树脂)作为实验材料,制备直径10 mm、厚1 mm的圆片,每组10个试样.每个试样浸于5 ml去离子水中,用氟离子选择电极测定浸出液氟离子量,浸泡1～7d每天测定,8～28d3d测定1次,计算每日释氟量.于浸泡28 d后用氟化泡沫对试样充氟4min,继续测定试样每日释氟量,连续测定7d;再充氟并测定氟释放7d,重复3次.结果 浸泡1d后所有材料均表现最大的释氟量,材料A释氟量最大[(99.68±15.21) μg·cm-2·d-1],其次为材料B[(37.12±1.67) μg·cm-2·d-1],再次为材料F和D[分别为(22.93±1.53)和(15.28±0.70) μg·cm-2·d-1],材料C和E释氟量较小[分别为(2.40±0.52)和(0.11±0.02) μg·cm-2· d-1],各组间差异有统计学意义(P＜0.05).浸泡2d后释氟量显著下降,随后(7～ 28 d)释氟量下降缓慢;浸泡1～28 d内,材料A和B的释氟量始终大于其他材料(P＜0.01),其次是材料D和F,显著大于材料C和E(P＜0.01).所有材料充氟1d后的释氟量均较充氟前显著增加,形成释氟高峰,充氟2d后的释氟量又显著下降.充氟1d后材料A的释氟量超过40 μg· cm-2·d-1,大于其他材料(P＜0.01);其次是材料B,释氟量超过25 μg· cm-2·d-1,大于除A外的其他材料(P＜0.01);材料C、D、F释氟量相近,在15～ 20μg·cm-2·d-1之间;材料E释氟量较小,＜1.5 μg· cm-2·d-1.结论 玻璃离子水门汀类材料的释放及再充氟能力最强,其次是复合体和释氟性复合树脂,离子体复合树脂释氟能力小,但其再充氟能力与复合体和释氟性复合树脂相当,普通复合树脂的释氟及再充氟能力均较小.     

乳牙龋坏非创伤性充填的1年临床结果观察

目的：探索适合中小城镇及农村的非创伤性充填治疗（ART）技术,评价ART修复乳牙龋坏的效果。方法：1997年在四川省成都及周边地区小学选取6～8岁儿童198名,由经过中专口腔专业训练的医生采用ART技术对乳牙龋坏进行充填,在1个月内对该儿童作了324个充填。结果：1年议后复查297个充填体。248个根据标判断为“成功”,成功率为88．89％。结论：ART不失为一种有前途的龋病充填治疗方法,是可以在农村及中小城镇广泛采用的有前景的防治措施。     

几种新型牙科充填材料边缘微漏的实验研究

选择临床常用的银汞合金，国产ＣＯ－１玻璃离子粘固剂以及新研制的新型银－稀土汞齐合金、无汞银合金、银玻璃离子粘固剂、Ｌ－型玻璃离子粘固剂作充填材料，采用染料逆扩散法测定牙齿浸出液中伊红含量，观察充填材料边缘微漏情况。结果表明，无汞银合金边缘微漏低于银汞合金，新型银－稀土汞齐合金较银汞合金大，银玻璃离子粘固剂和国产ＣＯ－１玻璃离子粘固剂的微漏无区别，Ｌ－型玻璃离子粘固剂的微漏高于银玻璃离子粘固剂和国产     

龋齿充填中两种预防牙科畏惧症方法的比较

目的　对治疗前教育法和局部麻醉法在龋齿的充填治疗中 ,预防牙科畏惧症 (dentalfear,DF)的效果进行临床评价。方法　对下颌第一恒磨牙面患中或深度龋的小学生 ,采用随机方法等量分为 3组 ,每组 50例 ,男女各 2 5例。治疗前教育组 :提前 1h ,在医生带领下 ,观看有关龋病防治的科教录像片 ,熟悉环境、器械 ,回答提问 ;局部麻醉组 :用 2 %利多卡因 1 8ml进行下齿槽神经局部注射麻醉 ;空白对照组 :不做任何针对DF的干预。 3组病例接受同样的常规充填治疗。根据Veerkamp的评价标准 ,3名专家盲法独立评分 ,取均值。结果　 3组的DF值分别为 0 57± 0 59、0 83± 0 66及 1 0 5± 0 68,差异有非常显著性 (H =1 8 646 ,P =0 0 0 0 1 ) ;3组DF的发生率分别为 1 0 %、1 8%和 42 % (χ2 =1 5 50 3 1 ,P =0 0 0 0 4 ) ;治疗前教育法和局部麻醉法均可预防DF ,前者的临床效果更好。结论　在疼痛不是主要矛盾的龋齿充填治疗中 ,治疗前教育法可以更好地预防DF。     

CO—Ⅱ粘固剂治疗楔状缺损的临床疗效观察

楔状缺损是临床上常见的一种非龋性缺损.随着口腔材料的发展,应用于楔状缺损的材料不断增多,但各种修复材料均存在不同的缺陷.本文选用昆明齿科材料厂研制生产的CO—Ⅱ粘固剂对楔状缺损进行修补,其粘接强度高,无毒无刺激性,有3种颜色根据所修补牙齿的色泽任意选色和调配,操作简便,省时间、少痛苦,其修补后的临床疗效高,深受患者欢迎.     

