自酸蚀粘结剂不同涂布方式对树脂充填效果的影响

Effect of Different Coating Methods of Self-etching Binder on Resin Filling Effect

目的采用体外及体内实验研究自酸蚀粘结剂不同涂布方式对树脂充填效果的影响。方法体外实验部分取120颗离体前磨牙,按粘结剂Adper Easy One不同的涂布方式分为Ⅰ、Ⅱ、Ⅲ 3组(n=40)。Ⅰ组粘结剂涂布1次;Ⅱ组粘结剂涂布1次后,再次蘸取粘结剂涂布第2次;Ⅲ组粘结剂涂布1次后静置20 s,再涂布第2次。随后3组静置、轻吹、固化,用Z350XT流动树脂充填。切割牙齿制备粘结树脂微拉伸试件,检测试件的粘结强度。体内临床研究部分选取60例前磨牙楔状缺损患者,共计150颗患牙,按体外实验方法分为A、B、C 3组(n=50),用改良USPHS评价标准评估6、12个月和18个月的复查结果,统计分析3组在充填体边缘密合度、边缘着色程度、充填体变色、脱落数目、继发龋等方面的差异。结果Ⅰ、Ⅱ、Ⅲ组的微拉伸强度(MPa)分别为(13.2±2.7)、(33.1±3.6)MPa和(22.6±6.4)MPa Ⅱ组与Ⅰ、Ⅲ组相比P<0.05)。临床随访第6个月和12个月各组评估指标差异无统计学意义(P>0.05),18个月后发现A、B、C 3组充填体脱落率分别为11%、2%和5%(B组与A、C组相比P<0.05);边缘不密合率分别为16%、5%和16%(B组与A、C组相比P<0.05);边缘着色率分别为30%、20%和21%;充填体变色率均为2%;继发龋发生率分别为5%、5%和7%。结论连续涂布两次自酸蚀粘结剂Adper Easy One后固化的粘结强度最高,临床上的充填效果更好。

Objective To study the effects of different coating methods on the resin filling effect by in vitro and in vivo experiments.Methods 120 in vitro premolars were taken from the in vitro experiment and divided into three groups Ⅰ、Ⅱ、Ⅲ according to the different coating methods of Adper Easy One(n=40). The group Ⅰ binder was applied once; the group Ⅱ binder was applied once, and the binder was applied again for the second time; the group Ⅲ binder was applied once and then allowed to stand for 20 seconds, and then coated for the second time. The three groups were then allowed to stand, lightly blown, solidified, and filled with Z350 XT flow resin. Cutting the teeth to prepare a bonded resin micro-tensile test piece, and detecting the bond strength of the test piece. In vivo clinical research selected 60 patients with wedge-shaped defects of premolars, a total of 150 teeth, according to in vitro experimental methods into three groups A, B, C(n=50), evaluated with improved USPHS evaluation criteria for 6, 12 month and 18-month review were statistically analyzed for differences in the margins of the filling body, the degree of edge coloration, the discoloration of the filling body, the number of shedding, and secondary sputum. Results The microtensile strengths of groups Ⅰ, Ⅱ and Ⅲ were(13.2±2.7),(33.1±3.6)MPa and(22.6±6.4)MPa, respectively(P<0.05 for group Ⅱ compared with groups Ⅰ and Ⅲ). There were no significant differences in the evaluation indexes between the 6 th and 12 th months of clinical follow-up(P>0.05). After 18 months, the A, B, and C filling rates were 11%, 2%, and 5%, respectively. Group B was compared with A and C groups(P<0.05); edge non-adhesion rate(%)was 16%, 5% and 16% respectively(P<0.05) in group B compared with group A and C); edge coloring rate were 30%, 20% and 21%respectively; the discoloration rate of the filling body was 2%; the incidence of secondary sputum was 5%, 5% and 7%, respectively.Conclusion The adhesive strength of the self-etching adhesive Adper Easy One after continuous application is the highest, and the clinical filling effect is better.