Nd:YAG激光对不同充填材料牙本质边缘微渗漏的影响

目的 评价Nd:YAG激光对不同充填材料与牙本质之间边缘微渗漏的影响。方法 选用人离体前磨牙36颗,制备V类洞,随机分为激光组和对照组,激光组使用80 rnJ、10 Hz脉冲Nd:YAG激光照射后,分别用全酸蚀粘接树脂、自酸蚀粘接树脂和玻璃离子充填洞型,对照组不使用激光,同样用如前所述的3种材料充填洞型。将所有标本浸泡在2%亚甲基蓝溶液中24 h后,用金刚砂片从颊舌向通过充填物中央纵向切开牙体,显微镜下观察龈壁染料渗透的深度。采用SAS8.0软件对数据进行统计学处理。结果 经Nd:YAG激光照射后尽管3种材料与牙本质之间微渗漏程度均有降低趋势,但只有玻璃离子组激光照射后较未照射组微渗漏降低具有统计学意义(P<0.05)。结论 脉冲Nd:YAG激光照射牙本质壁,在一定程度上可能会减少玻璃离子充填材料与洞壁的微渗漏。     

Nd: YAG激光对3种树脂水门汀与牙本质粘接强度的影响

目的观察Nd: YAG激光照射前后树脂水门汀-牙本质粘接界面的微观形貌特征,评价Nd: YAG激光对3种树脂水门汀与牙本质间粘接强度的影响。方法选择人离体前磨牙30颗,分为颊、舌两部分,将试件随机分为激光组和对照组。激光组以0.8 W、10 Hz脉冲Nd: YAG激光作用于牙本质表面25 s,联合3种树脂水门汀RelyX ARC、Panavia F和RelyX Unicem充填;对照组直接使用树脂水门汀充填。然后测试剪切强度,在根管显微镜下观察断裂模式并分类。另选人离体前磨牙6颗,按照标准的牙本质粘接面预备后,使用Nd: YAG激光照射3颗牙牙本质表面,并联合充填不同的树脂水门汀,用扫描电镜观察Nd: YAG激光照射前后树脂水门汀-牙本质界面的微观形貌变化。结果
激光照射可以提高自酸蚀树脂水门汀Panavia F和自粘接树脂水门汀RelyX Unicem与牙本质之间的剪切强度（P＜0.05）。激光会降低全酸蚀树脂水门汀RelyX ARC与牙本质间的剪切强度（P＜0.05）。根管显微镜下观察可见：试件断裂大部分发生在树脂水门汀-牙本质界面。扫描电镜观察可见：Nd: YAG激光照射后,全酸蚀亚组和自酸蚀亚组的混合层变薄、树脂突变短且少;自粘接亚组变化不明显,未见树脂突。结论Nd: YAG激光照射后,可提高Panavia F和RelyX Unicem与牙本质的剪切强度,建议临床联合应用。     

脉冲Nd:YAG激光用于磨损牙复合树脂粘接修复的临床观察

目的评价脉冲Nd：YAG激光联合自酸蚀粘接系统修复后牙面磨损的临床疗效。方法对15例患者的38颗后牙面磨损进行修复,要求每例患者至少有2颗磨牙或前磨牙有相似病损,试验组使用脉冲Nd：YAG激光联合AdperPromptL-Pop自酸蚀粘接剂,对照组直接使用AdperPromptL-Pop自酸蚀粘接剂,修复树脂为Z350光固化复合树脂,以改良美国公共卫生署标准评价修复后1、6、12个月的疗效。结果 12个月时试验组成功率为94.44%,对照组成功率为61.11%,2组的差异有统计学意义（P〈0.05）。1个月时试验组的牙髓牙本质反应好于对照组,差异有统计学意义（P〈0.05）;12个月时试验组的固位、边缘密合性好于对照组,差异有统计学意义（P〈0.05）。结论脉冲Nd：YAG激光处理后牙面磨损区可以提高光固化复合树脂与牙面的自酸蚀粘接力,降低术后敏感。     

