基于数字化设计和选区激光融化成形的个性化托槽粘接强度研究
摘要
目的研究基于数字化设计和选区激光融化成形技术制作的不锈钢合金个性化托槽的粘接强度,以确定其能否满足临床应用的要求。方法挑选因正畸治疗需要而拔除的完整前磨牙80颗,按随机数字表法分成2组,每组40个样本。第一组采用牙科三维激光扫描仪获取离体牙的数字模型,利用计算机辅助设计(CAD)和选区激光融化(SLM)技术,设计并制造出与患者牙冠形态高度匹配的不锈钢合金个性化托槽。第一组和第二组分别按常规方法粘接个性化托槽和普通不锈钢托槽(杭州普特网底直丝弓托槽)。每组再随机分为剪切实验亚组和拉伸实验亚组(每亚组20颗),采用电子万能材料测试仪进行剪切和拉伸实验,记录牙面粘接剂残留指数(ARI)计分值和托槽脱落时的最大载荷,并计算得到抗剪切强度和抗拉伸强度。结果个性化托槽组的抗剪切强度[(12. 38±3. 12)MPa]显著大于普通托槽组[(9. 16±2. 87)MPa](P <0. 05),抗拉伸强度[(13. 89±3. 76)MPa]与普通托槽组[(14. 33±4. 19)MPa]差异无统计学意义(P> 0. 05)。两组ARI计分值比较差异均无统计学意义(P> 0. 05)。结论本研究设计制作的个性化托槽抗剪切强度大于普通托槽,抗拉伸强度与普通托槽接近,其粘结强度能满足临床应用要求。
引文
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[15]邹道星,王泽敏,郭宏铭,等.选区激光融化成形钛合金个性化舌侧托槽粘接强度初探[J].中华口腔医学杂志,2013,48(7):419-422.DOI:10.3760/cma.j.issn.1002-0098.2013.07.009.
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[19]Dumbryte I,Jonavicius T,Linkeviciene L,et al.The prognostic value of visually assessing enamel microcracks:Do debonding and adhesive removal contribute to their increase?[J].Angle Orthod,2016,86(3):437-447.DOI:10.2319/021115-93.1.
[20]许翔.无托槽隐形矫治器附件三种粘接方法的效果研究[J].中国医师杂志,2018,20(2):281-283.DOI:10.3760/cma.j.issn.1008-1372.2018.02.036.
[2]白玉兴.三维数字化技术在正畸诊断和治疗设计中的应用[J].中华口腔医学杂志,2016,51(6):326-330.DOI:10.3760/cma.j.issn.1002-0098.2016.06.002.
[3]Guzman UA,Jerrold L,Vig PS,et al.Comparison of shear bond strength and adhesive remnant index between precoated and conventionally bonded orthodontic brackets[J].Prog Orthod,2013,14:39.DOI:10.1186/2196-1042-14-39.
[4]Andrews LF.The six keys to normal occlusion[J].Am J Orthod,1972,62(3):296-309.
[5]Andrews LF.The straight-wire appliance,origin,controversy,commentary[J].J Clin Orthod,1976,10(2):99-114.
[6]杨新海,曾祥龙.中国人正常合牙齿位置和形态[J].北京医科大学学报,1998,30(6):528-531.DOI:10.3321/j.issn:1671-167X.1998.06.016.
[7]Vadavadagi SV,Hombesh MN,Choudhury GK,et al.Variation in Size and Form between Left and Right Maxillary Central Incisor Teeth[J].J Int Oral Health,2015,7(2):33-36.
[8]张鹏,张弓,盛亚,等.纯钛个性化正畸托槽的设计与制造技术研究[J].口腔疾病防治,2017,25(4):216-222.DOI:10.12016/j.issn.2096-1456.2017.04.003.
[9]Weber DJ 2nd,Koroluk LD,Phillips C,et al.Clinical effectiveness and efficiency of customized vs.conventional preadjusted bracket systems[J].J Clin Orthod,2013,47(4):261-266;quiz 268.
[10]Brown MW,Koroluk L,Ko CC,et al.Effectiveness and efficiency of a CAD/CAM orthodontic bracket system[J].Am J Orthod Dentofacial Orthop,2015,148(6):1067-1074.DOI:10.1016/j.ajodo.2015.07.029.
[11]刘云峰,郑晓东,李伯休,等.基于SLM的个性化舌侧托槽的数字化设计与成型[J].浙江工业大学学报,2017,45(5):506-509.DOI:10.3969/j.issn.1006-4303.2017.05.007.
[12]Oz AA,Oz AZ,Arici S.In-vitro bond strengths and clinical failure rates of metal brackets bonded with different light-emitting diode units and curing times[J].Am J Orthod Dentofacial Orthop,2016,149(2):212-216.DOI:10.1016/j.ajodo.2015.07.036.
[13]Reynolds IR.A Review of Direct Orthodontic Bonding[J].Br J Orthod,2016,2(3):171-178.DOI:10.1080/0301228X.1975.11743666.
[14]Buyuk SK,Kucukekenci AS.Effects of different etching methods and bonding procedures on shear bond strength of orthodontic metal brackets applied to different CAD/CAM ceramic materials[J].Angle Orthod,2018,88(2):221-226.DOI:10.2319/070917-455.1.
[15]邹道星,王泽敏,郭宏铭,等.选区激光融化成形钛合金个性化舌侧托槽粘接强度初探[J].中华口腔医学杂志,2013,48(7):419-422.DOI:10.3760/cma.j.issn.1002-0098.2013.07.009.
[16]李曼,卞晶晶,侯志明.个性化舌侧托槽粘结强度的研究[J].中华口腔正畸学杂志,2014,21(1):32-36.DOI:10.3760/cma.j.issn.1674-5760.2014.01.08.
[17]Speer C,Zimny D,Hopfenmueller W,et al.Bond strength of disinfected metal and ceramic brackets:an in vitro study[J].Angle Orthod,2005,75(5):836-842.DOI:10.1043/0003-3219(2005)75[836:BSODMA]2.0.CO;2.
[18]Baherimoghadam T,Akbarian S,Rasouli R,et al.Evaluation of enamel damages following orthodontic bracket debonding in fluorosed teeth bonded with adhesion promoter[J].Eur J Dent,2016,10(2):193-198.DOI:10.4103/1305-7456.178296.
[19]Dumbryte I,Jonavicius T,Linkeviciene L,et al.The prognostic value of visually assessing enamel microcracks:Do debonding and adhesive removal contribute to their increase?[J].Angle Orthod,2016,86(3):437-447.DOI:10.2319/021115-93.1.
[20]许翔.无托槽隐形矫治器附件三种粘接方法的效果研究[J].中国医师杂志,2018,20(2):281-283.DOI:10.3760/cma.j.issn.1008-1372.2018.02.036.