无创伤修复技术治疗乳牙龋齿的临床效果评价

本文报告了应用无创伤修复技术治疗乳牙龋齿６个月后的临床观察结果。方法“选取没有牙髓问题的乳齿患儿、随机分为五组,应用两种充填材料和不同充填技术进行治疗。     

龋齿非创伤性充填技术的应用体会

非创伤性充填(ART)技术主要是运用手工器械来去除龋损,不需大型牙科综合治疗台,在简陋条件下就可以进行龋齿治疗的简便和有效的途径。我科对256例接受ART治疗3年以上的在校青少年和行动不便的离退休老干部进行了回访,取得了比较满意的结果,报告如下:1材料与方法1.1材料大、中、     

不同品牌玻璃离子水门汀氟释放的比较

目的：离体比较临床用不同品牌及固化方式的玻璃离子水门汀（ＧＩＣ）氟释放情况,为临床使用含氟充填材料防龋提供理论依据。方法：４种ＧＩＣ,分别为Ｓｈｏｆｕ,青浦,Ｃｈｅｍｆｉｌ３种化学固化型和ＶｉｔｒｅｍｅｒＴＭ光固化型ＧＩＣ,离子选择电极法测量材料在去离子水中氟释放量。结果：所有测试材料在实验期间都能在去离子水中持续释放氟,ＶｉｔｅｒｍｅｒＴＭ、Ｓｈｏｆｕ、Ｃｈｅｍｆｉｌ和青浦分别为（２１．１１±９．７６）μｇ、（８．０８±４．４３）μｇ、（６．５２±３．２８）μｇ,（１７．６７±６．９３）μｇ（Ｐ＜０．０１）。结论：不同品牌及固化方式的ＧＩＣ氟释放能力不同,树脂基因引入玻璃离子水门汀并不影响其氟释放能力。     

Effect of ionizing radiation on properties of restorative materials

Objective

To evaluate the effect of ionizing radiation from high energy X-ray on properties of restorative materials.

The residual caries dilemma

Restorative dentistry is based on the assumption that bacterial infection of demineralized dentine should prompt operative intervention. One of the concepts of practical dentistry is to create a favourable environment for caries arrest with minimal operative intervention. The progress of remaining primary caries is key to any discussion of this concept. This discussion is important for the atraumatic restorative treatment (ART) approach, since the removal of all carious dentine is sometimes difficult using hand instruments only. In this paper the results of possible measures to guard against the effects of residual carious and its consequences are reviewed, in order to obtain an impression of the justification for (in)complete excavation of occlusal dentinal caries. Three types of measure are considered: isolating the caries process from the oral environment, excavating the carious dentine, and using a cariostatic filling material. Each of these measures contributes to the arrest of the caries process. However, none of these measures can arrest this process by itself. A combination of all three seems necessary. It is concluded that although residual caries does not seem to be the criterion for rerestoration, one has to strive for as complete caries removal as possible. If this cannot be fulfilled the sealing capacities of the filling material seem to be more important than its cariostatic properties.     

中老年人根面龋的临床分析

本文通过对459例45岁至85岁患者的652颗患根面龋牙齿的临床分析和治疗,发现根面患龋率随年龄增长而增高,尤以60岁以上患者多发;病损牙多伴随有牙龈萎缩,根面龋治疗中不必刻意备洞;用含氟玻璃离子充填效果较为理想。中老年人应注意定期进行口腔检查。     

Effectiveness of caries removal by the partial tunnel preparation method

The tunnel preparation method is designed to remove approximal caries through a channel from the occlusal surface while preserving the marginal ridge. This method entails reduced access to the caries lesion and thereby uncertainty as to the complete removal of caries. The purpose of the present investigation was to study the effectiveness of caries removal in 60 extracted premolars and molars by the partial tunnel preparation method. The glass polyalkenoat (ionomer) filling and the distance to the pulp were also examined. Examination of the sectioned teeth showed residual caries in the axial wall of two teeth and in dentin close to the enamel lesion in 10 teeth. Very few porosities were found within the glass polyalkenoat material and at the interface between the filling and the cavity walls.     

