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.     

大块充填复合树脂后牙窝洞充填效果的回顾性研究

目的 分析高粘型大块充填复合树脂Filtek Bulk Fill、粘度可变型大块充填复合树脂SonicFill和分层复合树脂Filtek Z350用于后牙深龋窝洞充填的临床效果。方法 回顾分析2019年3月至2019年6月期间于南京大学医学院附属口腔医院牙体牙髓病科行后牙深龋窝洞充填的91例病例,根据治疗时使用的充填材料分为Filtek Bulk Fill(FB)组（n=31）、SonicFill(SF)组（n=27）、Filtek Z350(Z350)组（n=33）。比较三组的充填体术后超过1年的成功率,以及边缘着色、边缘适应性、继发龋、术后敏感等边缘密合性相关指标。结果 大块充填复合树脂在充填体成功率以及边缘密合性方面存在着优于分层复合树脂的趋势,但无统计学意义(均P>0.05)。结论 大块充填复合树脂可用于后牙深龋窝洞充填,且可获得略优于分层复合树脂的治疗效果。     

不同酸蚀条件下SonicFill~(TM)超声树脂修复后牙微渗漏的体外研究

目的自酸蚀和选择性酸蚀釉质处理下比较Sonic FillTM超声树脂充填系统与传统3M FiltekTMZ350树脂充填系统修复后牙Ⅱ类洞微渗漏程度的差别,为临床应用提供依据。方法在新鲜拔除的人上下颌恒磨牙制备Ⅱ类洞,随机分为4组,分别用3M Single Bond Universal粘接剂+3M FiltekTMZ350纳米树脂充填(A组)、37%磷酸选择性酸蚀洞壁釉质+3M Single Bond Universal粘接剂+3M FiltekTMZ350纳米树脂充填(B组)、Kerr Optibond Versa粘接剂+Sonic FillTM超声树脂充填(C组)、37%磷酸选择性酸蚀洞壁釉质+Kerr Optibond Versa粘接剂+Sonic FillTM超声树脂充填(D组)。标本经冷热温度循环、亚甲基蓝染色后,近远向沿长轴切片,体视显微镜下分别观察龈壁和侧壁染料渗漏情况。结果龈壁微渗漏程度B组低于A组、D组低于C组,C组低于A组、D组低于B组,差异均有统计学意义;侧壁微渗漏程度B组低于A组、D组低于C组,C组低于A组、D组低于B组,差异均有统计学意义。结论 Sonic FillTM超声树脂充填系统修复后牙Ⅱ类洞微渗漏程度轻于传统3M FiltekTMZ350树脂,临床上充填大体积Ⅱ类洞使用选择性酸蚀釉质的方法可进一步降低微渗漏程度。     

复合树脂充填近中(牙合)面洞颈壁边缘微渗漏的研究

目的:比较不同类型树脂充填近中(牙合)面洞的颈壁牙本质-牙骨质边缘微渗漏.方法:在36个新鲜拔除的人上下颌恒磨牙制备近中(牙合)面洞,随机分为3组,分别用3M后牙树脂P60、前后牙通用树脂Z250和纳米树脂z350充填.标本经温度循环,品红染色后,近中远中向沿长轴连续切3片,体视显微镜下观察染料渗漏情况.结果:3组微渗漏由小到大依次为:Z350<72500.05).结论:此3种树脂类型对近中(牙合)面洞颈壁牙本质-牙骨质边缘微渗漏无明显差异.     

Er:YAG激光和Nd:YAG激光辅助的牙漂白对树脂充填体粘接强度和边缘微渗漏的影响

目的：评价Er:YAG激光和Nd:YAG激光辅助的牙漂白对釉质表面树脂充填体粘接强度和边缘微渗漏的影响。方法：将离体牙制备成釉质测试试件（n=64）后随机分为4组（n=16），包括对照组、传统漂白组、Er:YAG激光辅助的漂白组和Nd:YAG激光辅助的漂白组。4组试件分别处理后，检测其釉质表面树脂充填体的剪切粘接强度（n=8）和微渗漏深度（n=8），利用体视显微镜观察各组试件的断裂模式。采用SPSS 26.0软件包对数据进行统计学分析。结果：与对照组相比，传统漂白后釉质表面树脂充填体的粘接强度显著下降，边缘微渗漏显著增加(P<0.05);Er:YAG激光辅助的漂白后釉质表面充填体的剪切粘接强度和微渗漏深度与对照组相比无显著差异（P>0.05）,Nd:YAG激光辅助的漂白后树脂充填体的剪切粘接强度显著下降（P<0.05），但其边缘微渗漏深度与对照组相比无显著差异(P>0.05)。4组试件的粘接断裂模式主要为粘接界面断裂。结论：相比传统漂白方法，激光辅助的牙漂白对树脂充填体粘接强度和微渗漏的影响较小，具有一定的临床优势。     

