流动复合树脂封闭法预防正畸治疗中牙釉质脱矿的研究
|
摘要
目的 本研究目的是通过临床对照实验，检验用光固化流动复合树脂封闭正畸托槽周边的牙釉质预防脱矿的疗效，用离体牙模拟实验检测封闭剂与牙釉质的粘接强度和密合度，为此封闭法的可行性提供理论依据。
方法 116名正畸患者，粘着托槽后，对其11、12、13号牙托槽周边的牙釉质用Single bond流动复合树脂封闭，设21、22、23号牙为对照组，对比正畸治疗完成后对照组和实验组牙釉质脱矿程度的差异。将30颗离体前磨牙均分为3组，牙釉质上分别粘着Singlebond流动复合树脂、京津釉质粘接剂涂剂+Single bond复合树脂、京津釉质粘接剂，检测各组材料的粘接抗剪强度，并观察发生断裂的部位。将9颗离体前磨牙均分为三组，牙釉质上分别粘着上述三种材料，用扫描电镜观察不同材料与牙釉质表面形成的粘接面。结果Single bond流动复合树脂封闭组与对照组比较，正畸治疗后牙釉质的脱矿减少，差异有显著性。Single bond流动复合树脂的粘接抗剪强度达13MPa，在与牙釉质粘接前，牙面预涂京津釉质粘接剂涂剂，Single bond流动复合树脂的抗剪强度没有出现显著性变化。Single bond流动复合树脂在牙釉质表面形成树脂突，但在结合面内有细小裂缝及孔隙。
结论用Single bond流动复合树脂封闭托槽周边牙釉质，能有效地
预防正畸过程中牙釉质脱矿，Single bond流动复合树脂与牙釉质的
粘接抗剪强度能够满足临床要求，保证封闭剂在牙面较长时间存
留。封闭剂与牙釉质的粘接面内存在微小孔隙，不排除边缘微渗漏
及致龋菌吸附的可能。京津釉质粘接剂涂剂对流动复合树脂与牙釉
质的粘接无明显影响。
Objective: Sealing the enamel around the brackets with Single bond light cured flowable composite resin, the effect of preventing decalcification was evaluated with clinical contrasting experimentation. Another experiment on the extracted teeth to examine the boning strength and adaptation between the sealing layer and enamel was carry out.
Methods: 116 othodontical patients were chosen to seal the enamel around the brackets of their IK 12. 13 teeth during the orthodontic treatment. Their 21. 22. 23 teeth were taken as control ones. The decalcification difference between the experiment group and the control group was determined. 30 extracted premolars which were randomly divided into three groups were respectively bonded with Single bond. Single bond plus the liquid of Jingjin enamel adhesive and Jingjin enamel adhesive to the enamel surface, Then the shear bonding strength was test. The position of the fracture was observed.9 extracted premolars which were randomly divided into three groups were respectively bonded with the three kinds of materials to the enamel surface. Then the interface was observed with the scanning electron microscope.
Results: Compared with the control group, the enamel decalcification reduced after they were sealed with Single bond flowable composite resin and there were satistically significant difference. The shear bonding strength of the flowable composite resin reached to 13 Mpa. Pretreating the surface of the premolars with the liquid of Jingjin enamel adhesive, the shear bonding strength of single bond didn't change significantly. Flowable composite resin formed resin tags on the enamel surface, with thin gaps or voids in their hybrid layer. Conclusions:Sealing the enamel around the brackets with Single bond flowable composite resin may prevent the enamel from decalcificationing during the orthodontic treatment. The shear bonding strength of the flowable composite resin may meet orthodontic clinic requirement. It can insure the sealant retention on the surface of the enamel for a long time. There were thin gaps or voids in the hybrid layer between the flowable composite resin and the enamel probably leading to marg
inal leakage and the adsorption of the germs. The liquid of Jingjin enamel adhesive doesn't obviously affect the bonding effect between the flowable composite resin and the enamel.
