数字化冠延长导板在前牙美学修复中的应用效果评价

目的: 评价三维数字化微笑设计（three-dimensional digital smile design,3D-DSD）联合双定位冠延长导板在前牙美学修复中的临床效果。方法: 选择需行上前牙美学牙冠延长术和全冠修复的患者20例,随机分为实验组和对照组,每组10例。实验组进行3D-DSD,3D打印双定位冠延长导板,指导美学牙冠延长术,术后3个月进行全冠修复。对照组采用传统美学牙冠延长术和全冠修复。术前、术后3个月、术后6个月进行粉白美学指数（pink esthetic score/white esthetic score,PES/WES）评估,术后6个月、7个月采用视觉模拟评分法（visual analogue scales,VAS）进行2次患者满意度评价,对2次VAS结果进行可重复性评价,并对术后6个月PES/WES评分和整体满意度进行相关性分析。采用SPSS 23.0软件包对数据进行统计学分析。结果: 2组患者术后3个月、术后6个月PES/WES评分均高于术前（P<0.05）。组间比较结果显示,术后3个月PES、术后6个月PES和WES,实验组显著高于对照组（P<0.05）。满意度调查结果显示,2次VAS结果的组内相关系数为0.956（P<0.05）;实验组牙冠长宽比例、微笑曲线、个性特征、患者参与度和整体满意度均优于对照组（P<0.05）。术后6个月PES和WES评分与整体满意度均呈正相关（r_S1=0.905,P<0.001;r_S2=0.460,P=0.041）。结论: 3D数字化微笑设计联合双定位冠延长导板指导前牙美学牙冠延长术和修复治疗,可提高治疗后粉白美学效果及患者满意度。     

树脂直接充填与超瓷嵌体修复牙体缺损的微渗漏比较

目的 探讨用Filtek Z350复合树脂和超瓷嵌体修复Ⅰ类、Ⅱ类洞的边缘微渗漏的差异.方法 选取40颗新鲜拔除的第三磨牙,随机分成4组,每组10颗.A1组为Ⅰ类洞树脂直接充填,A2组为Ⅱ类洞树脂直接充填,B1组为Ⅰ类洞型超瓷嵌体修复,B2组为Ⅱ类洞超瓷嵌体修复.4组均置于1％碱性品红溶液染色21 d.用低速金刚砂锯沿牙体长轴近远中向切开,制备牙齿切片,体视显微镜观测粘接界面染色剂渗透深度.结果 （1）Ⅰ类（Z=5.909）、Ⅱ类洞（轴壁Z=5.504,龈壁Z=2.958）超瓷嵌体的边缘微渗漏都显著小于Z350复合树脂直接充填（P＜0.05）;（2）无论树脂直接充填（Z=1.413）还是嵌体修复（Z=0.455）,Ⅰ类、Ⅱ类洞的微渗漏差异无统计学意义（P＞0.05）.结论 超瓷嵌体修复是牙体缺损理想的修复方法.     

嵌体修复体的微渗漏研究

目的：使用两种黏结剂黏结5种不同嵌体材料，观察其边缘微渗漏情况，为临床选择嵌体材料和黏结剂提供参考。方法：选择近期拔除的24个完整磨牙，制备成近中殆远中面洞，随机分为8组，每实验组3个牙。1～3组：为金合金、钛合金、镍铬合金嵌体，使用3M ESPE RELY X^TM ARC黏结；4～6组：为金合金、钛合金、镍铬合金嵌体，使用SHOFU CX-Plus Glass poly alkenoqte黏结；7～8组：为铸瓷、水晶瓷嵌体，使用SHOFU CX-Plus Glass poly alkenoqte黏结。经恒温保存，5g／L碱性品红染色24h，2次纵剖牙体后，体视显微镜观测微渗漏值。结果：在两种黏结剂黏结下，金合金嵌体的微渗漏值最小，镍铬合金嵌体的微渗漏值最大。在松风玻璃离子黏结下，瓷嵌体组的微渗漏值小于钛合金的微渗漏值。结论：金合金、钛合金、铸瓷、水晶瓷嵌体均能满足临床修复需要。临床应用镍铬合金嵌体时应选择合适的黏结剂。     