两种复合树脂与牙本质剪切粘接强度的比较

目的 在离体牙牙本质上涂布粘接剂后分别予以声波技术充填 Sonicfill树脂及分层充填 P60树脂,评估应用两种复合树脂与牙本质的剪切粘接强度。方法 选择因牙周病拔除的磨牙 40颗,制成 40个牙本质试件,随机分为 2组。A 组为 Sonicfill树脂组,B 组为 P60树脂组。每组涂布粘接剂后,A 组采用声波技术充填树脂,B组采用分层技术充填树脂。经过循环温度为5 ℃及55 ℃的冷热循环疲劳试验,每个循环为3 min,共循环 500 次后,测试 2 组的剪切粘接强度（Shear Bond Strength,SBS）。结果 A 组的 SBS 为（10.32±1.13）MPa,B 组的 SBS 为（8.43±0.98）MPa,两者差别有统计学意义（P<0.05）。结论 运用声波技术的 Sonic‐fill树脂充填体相比采用分层充填的P60树脂拥有更高的剪切粘接强度。因此,在修复过程中使用声波充填技术不亚于传统分层充填树脂,且临床操作时间更短。     

Nd:YAG激光增加非龋性硬化牙本质全酸蚀粘接强度的实验研究

目的 通过微拉伸粘接强度实验,探讨激光对全酸蚀粘接剂处理后的非龋性硬化牙本质与复合树脂粘接强度的影响.方法 选择牙本质视觉分级为3级以上的(牙合)面磨损后牙10颗,每颗牙以低速锯垂直于牙本质表面,将硬化牙本质分为面积相等的两部分(约12 mm2),按随机数字表法将这两部分分为实验组和对照组,实验组经Nd∶YAG激光(1 W,10 Hz)处理后,使用Scotchbond (STB)酸蚀、涂布粘接剂Adper Single bond 2(ASB)联合Z350复合树脂充填,对照组使用STB酸蚀、涂布粘接剂ASB联合Z350复合树脂充填.置于37 ℃生理盐水中24 h后,制作微拉伸试件并测试微拉伸粘接强度,体视显微镜下观察断裂模式并分类.采用SPSS13.0软件对微拉伸粘接强度值做t检验.结果 实验组粘接强度[(26.11±1. 62)Mpa]显著高于对照组[(22.27±2.16)Mpa],差异有统计学意义(P=0.006).体视显微镜下可见断裂多发生于牙本质-树脂粘接面.结论 Nd∶YAG激光能够提高硬化牙本质与全酸蚀粘接系统的粘接强度.     

脉冲Nd:YAG激光照射牙本质后对光固化树脂充填体边缘微渗漏的影响

目的研究脉冲Nd：YAG激光照射牙本质后对光固化树脂充填体边缘微渗漏的影响，以探讨脉冲Nd-YAG激光在龋病治疗中的临床应用意义。方法选用正畸要求拔除的正常双尖牙30颗，随机分为A。B，C三组，每组10颗，用高速裂钻备洞（洞长、宽为3mm；洞深为2mm），A组为对照组，常规酸蚀树脂充填；B，C两组分别用50mJ，10Hz和100mJ，10Hz的脉冲Nd：YAG激光能量照射窝洞牙本质壁30s后树脂充填，分别用体视显微镜和扫描电镜观察充填体边缘和洞壁结合情况。结果．体视显微镜下观察：A组的牙本质洞壁与光固化树脂充填体间染料渗入较多，着色较深；B、C组的牙本质洞壁与光固化树脂充填体间染料渗入较少，着色较浅。扫描电镜下观察：B、C组的牙本质洞壁与光固化树脂充填体间裂隙明显小于未经激光处理的对照组。结论脉冲Nd：YAG激光处理牙本质后进行光固化复合树脂充填，可以减少充填体微渗漏，有利于充填的成功．     