方法 116名正畸患者，粘着托槽后，对其11、12、13号牙托槽周边的牙釉质用Single bond流动复合树脂封闭，设21、22、23号牙为对照组，对比正畸治疗完成后对照组和实验组牙釉质脱矿程度的差异。将30颗离体前磨牙均分为3组，牙釉质上分别粘着Singlebond流动复合树脂、京津釉质粘接剂涂剂+Single bond复合树脂、京津釉质粘接剂，检测各组材料的粘接抗剪强度，并观察发生断裂的部位。将9颗离体前磨牙均分为三组，牙釉质上分别粘着上述三种材料，用扫描电镜观察不同材料与牙釉质表面形成的粘接面。结果Single bond流动复合树脂封闭组与对照组比较，正畸治疗后牙釉质的脱矿减少，差异有显著性。Single bond流动复合树脂的粘接抗剪强度达13MPa，在与牙釉质粘接前，牙面预涂京津釉质粘接剂涂剂，Single bond流动复合树脂的抗剪强度没有出现显著性变化。Single bond流动复合树脂在牙釉质表面形成树脂突，但在结合面内有细小裂缝及孔隙。
结论用Single bond流动复合树脂封闭托槽周边牙釉质，能有效地
预防正畸过程中牙釉质脱矿，Single bond流动复合树脂与牙釉质的
粘接抗剪强度能够满足临床要求，保证封闭剂在牙面较长时间存
留。封闭剂与牙釉质的粘接面内存在微小孔隙，不排除边缘微渗漏
及致龋菌吸附的可能。京津釉质粘接剂涂剂对流动复合树脂与牙釉
质的粘接无明显影响。
Objective: Sealing the enamel around the brackets with Single bond light cured flowable composite resin, the effect of preventing decalcification was evaluated with clinical contrasting experimentation. Another experiment on the extracted teeth to examine the boning strength and adaptation between the sealing layer and enamel was carry out.
Methods: 116 othodontical patients were chosen to seal the enamel around the brackets of their IK 12. 13 teeth during the orthodontic treatment. Their 21. 22. 23 teeth were taken as control ones. The decalcification difference between the experiment group and the control group was determined. 30 extracted premolars which were randomly divided into three groups were respectively bonded with Single bond. Single bond plus the liquid of Jingjin enamel adhesive and Jingjin enamel adhesive to the enamel surface, Then the shear bonding strength was test. The position of the fracture was observed.9 extracted premolars which were randomly divided into three groups were respectively bonded with the three kinds of materials to the enamel surface. Then the interface was observed with the scanning electron microscope.
Results: Compared with the control group, the enamel decalcification reduced after they were sealed with Single bond flowable composite resin and there were satistically significant difference. The shear bonding strength of the flowable composite resin reached to 13 Mpa. Pretreating the surface of the premolars with the liquid of Jingjin enamel adhesive, the shear bonding strength of single bond didn't change significantly. Flowable composite resin formed resin tags on the enamel surface, with thin gaps or voids in their hybrid layer. Conclusions:Sealing the enamel around the brackets with Single bond flowable composite resin may prevent the enamel from decalcificationing during the orthodontic treatment. The shear bonding strength of the flowable composite resin may meet orthodontic clinic requirement. It can insure the sealant retention on the surface of the enamel for a long time. There were thin gaps or voids in the hybrid layer between the flowable composite resin and the enamel probably leading to marg
inal leakage and the adsorption of the germs. The liquid of Jingjin enamel adhesive doesn't obviously affect the bonding effect between the flowable composite resin and the enamel.
引文
1 胡炜，王勤，傅民魁等．口腔正畸固定矫治器应用中牙釉质脱矿的临床调查．口腔正畸学 2001，8(2)：51
2 Artun J, Thylstrup A. 3-year clinical and SEM study of surface changes of carios enamel lesions after inactivation. Am J Orthod Dentofac Orthop 1989,95:327.
3 胡炜，王勤，傅民魁．矿化液、低浓度氟化物溶液和氟泡沫再矿化作用比较．口腔正畸学 2000，7(3)：115
4 Basdra EK, Huber H. Fluoride released from orthodontic bonding agents alters the enemel surface and inhibits enamel demineralization in vitro. Am J Orthod Dentofacial Orthop 1996 May, 109(5):466.