Mineral loss on adjacent enamel glass ionomer cements restorations after cariogenic and erosive challenges

Objectives

the purpose of this study was to determine the mineral loss on surrounding enamel restored with glass ionomer cements (GIC) after erosive and cariogenic challenges.

Methods

Bovine enamel specimens were randomly assigned into six groups according to the restorative material: G1 – composite resin; G2 – high viscous GIC; G3 – resin-modified glass ionomer with nanoparticles; G4 – encapsulated resin-modified GIC; G5 – encapsulated high viscous GIC; G6 – resin-modified GIC. After restorative procedures, half of specimens in each group were submitted to caries challenge using a pH cycling model for 5 days, and the other half were submitted to erosive challenge in citric acid for 10 min. Before and after the challenges, surface Knoop microhardness assessments were performed and mineral changes were calculated for adjacent enamel at different distances from restorative margin.

Results

Data were compared for significant differences using two-way ANOVA and Student–Newman–Keuls tests (p < 0.05). Erosive challenge significantly reduced enamel surface hardness, but no significant difference was observed irrespectively restorative materials (p > 0.05). The cariogenic challenge promoted a higher surface hardness loss for the resin-modified GIC (G4) and only for the High viscous GIC (G2) an increase in surface hardness was observed. For enamel analyses, significant differences were observed with respect to the different materials (p < 0.001) and distances (p = 0.023). Specimens restored with the composite resin presented higher mineral loss and specimens restored with the conventional high viscous GIC and the encapsulated resin-modified GIC presented the lowest values for mineral loss.

Conclusion

The GICs exerts protective effect only for cariogenic challenge.     

EFFECT OF ACID ETCHING OF GLASS IONOMER CEMENT SURFACE ON THE MICROLEAKAGE OF SANDWICH RESTORATIONS

The purposes of this study were to evaluate the sealing ability of different glass ionomer cements (GICs) used for sandwich restorations and to assess the effect of acid etching of GIC on microleakage at GIC-resin composite interface. Forty cavities were prepared on the proximal surfaces of 20 permanent human premolars (2 cavities per tooth), assigned to 4 groups (n=10) and restored as follows: Group CIE – conventional GIC (CI) was applied onto the axial and cervical cavity walls, allowed setting for 5 min and acid etched (E) along the cavity margins with 35% phosphoric acid for 15 s, washed for 30 s and water was blotted; the adhesive system was applied and light cured for 10 s, completing the restoration with composite resin light cured for 40 s; Group CIN – same as Group CIE, except for acid etching of the CI surface; Group RME – same as CIE, but using a resin modified GIC (RMGIC); Group RMN – same as Group RME, except for acid etching of the RMGIC surface. Specimens were soaked in 1% methylene blue dye solution at 24°C for 24 h, rinsed under running water for 1 h, bisected longitudinally and dye penetration was measured following the ISO/TS 11405-2003 standard. Results were statistically analyzed by Kruskal-Wallis and chi-square tests (α=0.05). Dye penetration scores were as follow: CIE – 2.5; CIN – 2.5; RME – 0.9; and RMN – 0.6. The results suggest that phosphoric acid etching of GIC prior to the placement of composite resin does not improve the sealing ability of sandwich restorations. The RMGIC was more effective in preventing dye penetration at the GIC-resin composite- dentin interfaces than CI.     

垫底材料对深龋近髓磨牙充填后疼痛及术后敏感的影响

目的 比较玻璃离子水门汀与流动树脂垫底对深龋近髓磨牙充填后的疼痛及术后敏感性。方法120颗深龋近髓磨牙，随机分为对照组，玻璃离子水门汀组和流动树脂组，每组40颗患牙。对照组采用dycal护髓，玻璃离子水门汀组采用dycal护髓和玻璃离子水门汀垫底，流动树脂组采用dycal护髓和流动树脂垫底，酸蚀粘接后，3组上层均加压充填3M ESPE Filtek^TM P60复合树脂。分别于修复后1天，1周，1个月，3个月采用疼痛程度标尺(Visual Analog scales,VAS)记录自觉疼痛程度，采用Ryge评价标准记录对压缩空气刺激的敏感性。结果 术后1天、1周、1个月和3个月，对照组与两个实验组之间自觉疼痛程度上差异有统计学意义(P<0.05)，各观察期两实验组之间自觉疼痛程度差异无统计学意义(P>0.05)。术后1天和1周，3组之间的术后敏感发生率差异无统计学意义(P>0.05)，术后1个月和3个月，玻璃离子水门汀组和流动树脂组与对照组之间差异有统计学意义(P<0.05)，而玻璃离子组与流动树脂组之间差异没有统计学意义(P>0.05)...