微瓷树脂嵌体和复合树脂嵌体微渗漏的对比研究

目的 对比研究1种微瓷聚合树脂嵌体和另外3种复合树脂嵌体的边缘微渗漏情况,为临床选择嵌体材料提供参考。方法 将80颗健康离体上颌前磨牙随机分为8组,每组10颗,嵌体窝洞制备后,分别用微瓷聚合树脂Ceramage（C）和复合树脂Brilliant new line(B)、Z350(Z)、P60(P)间接法制成嵌体,每种材料2组,使用即刻牙本质封闭(immediate dentin sealing,IDS)/延时牙本质封闭(delayed dentin sealing,DDS)技术粘结,冷热循环品红染色后,用金刚砂片将实验牙切开,体视镜下观察微渗漏。结果 4种树脂嵌体龈壁与轴壁微渗漏无显著性差异（P>0.05）,各IDS组与DDS组微渗漏亦无显著性差异（P>0.05）。无论龈壁还是轴壁,采用IDS或DDS粘结技术,4种材料之间皆有显著性差异（P<0.05）并且渗漏情况一致。微渗漏从小到大依次均为C、Z、P、B。结论 单从微渗漏方面评价,Ceramage和Z350均为制作树脂嵌体的良好选择。     

瓷嵌体与树脂嵌体边缘微渗漏的对比研究

目的：对比研究Ceramage聚合瓷嵌体和复合树脂嵌体、铸瓷嵌体的边缘微渗漏情况.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Ceramage、Z350、P60、IPS EmpressⅡ制作嵌体后使用Single Bond 2和Rely X ARC进行粘接.经冷热循环500次后品红染色,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种材料微渗漏长度经单因素方差分析有统计学意义（轴壁：F=6.667,龈壁：F=11.1,P＜0.01）,q检验进行组间两两比较,IPS EmpressⅡ的微渗漏值高于Ceramage、Z350、P60,差异有统计学意义（P＜0.05）,其他三组间差异无统计学意义（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：从微渗漏深度进行评价,Ceramage聚合瓷是临床上制作树脂嵌体较理想的材料;     

SiO2/Poss树脂嵌体的微渗漏研究

目的:用SiO₂/Poss复合树脂嵌体和3种临床常见树脂嵌体修复牙体组织,观察边缘微渗漏情况,为临床工作提供选择依据。方法:将32颗离体前磨牙按嵌体备洞原则制备V类洞,随机分为4 组,每组8颗。分别用SiO₂/Poss, Z250,Z350,BeautifulⅡ树脂制作嵌体, 冷热循环和品红染色处理后,剖开牙体。体视显微镜观察每组嵌体龈壁和牙合壁的微渗漏最显著部位,测量3次取平均值。结果:SiO₂/Poss复合树脂嵌体边缘微渗漏深度最小。结论:SiO₂/Poss可以作为临床嵌体材料的选择。     

树脂嵌体修复磨牙髓室底穿孔的形态学及微渗漏研究

目的研究树脂嵌体修复离体人恒磨牙髓室底穿孔的形态学及封闭效果。方法将50颗新鲜拔除的离体人恒磨牙随机分为A、B、C 3个实验组（每组15颗牙）和1个对照组（5颗牙）。制备髓室底穿孔后,A组采用树脂嵌体和AH Plus糊剂修复髓室底穿孔,B组采用树脂嵌体和玻璃离子修复髓室底穿孔,C组采用光固化复合树脂直接充填修复髓室底穿孔。对照组5颗离体牙,只开髓不制备髓室底穿孔。体视显微镜下观察髓室底穿孔修复后的外形恢复情况,葡萄糖氧化酶－蒽酮法测定微渗漏情况。结果嵌体法修复髓室底穿孔的形态恢复优良率为83.3%,直接充填法修复髓室底穿孔的形态恢复优良率为46.7%,两种方法修复的形态恢复优良率之间的差异有统计学意义（P<0.05）。3组在各个时间点上任意2组的日均葡萄糖浓度差异都有统计学意义,A组相似文献   

