表面封闭剂在复合树脂充填中对微渗漏的影响

Effect of surface sealants on the marginal permeability of composite resin filling

背景:许多学者在改进复合树脂和粘接剂的性能进行了大量的实验工作,但仍不能完全消除复合树脂充填体材料与牙体之间的微渗漏,微渗漏是影响牙体修复远期疗效的主要障碍之一。目的:观察Fortify Light-Cured表面封闭剂减少复合树脂修复体边缘微渗漏的作用。设计、时间及地点:对比观察实验,于2008-01/08在解放军四五八医院口腔科完成。材料:选择因正畸拔除的前磨牙45个,在每个牙齿的颊面颈部分别制洞,大小为3mm×3mm×2mm的长椭圆形窝洞,窝洞颌壁位于釉质,颈壁位于牙骨质。Fortify Light-Cured表面封闭剂为美国Bisco公司产品。方法:将实验牙随机分为3组:表面封闭剂组、粘结剂组、空白对照组,15颗/组。表面封闭剂组:用可乐丽菲露SE BOND牙质粘合用处理剂处理20s,中弱气流彻底干燥,涂布粘接剂,光照射10s,可乐丽菲露复合树脂充填,光照40s,调磨抛光后,牙质粘合用处理剂处理牙-树脂充填体表面,中弱气流彻底干燥,均匀涂布表面封闭剂,光照20s。粘结剂组:与表面封闭剂组处理方式相同,粘接剂均匀涂布代替表面封闭剂。空白对照组:也以同样的方式处理但调磨抛光后,将所有实验牙置于37℃生理盐水24h备用。主要观察指标:体式显微镜下测量染料渗入洞壁的深度,扫面电镜下观察树脂与牙体组织粘结面的情况。结果:复合树脂充填修复后使用表面封闭剂、粘接剂封闭充填体表面,边缘微渗漏明显减少。Kruskal-Wallis检验对3组树脂进行比较,差异均有显著性(P<0.05)。各组内冠侧壁与龈壁侧相比,冠侧壁略低于龈侧壁,但差异无显著性(P>0.05)。扫描电镜下观察可见,表面封闭剂组:树脂与牙体组织结合良好;粘结剂组:树脂与牙体组织间出现裂隙;空白对照组:树脂与牙体组织间出现裂隙,裂隙较粘结剂组明显。结论:使用表面封闭剂可减少微渗漏的程度。

BACKGROUND： Performances of composite resin and binder have been modified greatly; however, marginal permeability between composite resin filling material and teeth has been not completely resolved yet. Marginal permeability is a major factor to influence long-term therapeutic effect of teeth. OBJECTIVE： To evaluate the effect of surface sealants （Fortify light-cured） on the marginal permeability of composite resin filling. DESIGN, TIME AND SETTING： A contrast study was performed at the Department of Stomatology, the 458 Hospital of Chinese PLA between January and August 2008. MATERIALS： A total of 45 premolars resulting in deformed extraction were collected in this study. A pore sized 3 mm × 3 mm × 2 mm was drilled at buccal cervical surface of each tooth. Jaw wall of cavity was located in enamel, and cervical wall in cementum Fortify Light-Cured surface sealant was provided by Bisco Company, USA. METHODS： All 45 teeth were randomly divided into three groups： surface sealants group, binder group, and blank control group, with 15 teeth for each group. Surface sealants group： the teeth were treated with SE-BOND for 20 s, thoroughly dried with moderate and light air flow, covered with binder, light-irradiated for 10 s, filled with SE-BOND composite resin, light-irradiated for 40 s, polished, filled with resin, thoroughly dried with moderate and light air flow, evenly covered with surface sealants, and light-irradiated for 20 s. Binder group： the treatment was the same as surface sealants group except covering with binder. Blank control group： the teeth were maintained in saline for 24 hours at 37 ℃following polishing. MAIN OUTCOME MEASURES： Depth of composite resin filling material under somatotype microscopy; adhesion between resin and teeth under scanning electron microscopy. RESULTS： Marginal permeability decreased in the surface sealants and binder groups. Kruskal-Wallis test indicated that there were significant differences in marginal permeability between the three groups （P 〈 0.05）. Furthermore, marginal permeability at coronal wall was lower than gingival wall, but there was no significant difference between the two sides （P 〉 0.05）. Scanning electron microscopy indicated that adhesion was great in the surface sealants group; a leakage was observed in the binder group the leakage in the blank control group was wider than binder group. CONCLUSION： The application of surface sealants can effectively decrease the marginal permeability.