5 Wenderoth CJ, Weinstein M. Effectiveness of a fluoride releasing sealant in reducing decalcification during orthodontic treatment. Am J Orthod Dentofacial Orthop 1999 Dec, 116(6):629
6 Ogaard B, Larsson E. Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients. Am J Orthod Dentofacial orthop 2001 Jul, 120(1):28
7 Harazaki M, Hayakaw K. The Nd-YAG laser is useful in prevention of dental caries during orthodontic treatment. Bull Tokyo Dent coll 2001 May,42(2):79
8 Bayne SC, Thompson JY. A characterization of first generation flowable composites. J Am Dent Assoc 1998 May, 129(5):567
9 陈治清，管利民．口腔粘接学．北京：北京医科大学·中国协和医科大学联合出版社，1992：94、92
10 纪昌蓉，屠克庆等．京津釉质粘合剂在口腔正畸临床应用的评价．中华口腔医学杂志 1990，25(2)：76
11 Moon PC, Tabassian MS. Flow characteristics and film thickness of flowable resin composites. Oper Dent 2002 May Jun,27(3):248
12 Bayne SC, Taylor DE Pretection hypothesis for composite wear. Dent Mater 1992, 8(5):305
13 A A E1-Housseiny, N Farsi. Sealing ability of Single bond adhesive in primary teeth. An in vivo study. International Journal of Paediatric Dentistry 2002, 12:265
14 徐恒昌，王鸿颖，王同．探讨釉质粘合机制中的几个问题，中华口腔科杂志 1981，16(1)：6
15 Bishara S E, et al. Evaluation of a new light-cured orthodentic bonding adhesive. Am J Orthod 1998, 114:80
16 chung C H. shear bond strength of a resin reinforced glass ionomer cement:An in vitro comparative study. Am J Orthod 1999,115:52
17 Ferdianakis K. Microleakage reduction from newer esthetic restorative materials in permanent molars. J clin Pediatr Dent 1998, 23:221
18 邓晖．牙科粘合剂的湿性粘接．医学研究通讯 1999，28(12)：36
19 Kanca J. One step bond strength to enamel and dentin. American Journal of Dentistry 1997, 10:5
20 Xalabarde A. Garcia Gocloy F, et al. Microleakage of fissure sealants after occlusal enameloplasty and termocyling .J clin pediatr dent 1998,22:231
21 R Labella, P Lambrechts. Polymerization shrinkage and elasticity of flowable composites and filled adhesives. Dental materials 1999, 15:128
22 AC Obici, MAC Sinhoreti. Effect of the photo-activation method on polymerization shrinkage of restorative composites. Operative Dentistry 2002, 27:192
2 Artun J, Thylstrup A. 3-year clinical and SEM study of surface changes of carios enamel lesions after inactivation. Am J Orthod Dentofac Orthop 1989,95:327.
3 胡炜，王勤，傅民魁．矿化液、低浓度氟化物溶液和氟泡沫再矿化作用比较．口腔正畸学 2000，7(3)：115
4 Basdra EK, Huber H. Fluoride released from orthodontic bonding agents alters the enemel surface and inhibits enamel demineralization in vitro. Am J Orthod Dentofacial Orthop 1996 May, 109(5):466.
5 Wenderoth CJ, Weinstein M. Effectiveness of a fluoride releasing sealant in reducing decalcification during orthodontic treatment. Am J Orthod Dentofacial Orthop 1999 Dec, 116(6):629
6 Ogaard B, Larsson E. Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients. Am J Orthod Dentofacial orthop 2001 Jul, 120(1):28
7 Harazaki M, Hayakaw K. The Nd-YAG laser is useful in prevention of dental caries during orthodontic treatment. Bull Tokyo Dent coll 2001 May,42(2):79
8 Bayne SC, Thompson JY. A characterization of first generation flowable composites. J Am Dent Assoc 1998 May, 129(5):567
9 陈治清，管利民．口腔粘接学．北京：北京医科大学·中国协和医科大学联合出版社，1992：94、92
10 纪昌蓉，屠克庆等．京津釉质粘合剂在口腔正畸临床应用的评价．中华口腔医学杂志 1990，25(2)：76
11 Moon PC, Tabassian MS. Flow characteristics and film thickness of flowable resin composites. Oper Dent 2002 May Jun,27(3):248
12 Bayne SC, Taylor DE Pretection hypothesis for composite wear. Dent Mater 1992, 8(5):305
13 A A E1-Housseiny, N Farsi. Sealing ability of Single bond adhesive in primary teeth. An in vivo study. International Journal of Paediatric Dentistry 2002, 12:265
14 徐恒昌，王鸿颖，王同．探讨釉质粘合机制中的几个问题，中华口腔科杂志 1981，16(1)：6
15 Bishara S E, et al. Evaluation of a new light-cured orthodentic bonding adhesive. Am J Orthod 1998, 114:80
16 chung C H. shear bond strength of a resin reinforced glass ionomer cement:An in vitro comparative study. Am J Orthod 1999,115:52
17 Ferdianakis K. Microleakage reduction from newer esthetic restorative materials in permanent molars. J clin Pediatr Dent 1998, 23:221
18 邓晖．牙科粘合剂的湿性粘接．医学研究通讯 1999，28(12)：36
19 Kanca J. One step bond strength to enamel and dentin. American Journal of Dentistry 1997, 10:5
20 Xalabarde A. Garcia Gocloy F, et al. Microleakage of fissure sealants after occlusal enameloplasty and termocyling .J clin pediatr dent 1998,22:231
21 R Labella, P Lambrechts. Polymerization shrinkage and elasticity of flowable composites and filled adhesives. Dental materials 1999, 15:128
22 AC Obici, MAC Sinhoreti. Effect of the photo-activation method on polymerization shrinkage of restorative composites. Operative Dentistry 2002, 27:192