4种树脂嵌体磨损性和微渗漏的比较

目的研究4种树脂嵌体的磨损性能和边缘微渗漏情况,为临床选择嵌体材料提供参考。方法磨损实验:将Ceramage(C)、Brilliant new line(B)、Z350(Z)、P60(P)制成树脂嵌体,应用UMT-2微摩擦磨损实验机,将试件与天然牙对磨,称重法计算磨损量,扫描电镜观察磨损表面形貌。微渗漏实验:将80颗上颌前磨牙随机分为8组,每组10颗,嵌体窝洞制备后,分别用C、B、Z、P间接法制成嵌体,每种材料2组,分别使用即刻牙本质封闭(immediate dentin sealing,IDS)和延时牙本质封闭(delayed dentin sealing,DDS)技术粘接,冷热循环品红染色后,沿嵌体长轴剖开,体视镜下观察微渗漏。结果 4种树脂摩擦18 000次后总磨损量从小到大依次是Z、P、B、C。C、B、Z随摩擦次数增加,一定摩擦次数间产生的磨损量呈减少趋势。相同材料的树脂嵌体,其IDS组与对应DDS组的微渗漏情况差异没有统计学意义(P>0.05),其龈壁微渗漏与对应轴壁微渗漏差异亦没有统计学意义(P>0.05);但4种不同材料嵌体间的微渗漏情况皆有统计学差异(P<0.05),微渗漏从小到大依次为C、Z、P、B。结论 Z350拥有优良的耐磨性能和较小的微渗漏;随摩擦次数增加,Ceramage一定摩擦次数间产生的磨损量呈减少趋势,且边缘微渗漏最小。Z350和Ceramage均为制作树脂嵌体的优良选择。     

Ceramage聚合瓷嵌体和纳米树脂嵌体边缘微渗漏的对比研究

对于牙体大面积缺损,树脂嵌体修复是近年来一种新型修复技术,与树脂直接充填修复相比较,树脂在体外经二期固化处理后,抗压强度、硬度、耐磨性、恢复邻接关系等方面具有较好的临床效果[1]。Ceramage聚合瓷是近年来一种新型瓷化树脂,主要用于制作冠、贴面、嵌体、高嵌体等。然而嵌体的边缘线较长,发生微渗漏的可能性较大,且不同树脂嵌体材料与牙体间微渗漏的程度也不同[2]。     

影响复合树脂微渗漏的多因素分析

目的：探讨不同树脂、不同粘结剂、不同光源、不同光照时间、不同光照角度对复合树脂微渗漏的影响。方法：64颗离体磨牙,随机分为32组,每组2颗牙,分别采用不同材料及方法充填牙齿,2％碱性品红染色,体视显微镜下观察微渗漏情况。结果：粘结剂、光源、光照角度3种处理因素自身不同水平比较,差异具有统计学意义（P〈0．01）,树脂与光照时间之间存在交互作用（P〈0．01）。结论：粘结剂、光源、光照角度、树脂和光照时间的交互作用对光固化复合树脂微渗漏有影响。     

渗透性树脂对树脂修复体微渗漏影响的实验观察

目的:观察使用渗透性树脂ICON对修复体边缘进行处理后的微渗漏变化。方法:20颗健康离体牙随机分为2组,颊面制备深度2mm的窝洞,Z350树脂充填,A组使用渗透性树脂ICON处理树脂修复体边缘处的牙体组织及树脂牙体结合处,B组为对照组。37℃水浴条件下分别置于0.1%罗丹明B荧光染料浸染,24h后激光扫描共聚焦显微镜测量染液渗入深度,定量评价微渗漏程度,对检测结果进行统计学分析。结果:A、B组微渗漏差异有统计学意义(P<0.05)。结论:渗透性树脂对改善树脂修复体微渗漏状况有明显效果。     

不同桩核修复系统在长期水储存条件下的根管微渗漏表现

目的：长时间水储存后桩核修复体冠外微渗漏情况。方法：选用72颗上颌单根管牙,随机分为6组,其中4组为实验组,2组为对照组。所有组别牙齿置人蒸馏水中储存半年后,用体视显微镜观察修复体冠方染料微渗漏情况。结果：采用纤维桩树脂核系统修复的牙体和传统铸造桩核修复后的牙体冠方微渗漏情况有明显差别,而采用DCBOND的实验组与另外两组树脂粘接剂问有明显差别。结论：DCBOND树脂粘接剂进行纤维桩核修复后在冠方微渗漏方面本实验显示了优越性。     