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;     

无机填料含量对流动树脂挠曲强度和压缩强度影响体外研究

目的 研究无机填料含量对流动树脂的挠曲强度和压缩强度的影响。方法 于2012年4月在北京大学口腔医学院口腔材料研究室测定Clearfil Flow、Filtek Flow、DenFil Flow、Filtek Z250复合树脂无机填料的质量分数、挠曲强度和压缩强度。结果 流动树脂中无机填料的质量分数与其挠曲强度的变化顺序相一致,由小到大依次为DenFil Flow、Filtek Flow、Clearfil Flow、Filtek Z250。DenFil Flow与其余3组间挠曲强度差异均有统计学意义（P < 0.05）,Filtek Flow与Clearfil Flow、Filtek Z250间挠曲强度差异亦均有统计学意义（P＜0.05）,但Clearfil Flow与Filtek Z250间挠曲强度差异无统计学意义（P＞0.05）。4种材料压缩强度差异均无统计学意义（P＞0.05）。结论 高填料型流动树脂的挠曲强度远高于普通流动树脂,并且可达到我国医药行业标准规定牙合面修复材料的要求;压缩强度与前后牙通用树脂相近,可以满足临床应用的需要。     

3种大块后牙充填树脂体外操作时间与微渗漏的对比观察

目的以传统分层充填树脂为对照比较3种大块充填后牙树脂体外充填所用时间及微渗漏的情况。方法选取符合纳入标准的第三磨牙40颗于面统一制备4 mm×4 mm×4 mm的Ⅰ类洞,随机分成A、B、C、D四组,分别用Sonic Fill超声充填树脂,Sure Fil SDR整层充填流动树脂,Tetric N-Ceram bulk Fill大块充填树脂,Filtek Z350后牙树脂充填,记录每次充填完成的时间,充填样本经冷热循环实验后置于印度墨水中浸泡24 h,干燥后沿样本近远中向剖开,于体视显微镜下观察样本染料渗入深度,并测量计数,进行统计学分析。结果四组操作时间的差异比较,A、B组差异无统计学意义(P>0.05),其余各组两两比较差异均有统计学意义(P<0.05),C组耗时最少,传统分层充填D组耗时最多。四组微渗漏均有发生,数值差异无统计学意义(P>0.05)。结论 3种后牙大块充填树脂均可达到与传统分层充填相同的边缘封闭性,且较后者操作时间短,操作简单。     

不同抛光时机对复合树脂边缘微渗漏的影响

目的:评价不同抛光时机对不同种类树脂边缘微渗漏的影响。方法:选择80颗离体恒前磨牙,在每颗牙的颊侧颈部釉牙骨质界处用高速涡轮机制备盒形单面洞,长和宽均为3mm,洞深2mm。按照使用树脂充填的种类分为Filtek Z350充填组和Filtek Z250充填组,每组再按照抛光与否及抛光时机分为不抛光组、充填后即刻抛光组、充填10min后抛光组和充填24h后抛光组。使用Sof-lex discs抛光系统对树脂进行抛光。实验样本经冷热循环后,在2%亚甲基蓝溶液中浸泡24 h,沿牙体长轴将充填体正中颊舌向纵行剖开,立体显微镜下观察剖面,采用Spot version4.6图像分析软件测量微渗漏深度。采用SPSS 17.0软件包对各组的微渗漏程度和深度分别进行Mann-Whitney U检验和Kroskal-Walis秩和检验。结果:Filtek Z350各组的边缘微渗漏深度分别为(0.655±0.486)mm、(0.626±0.497)mm、(0.648±0.370)mm和(0.639±0.453)mm。Filtek Z250各组的边缘微渗漏深度分别为(0.785±0.553)mm、(0.763±0.491)、(0.74...     

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。     

不同固化充填方法对Z350纳米树脂微渗漏和压缩强度的影响

目的 对比研究整体固化和分层固化充填方法 对光固化复合树脂微渗漏和压缩强度的影响。方法 选取下颌恒磨牙36颗,面中央制备标准Ⅰ类洞,随机分为3组。A组:整体固化充填;B组:水平分层固化充填;C组:斜向分层固化充填组。每组均用SingleBond2粘结,Z350纳米树脂充填,冷热循环500次,2%亚甲基蓝染色,沿牙体长轴颊舌向切片,体视显微镜下观察染料渗透情况。制备Z350整体固化及分层固化试样,万能材料试验机上测定材料的抗压缩强度。结果 微渗漏方面,A组最大,C组最小,三组之间比较皆有显著性差异(P<0.01)。抗压缩强度方面,A组最小,B组最大,A组与B组、C组比较有显著性差异(P<0.05),B、C组间无显著性差异(P>0.05)。结论 斜向分层充填技术既能减少微渗漏,又能保证树脂的抗压缩强度,是Ⅰ类洞树脂充填的首选方案。     