脉冲Nd:YAG激光对非龋性硬化牙本质自酸蚀黏结强度的影响

目的:采用微拉伸黏结强度实验,比较脉冲Nd:YAG激光作用于硬化牙本质对复合树脂-硬化牙本质之间自酸蚀黏结强度的影响。方法:选择10颗硬化牙本质视觉分级均为3级以上的面磨损后牙,将磨损面硬化牙本质分为面积近似相等的两部分(约12mm2),随机分为实验组和对照组。实验组以1W、10Hz脉冲Nd:YAG激光作用于硬化牙本质表面,联合自酸蚀黏结剂Adper Prompt L-Pop处理和Z350复合树脂充填;对照组直接使用自酸蚀黏结剂Adper Prompt L-Pop处理硬化牙本质表面,并用Z350复合树脂充填。24h后制作微拉伸试件,测试微拉伸黏结强度,在体视显微镜下观察断裂模式并分类。采用SPSS13.0软件包对试件微拉伸黏结强度值做配对t检验。结果:实验组和对照组的微拉伸黏结强度分别为(18.94±6.81)MPa和(15.76±5.61)MPa。实验组复合树脂与硬化牙本质黏结强度高于对照组,差别有统计学意义(P0.05)。体视显微镜下观察,断裂多发生在黏结树脂-牙本质界面。结论:脉冲Nd:YAG激光处理硬化牙本质,能够提高复合树脂与硬化牙本质之间的自酸蚀黏结强度。     

Nd：YAP激光配合不同冲洗液对根管粪肠球菌消除作用的体外研究

目的 通过观察Nd：YAP激光分别与3% H₂O₂、3% NaClO溶液和2% CHX溶液3种临床常用的根管冲洗剂联合使用时,对根管内粪肠球菌的杀灭效果,为临床寻找更有效、更理想的根管消毒方法提供参考。方法 选取48颗成人单根管离体前磨牙,建立粪肠球菌感染根管模型,随机将其均分为6组并做不同处理。A组为生理盐水冲洗组,B组为3% NaClO溶液冲洗组（阳性对照组）,C组为Nd：YAP激光+3% NaClO溶液处理组,D组为Nd：YAP激光+2% CHX溶液处理组,E组为Nd：YAP激光+3% H₂O₂溶液处理组,F组为Nd：YAP激光+NS处理组。激光使用参数均为5 Hz,280 mJ,5 s。选用纸尖法取样,稀释培养48 h后,计算每个样本菌落形成单位（CFU）值。使用SAS 8.02统计软件对结果进行统计学分析。结果 B、C、D、E、F组的CFU值均显著低于A组（P<0.05）,表明该5组的杀菌效果优于A组,其中C、D组的杀菌效果最为显著。阳性对照组（B组）结果显著低于E、F组（P<0.05）,表明B组杀菌效果优于E、F组。而E、F组的CFU值之间的差异则无统计学意义（P>0.05）。结论 Nd：YAP激光在5 Hz,280 mJ的参数设定下对粪肠球菌具有显著的清除作用,明显优于单纯使用生理盐水冲洗;Nd：YAP/NaClO组和Nd：YAP/CHX组对粪肠球菌生物膜具有最为有效的清除作用。     

EverStick高强纤维树脂贴面用于四环素牙美容修复的临床评价

目的 探讨everStick高强纤维树脂贴面修复四环素染色牙的优势。方法 选取四环素染色牙患者20例（共80颗患牙），随机分为实验组（10例）和对照组（10例），按照树脂贴面修复的牙备要求对患者上颌4颗切牙进行牙体预备，实验组和对照组分别采用everStick高强纤维树脂材料（NET型）及3M光固化复合树脂材料制作成树脂贴面，利用Kerr全酸蚀粘接系统进行粘接。贴面完成后进行6~30个月、每次间隔6个月的临床随访，采用改良Ryge贴面复查标准及牙龈指数（GI）、龈沟出血指数（SBI）、菌斑指数（PLI）作为临床检查指标，观察贴面色彩稳定性、边缘适合性、邻接边缘变色情况、继发龋及牙周组织健康状况等，评价2种材料制成贴面的上述指标之间的差异是否具有统计学意义（P<0.05）。结果 在6~30个月、每次间隔6个月的临床随访中，实验组的修复体无松动脱落，无继发龋，边缘无明显染色，色泽稳定；对照组有5只贴面出现脱落，2只出现折裂，2组差别有统计学意义（P<0.05）；2组的牙龈指数（GI）、龈沟出血指数（SBI）、菌斑指数（PLI）结果中，实验组均低于对照组，差异有统计学意义（P<0.05）。结论 相比3M复合树脂材料，everStick高强纤维树脂材料用于四环素染色牙的贴面修复具有较好的机械强度，色泽稳定，对牙龈刺激小，有利于牙周组织健康。     