固化光源光照方向和角度对微渗漏影响的研究

目的：研究固化光源光照方向及角度对复合树脂固化后微渗漏的影响。方法：选择63颗离体前磨牙,在颊面牙颈部以釉牙骨质界为中心制备圆形V类洞,常规酸蚀粘结,充填复合树脂,将所有实验牙以光源不同朝向随机分为A组：光源方向朝向龈壁;B组：光源方向朝向牙合壁;C组：光源方向朝向近中壁。再将A、B、C每组按固化光源与充填材料表面所成的角度不同随机分1组：成30°光照;2组：成60°光照;3组：成90°光照。所有实验牙均光照40s。分别浸泡于0.1%罗丹明B荧光染色剂中24h。然后经修复体中央,沿牙体长轴沿颊舌向纵向剖成两半,在激光扫描共聚焦显微镜（Laser Scanning Confocal Microscopy,LSCM）下分别观察检测微渗漏大小。结果：龈壁处的微渗漏情况：在光源的不同朝向下,不同的光照角度对龈壁处微渗漏的影响均具有统计学意义,光照角度均为90°时微渗漏值最小（P〈0.05）;牙合壁处的微渗漏情况：当光源朝向牙合壁及近中壁照射时,牙合壁处3组之间微渗漏有明显差异（P〈0.05）,光照角度90°时微渗漏最小;当光源朝向龈壁时,牙合壁处微渗漏之间没有明显的差异。结论：固化光源的光照方朝向及光照角度对微渗漏有影响。     

两种树脂水门汀对纤维桩冠方微渗漏的影响

目的：通过观察两种树脂水门汀引起的纤维桩冠方微渗漏值及在扫描电镜下与牙本质的粘接界面,比较两种树脂水门汀的封闭性能。方法：42颗离体下颌前磨牙分成6组,其中30颗牙分为2组,分别用Panavia F、Paracore 5mL粘接纤维桩,经染色、透明化处理后,在体式显微镜下记录2组微渗漏得分;另有10颗牙分为2组,分别用Panavia F、Paracore 5mL粘接纤维桩后纵形剖开,置于扫描电镜下观察牙本质水门汀界面;其余2颗牙分别作为阳性对照组及阴性对照组。结果：Paracore 5mL引起的纤维桩冠方渗漏值明显较Panavia F小（P〈0.01）。两种树脂水门汀与牙本质界面均可形成混合层,而仅Paracore 5mL组可发现树脂突及粘接性侧枝。结论：全酸蚀树脂水门汀对纤维桩冠方微渗漏的影响较自酸蚀树脂水门汀小;全酸蚀树脂水门汀与牙本质结合紧密,封闭性能较自酸蚀树脂水门汀优越。     

Influence of Modifying the Resin Coat Application Protocol on Bond Strength and Microleakage of Metal Orthodontic Brackets

Objective:To determine the shear bond strength (SBS) and microleakage of metal brackets bonded with two different adhesives when a resin coat and the adhesive were light-cured separately or simultaneously.Materials and Methods:Eighty stainless steel brackets were bonded to the enamel of extracted premolars, 40 with Transbond Plus adhesive (group 1) and 40 with Transbond XT (group 2). Each group was subdivided into four equal subgroups; a, b, c, and d. Brackets in subgroups a and b were bonded with the adhesive without coating. For brackets in subgroup c, Ortho-Choice Ortho-Coat was applied and cured after curing of the adhesive, while the coat was applied and cured with the adhesive for brackets in subgroup d. The specimens were immersed in a 2% methylene blue dye. After debonding, the teeth and brackets were examined with a stereomicroscope. The data were subjected to a two-way analysis of variance (ANOVA), Duncan multiple range test, and Pearson correlation.Results:Both adhesives had comparable SBS. Curing of the coat after curing of the adhesive showed significantly higher SBS than other protocols. There was no significant difference in SBS of the adhesives without coating and with curing of the coat and adhesive simultaneously. Application of the coat significantly reduced microleakage. There was a significant negative relationship between SBS and microleakage.Conclusions:SBS was significantly improved with curing of the coat and adhesive separately, while it was not adversely affected when the coat and adhesive were cured simultaneously. Using the coat with either protocol significantly reduced the microleakage.     