体外模型中3种光固化树脂充填体边缘微渗漏实验研究

目的：比较3种光固化充填材料在体外模型中充填体边缘的微渗漏程度。方法：在36颗离体的前磨牙颊侧颈部备洞。随机分为3组,每组12颗牙。分别充填3M前后牙通用树脂Valux Plus、流动性纳米复合树脂Z350、登士柏Esthet.XTM复合树脂。样本经温度循环,采用10g/L碱性品红染色后,颊舌向沿长轴连续切开,在体式显微镜下观察修复体与牙体洞壁间染料渗漏情况。结果：3种材料中流动性纳米复合树脂Z350微渗漏最小。前后牙通用树脂Valux Plus微渗漏最大。流动性纳米复合树脂Z350与其他两组相比有显著性差异（P〈0.01）。结论：流动性纳米复合树脂Z350是临床上充填颊侧颈部窝洞的较好材料。     

不同光固化充填材料边缘微渗漏比较研究

目的    评价不同光固化充填材料对窝洞充填修复边缘微渗漏的影响。方法    收集2015年6—12月于中国医科大学附属口腔医院就诊患者因正畸需要而拔除的健康前磨牙60颗,在牙体牙合面制备Ⅰ类洞型后将离体牙随机均分成3组,分别充填Z350树脂（A组）、预热后Z350树脂（B组）和SonicFill声波树脂（C组）。采用染料渗入法进行修复边缘微渗漏试验,在体视显微镜下检测洞壁的微渗漏情况。结果    各组样本均可见微渗漏,C组微渗漏程度明显小于A、B组,差异均有统计学意义（均P < 0.05）;而B组与A组的微渗漏程度差异无统计学意义（P > 0.05）。结论    3种光固化充填材料修复边缘都可能发生微渗漏,SonicFill声波树脂较Z350树脂充填可明显减少微渗漏的发生。     

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??Objective    To evaluate the effect of various light-cured filling materials on marginal microleakage. Methods    The cuboid class ?? cavities were cut in 60 freshly extracted human premolars for orthodontic purpose in the Hospital of Stomatology affiliated to China Medical University from June to December of 2015??and they were randomly divided into 3 groups??filled with Z350 ??group A????Z350 preheat ??group B?? and SonicFill resin ??group C??. After placement of the restorations??each specimen was sectioned buccolingually and then the microleakage at the margin was evaluated under a stereomicroscope. Results    There was microleakage in all 3 groups. The microleakage of  group C was significantly slighter than the other two groups??P < 0.05????but there was no significant difference between group A and B??P > 0.05??. Conclusion    Marginal microleakage occurs in each of the 3 groups. SonicFill is the dental filling material with lesser marginal microleakage.     

Effect of elastic cavity wall and occlusal loading on microleakage and dentin bond strength

OBJECTIVE: This study evaluated the effect of an unfilled-adhesive resin (Adper Single Bond) and a filled-adhesive resin (Adper Single Bond 2) with and without a low viscosity resin (Filtek Flow) as an elastic cavity wall on marginal leakage and dentin microtensile bond strength in Class V composite restorations under unloaded and loaded conditions. METHODS: V-shaped cavities were prepared on the buccal surfaces of 56 premolars lined with unfilled (Groups 1 and 3) or filled (Groups 2 and 4) adhesives with (Groups 3 and 4) and without (Groups 1 and 2) a low viscosity resin and restored with a resin composite. The restored teeth in each group were divided into two sub-groups for unloaded and loaded conditions with 50N loading force for 250,000 cycles parallel to the long-axis of the tooth. Five specimens from each group were cut bucco-lingually 0.7 mm thick and subjected to a dye leakage test for four hours using 2% methylene blue dye. The tested specimens were then trimmed into dumbbell shapes at the gingival margin and subjected to microtensile testing. The remaining two specimens were cut, embedded and observed for resin/dentin interfaces under a scanning electron microscope. RESULTS: For the microleakage test, there were no significant differences in microleakage among the groups on both the enamel and dentin margin. No statistically significant differences were found between microleakage of the loaded and unloaded groups on enamel margins for all materials. There were statistically significant differences between microleakage of the loaded and unloaded groups on the dentin margin for Groups 3 and 4. For the microtensile test, the significant difference was found between Groups 1 and 4 for the unloaded groups. For the loaded groups, there were no significant differences between Groups 1 and 2 and Groups 3 and 4. There were no statistically significant differences in microtensile bond strength between the loaded and unloaded groups except for Group 2. CONCLUSION: The application of filled adhesive or low viscosity resin had no influence on marginal leakage at both the enamel and dentin margin but it had an influence on the microtensile bond strength to dentin of Class V restorations. Occlusal loading significantly increased the degree of marginal leakage at the dentin margin when low viscosity was applied in combination with either unfilled or filled-adhesives, but it decreased dentin bond strength in the group treated with only filled adhesive.     