流体树脂材料用于固定修复牙体预备后暂时修复的临床效果

目的 评价临时冠用流体树脂材料在固定修复牙体预备后暂时修复中的临床应用效果。方法 选择来我院就诊的固定修复患者38例43个单位修复体,随机分为实验组和对照组,在完成牙体预备后,实验组采用流体树脂临时冠材料制作暂时修复体,对照组采用传统的自凝树脂材料制作暂时修复体,通过医师椅旁制作时间、边缘适合性、复诊时暂时修复体情况、牙龈状态及患者满意度5个方面对比暂时修复效果。结果 暂时冠粘接前2组修复体边缘适合性无显著性差异（P > 0.05）,实验组医师椅旁制作时间少于对照组,患者满意度较对照组高;复诊时暂时修复体情况及牙龈状态均优于对照组,2组差异有统计学意义（P ≤ 0.05）。结论 对于固定修复牙体预备后的暂时修复,选择流体树脂作为临时冠材料制作的暂时修复体可以达到更令人满意和实用的临床修复效果。     

The effect of thermocycling and dentine pre-treatment on the durability of the bond between composite resin and dentine

The high bond strength between restorative resin and dentine plays an important role in long-term performance of restorations in the oral environment. A variety of treatment techniques have been described to enhance the bond strength of composite resin to dentine. Unfortunately, few studies have reported available bond durability of adhesive resins to dentine. The purpose of this research was to study the shear bond strength of composite resin to dentine pre-treated with phosphoric acid, self-etching agent or Nd:YAP laser irradiation. The durability of bond strength between resin and dentine stored in the artificial saliva thermocycling between 5 and 55 degrees C was also evaluated. The scanning electron microscope was used to assess the treated-dentine surfaces. The mean value of the shear bond strength in the acid-etching group (18.2 +/- 4.9 MPa) was the highest among the three dentine treatments (self-etching system: 12.6 +/-3.0 MPa, Nd:YAP laser: 13.4 +/- 3.3 MPa) prior to thermocycling. After thermocycling, shear strength values of all treated dentines decreased with increasing number of the cycles. When subjected to 3000 thermocycles, the mean bond strengths of these pre-treated samples to composite resin became 9.1 +/- 1.4, 7.8 +/- 1.8, and 8.1 +/- 1.7 MPa for acid-etching, self-etching and laser-irradiation, respectively, with a significant reduction of 38-50%.     

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目的    研究G-BOND自酸蚀黏结系统用于牙颈部楔状缺损修复的临床疗效。方法    选择2009年3月至2010年3月在大连大学附属中山医院口腔科就诊的口内有多颗颊侧颈部楔状缺损牙的患者53例（共187颗患牙）,采用自身配对方法将患牙随机分为2组。试验组（94颗患牙）使用G-BOND自酸蚀黏结系统;对照组（93颗患牙）使用Adper Scotchbond全酸蚀黏结系统。治疗后7 d、6个月、12个月复查,以改良的美国公共健康部（USPHS）制定的评定系统标准记录修复效果,对各组患牙的治疗效果进行比较分析。结果    治疗后6个月失访2例,12个月失访3例。治疗后7 d、6个月、12个月两组修复体固位率均为100％,无脱落,无继发龋。在12个月时,试验组和对照组各有2、3颗患牙边缘完整性不佳和边缘着色,组间差异无统计学意义（P > 0.05）。在术后敏感方面,治疗后7 d复查试验组无敏感症状出现,对照组有4颗患牙出现了敏感症状,两组间差异具有统计学意义（P < 0.05）。结论    G-BOND自酸蚀黏结系统应用于修复楔状缺损的治疗效果可靠。     