浸提液浓度对医用硅橡胶制品诱变性的实验研究

根据硅橡胶制品的特性，设置了5个实验组，以不同的浸提液浓度处理CHL细胞，对医用硅橡胶制品进行了体外染色体畸变和姐妹染色单体交换试验．实验结果显示：随处理剂量的增加，畸变率和SCE频率也相应增加。由此表明．实验设置的浓度梯度不仅是有效和适合的，而且对硅橡胶等口腔材料的诱变性测试研究具有明显的实用意义。     

Effect of Resin Coating and Chlorhexidine on the Microleakage of Two Resin Cements after Storage

Purpose: This study evaluated the effect of resin coating and chlorhexidine (CH) on microleakage of two resin cements (Panavia F2.0, Nexus 2) after water storage. Materials and Methods: Class V cavities were prepared on the facial and lingual surfaces of 120 intact human molars with gingival margins placed 1 mm below the cementoenamel junction. Indirect composite inlays were fabricated. The specimens were randomly assigned into six groups (n = 40). Indirect composite inlays (Gradia) were cemented as follows: Group 1 (control): inlays were cemented with Panavia F2.0 according to the manufacturer's instructions. Group 2: the ED‐primed (ED Primer, Kuraray Dental, Tokyo, Japan) dentin was coated with a resin layer before cementation of the inlays with Panavia F2.0. Group 3: a 2% CH solution was applied before bonding with Panavia F2.0. Group 4: after CH application, the primed dentin was coated with a resin layer before cementation with Panavia F2.0. Group 5: (control) after applying Optibond Solo Plus, the inlays were cemented with Nexus 2. Group 6: after etching, CH was applied, and cementation was performed similarly to group 5. Half the specimens in each group were stored in distilled water for 24 hours, while the other half were stored in distilled water for 6 months. After storage, the teeth were placed in 1% methylene blue dye for 24 hours, sectioned, and evaluated under a 20× stereomicroscope. Dye penetration was scored using 0 to 3 criteria. Data were analyzed using nonparametric tests. Results : Resin coating of ED primer for Panavia F2.0 significantly reduced microleakage at the gingival margins after 6 months (p < 0.05). CH application in Panavia F2.0 did not lead to a significant difference in the microleakage at both margins, after 24 hours and 6 months (p > 0.05). The application of CH showed significantly less microleakage than that of the control group at the gingival margins of Nexus 2 after 6 months. In general, gingival margins showed more microleakage than occlusal margins. Conclusion: An additional resin layer applied to a self‐etch cement can improve long‐term dentinal sealing for indirect restorations, while CH cannot; however, CH reduces gingival microleakage in an etch‐and‐rinse cement after aging.     

Effect of Pretreatment and Activation Mode on the Interfacial Adaptation of Nanoceramic Resin Inlay and Self-adhesive Resin Cement

ObjectivesThe first objective of this study was to determine if the luting material used for resin nanoceramic inlay affects interfacial adaptation. The second was to investigate whether pretreatment and the adhesive curing method before cementation affects interfacial adaptation. The final objective was to compare activation modes of luting material.MethodsClass I cavities were prepared on extracted human third molars. Resin nanoceramic inlays were fabricated using Lava Ultimate CAD/CAM block (3 M). For the control groups, inlays were cemented using Panavia V5 (Kuraray Noritake). For the experimental groups, teeth were randomly divided into five experimental groups with four subgroups using different self-adhesive cements (SACs). Cement in Group I was dual-cured without pretreatment. In Group II, the cement was dual-cured after polyacrylic acid treatment of the tooth cavity. In Groups III and IV, the cement was dual-cured after universal dentin adhesive treatment with pre-cure and co-cure methods. In Group V, the inlay was cemented in self-cure mode. After thermocycling, interfacial adaptation at the inlay-tooth interface was measured using swept-source optical coherence tomography (SS-OCT) imaging. Finally, polymerization shrinkage strain of the luting material was measured and compared.ResultsInterfacial adaptation differed depending on the luting material. After application of a universal adhesive, some subgroups showed improved interfacial adaptation. Interfacial adaptation and polymerization shrinkage strain differed significantly depending on activation mode.SignificanceInterfacial adaptation for a resin nanoceramic inlay can differ according to the type of SAC and activation mode. For some SACs, application of a universal adhesive before cementation improves interfacial adaptation.