SonicFill系统对II类洞充填后微渗漏影响的研究

目的:探讨树脂充填系统SonicFill对Ⅱ类洞树脂充填后微渗漏的影响。方法:收集口腔颌面外科门诊拔除的各类恒磨牙15例,每例样本中2个Ⅱ类洞随机分为实验组、对照组。实验组:用SonicFill超声树脂充填系统充填窝洞;对照组:用HerculitePrécis纳米树脂斜向分层充填窝洞。500次冷热循环实验后保存于0.5%碱性品红溶液中,24 h后沿近远中向剖开,体视显微镜观察染色情况并记录评分(0-3);扫描电镜测量树脂与牙体组织间微缝隙宽度。轴壁和龈壁染料渗入深度采用Mann-Whitney U检验进行评估;采用两个样本t检验比较微缝隙的宽度,检验水准α设为0.05。结果:染料渗入评分结果表明:SonicFill组与对照组相比,染料渗入的深度明显不同,差异具有统计学意义(P＜0.05);各组内轴壁染料渗入深度明显少于龈壁(P＜0.05)。扫描电镜2000倍视野下微缝隙宽度测量结果表明:SonicFill组与对照组的微缝隙宽度存在明显不同,差异具有统计学意义(P＜0.01);各组内轴壁与龈壁相比,轴壁微缝隙的宽度明显小于龈壁(P＜0.01)。结论:SonicFill超声树脂充填系统能够有效减少Ⅱ类洞树脂充填术后微渗漏的发生。轴壁与龈壁相比,轴壁微渗漏明显小于龈壁。     

酸蚀和粘结对陈旧性树脂表面粘结强度的影响

目的：研究不同的表面处理方式对陈旧性树脂与新鲜树脂间粘结强度的影响。方法：制备Z350纳米树脂样本40例,浸泡于37℃蒸馏水2个月,表面经金刚砂车针研磨后随机分为4组：A组（对照组）表面未经处理;B组表面仅涂布粘结剂;12组表面仅37％磷酸酸蚀;D组表面37％磷酸酸蚀后涂粘结剂。上述表面处理后使用新鲜树脂完成样本制备。万能材料试验机上测定材料的微拉伸强度。结果：仅涂粘结剂组微拉伸强度最大,对照组次之,仅酸蚀组最小,酸蚀后涂粘结剂组与对照组间无显著性差异。结论：表面使用粘结剂可明显提高陈旧性树脂与新鲜树脂间的粘结强度。     

Shear strength evaluation of composite-composite resin associations

OBJECTIVE: The aim of this study was to investigate the shear strength between distinct associations of different commercial composite resins and their fracture modes. METHODS: Nine composite-composite associations (n=90) were prepared for shear strength evaluation and separated into the following groups: Z/Z (Filtek Z250 UD+Filtek Z250 A2); Z/D (Filtek Z250 UD+Durafill VS A2); Z/S (Filtek Z250 UD+Filtek Supreme YT); C/C (Charisma OA2+Charisma A2); C/D (Charisma OA2+Durafill VS A2); C/S (Charisma OA2+Filtek Supreme YT); H/H (Herculite XRV B2D+Herculite XRV B2E); H/D (Herculite XRV B2D+Durafill VS A2); H/S (Herculite XRV B2D+Filtek Supreme YT). Shear tests were carried out using universal mechanical test equipment with a load of 200kgf and speed of 0.5mm/min. Ultimate shear strength data (MPa) from all tested groups were submitted to analysis of variance (one-way ANOVA) and the Tukey test. The fractured surfaces of the test samples were visually evaluated by binocular stereomicroscope at 20 times magnification. Fractures were classified as either adhesive or cohesive or mixed. RESULTS: The highest ultimate shear strength observed for composite-composite associations was found for the groups: Z/Z, C/S, H/H, H/S, Z/S and C/C. Those associations containing the Durafill resin were weaker than the others. CONCLUSION: Microparticle RBC associations presented lower shear strength than hybrid and/or nanoparticle RBC associations, once the only significant difference was found when the Durafill resin was involved.