Nd:YAP激光治疗干槽症的临床评价

目的 评价Nd:YAP激光治疗干槽症的临床疗效.方法 收集门急诊40例干槽症患者,随机分成观察组和对照组,彻底刮除坏死组织后,实验组采用Nd:YAP激光照射,对照组使用添加丁香油的碘仿纱条填塞,每3天治疗一次,比较2组治疗次数和每次治疗前疼痛评分,每次治疗前由同一位有经验的临床医师探查拔牙创愈合情况,检查局部是否有红肿...     

两种参数设置的激光联合氟化物治疗牙本质敏感症的临床评价

目的比较两种不同参数设置的激光联合氟化物治疗牙本质敏感症的临床效果。方法 60例患者,270颗面磨耗导致牙本质敏感症的患牙,随机分为:Nd:YAG激光治疗(A组)、Er:YAG激光治疗(B组)和多乐氟组(C组),根据激光输出功率不同分为低功率组(A1、A2、B1、B2组),高功率组(A3、A4、B3、B4组),其中A2,A4、B2,B4组为激光与多乐氟联用。采用数字化疼痛评判法(visual analogue scale, VAS)记录其在治疗前、治疗后5 min、1周、1个月、3个月和6个月的牙齿敏感程度,并进行统计学分析。结果各实验组治疗前VAS评分差异无统计学意义;A4组疼痛降低86.9%,明显优于其他实验组(P<0.01);A2、A4组(疼痛分别降低76.9%、86.9%)疗效优于A1、A3组(疼痛分别降低66.6%、73.7%),A3疗效优于A1组(P<0.01);Er:YAG激光治疗组是否联合氟化物治疗或增加输出功率对疗效无明显影响(P>0.05);A1、B1组疼痛降低(66.6%、62%)差异无统计学意义(P>0.05),A3、B3组仅在即刻(70...     

自酸蚀粘接系统和复合树脂修复牙体缺损的疗效比较

目的:比较自酸蚀粘接系统和复合树脂修复牙体缺损的效果。方法:随机抽取201颗患牙随机分为2组,治疗组101颗,采用自酸蚀底料的可乐丽菲露SEBOND及AP-X复合树脂修复牙体缺损;对照组100颗,应用Durafill釉质粘接剂及Charisma复合树脂修复。治疗后随访观察1、3、6个月,所得结果用四格表χ2检验。结果:治疗组修复体成功率达98%,而对照组则为90%,两组疗效有显著差异(P<0.05)。结论:应用自酸蚀粘接系统和复合树脂修复牙体缺损,可以获得较好的固位性能和边缘封闭性,值得在临床上推广。     

Er:YAG激光联合3M ESPE Adper Easy-one粘结剂堵塞牙本质小管的体外研究

目的:研究Er:YAG激光联合3M ESPE Adper Easy-one自酸蚀树脂粘结剂堵塞牙本质小管的效果,为其治疗牙本质敏感提供实验室依据。方法:选择因正畸需要拔除的牙体完整、无龋损的前磨牙8个,制备牙颈部牙本质小管暴露的牙本质样本32个,按处理方法不同随机分为4组:空白对照组、Er:YAG激光处理组、3M ESPE Adper Easy-one粘结剂处理组、Er:YAG激光、3M ESPE Adper Easy-one粘结剂联合处理组,扫描电镜下比较牙本质表面超微形态、纵断面的粘结剂牙本质界面的混合层、树脂突的微观表现,观察牙本质小管的堵塞效果。结果:Er:YAG激光联合3M ESPE Adper Easy-one粘结剂组与粘结剂组的堵塞牙本质小管的表面微观形态类似,牙本质小管被完全堵塞;激光处理组的牙本质小管基本完全堵塞;纵断面观察联合组粘结界面可见到清晰的混合层和树脂突,且树脂突深度较粘结剂组明显增加,激光组纵断面牙本质小管内无明显堵塞物。结论:Er:YAG激光与3M ESPE Adper Easy-one粘结剂联合处理能够有效的堵塞牙本质小管。     

Analysis of microleakage and marginal gap presented by new polymeric systems in class V restorations: An in vitro study

ObjectiveEvaluating the contraction of polymerization effect of silorane-based composite on dental interface in enamel.Materials and MethodsEighty class V cavities were confectioned in forty extracted molar teeth and restored with different combinations of resinous-based and bond system. They were divided into the following groups: (G1) three-step etch-and-rinse adhesive system and methacrylate-based resin, (G2) two-step etch-and-rinse adhesive system and methacrylate-based resin, (G3) Filtek P-90 self-conditioning adhesive system and methacrylate-based resin, (G4) Adper SE Plus self-conditioning adhesive system and methacrylate-based resin, (G5) three-step etch-and-rinse adhesive system and silorane-based resin, (G6) two-step etch-and-rinse adhesive system and silorane-based resin, (G7) Filtek P-90 self-conditioning adhesive system and silorane-based resin, (G8) Adper SE Plus self-conditioning adhesive system and silorane-based resin.ResultsGroup 7 showed lower marginal leakage when compared with all other groups (p = 0.001).ConclusionsThe results allows suggesting that silorane-based resinous system is adequate to promote more satisfactory marginal sealing than any other combination, since the system is combined with its own bond system.     

The clinical performance of one- and two-step self-etching adhesive systems at one year

BACKGROUND: The author compared the clinical performance of a two-step self-etching adhesive system and a one-step self-etching adhesive system over one year. METHODS: Thirty-five patients with noncarious cervical lesions were enrolled in the study. The author restored 163 lesions using a two-step (Clearfil Protect Bond, Kuraray, Osaka, Japan) or a one-step (Xeno III, Dentsply/DeTrey, Konstanz, Germany) self-etching adhesive system. Enamel margins were not beveled, and no mechanical retentions were placed. The author evaluted the restorations at baseline and at three, six, nine and 12 months after placement using modified Ryge criteria for color-matching ability, marginal discoloration, marginal adaptation, initial caries formation, anatomical form, postoperative sensitivity and retention loss. RESULTS: The author assessed the changes in the parameters using the Cochran Q test and the McNemar test at a significance level of .05. At one year, the retention rates for the restorations in the two-step group were 100 percent; they were 96 percent for the restorations in the one-step group. Of the retained 75 restorations from the one-step group, two had marginal discoloration and slight anatomical form problems. In both groups, color-matching ability and postoperative sensitivity remained excellent. CONCLUSION: The performance of both self-etching adhesive systems was excellent during this one-year clinical trial. However, the two-step system exhibited slightly better retention than the one-step system. CLINICAL IMPLICATIONS: The one- and two-step self-etching adhesive systems evaluated in this study provided excellent clinical retention in noncarious lesions without mechanical retention.     

Evaluation of a self-adhering flowable composite in terms of micro-shear bond strength and microleakage

Abstract

Purpose. The objective of this study was to evaluate dentin bond strength and microleakage of a self-adhering flowable resin with or without adhesive resin. Materials and methods. Dentin pieces were randomly assigned to three groups (n = 10): Group OR (Optibond+Revolution Formula 2 Flow); Group VF (Vertise Flow); and Group OVF (Optibond+Vertise Flow). Then specimens were stressed in shear at a cross-head speed of 1 mm/min until the bond failed. Moreover, microleakage was determined by restoring Class V cavities. A statistical analyses was carried out using Mann-Whitney U and Kruskal-Wallis tests (p < 0.05). Results. Group OVF specimens produced the highest mean shear bond strength. In addition, the results showed that the marginal seal in group VF was similar to that in group OR. Conclusion. Self-adhering flowable composite resin combined with adhesive resin provided stronger dentin bond strength and a better marginal seal than when it was used individually. VF is a useful material with an acceptable bond strength and marginal seal.