血液污染对新型托槽粘接剂微渗漏的影响

Effect of blood contamination on microleakage of orthodontic bracket bonding materials

背景:微渗漏增加继发龋和治疗结束后的敏感性,也增加了粘接剂-釉质界面白斑形成的可能性,但目前涉及托槽粘接材料微渗漏的报道很少。目的:以自酸蚀底胶+树脂加强型玻璃离子粘接剂为新型托槽粘接剂,观察血液污染对其粘接托槽时微渗漏的影响。设计、时间及地点:材料学对比观察,于2009-02在河北医科大学第二医院实验室完成。材料:因正畸需要而拔除的健康前磨牙50颗,杭州三比燕尾型托槽,自酸蚀底胶、37%磷酸、树脂加强型玻璃离子粘接剂,复合树脂釉质粘结剂,志愿者献血10mL。方法:50颗牙齿随机分为5组,10颗/组。磷酸复合树脂组:37%磷酸30s,喷枪彻底冲洗5s,吹干5s,用棉球蘸混合后的A、B底胶于牙面上,10s后将调好的适量复合树脂釉质粘接剂涂于托槽背板,将其置于牙面并稍加压,清除托槽周围的多余粘接剂。无污染对照组:自酸蚀底胶涂布30s,用树脂加强型玻璃离子粘接剂粘接托槽后照射。血液污染1组:在牙面上滴1滴血液,用气枪吹5s,自酸蚀底胶涂布30s,用树脂加强型玻璃离子粘接剂粘接托槽后照射。血液污染2组:自酸蚀底胶涂布30s,在牙面上滴1滴血液,用气枪吹5s,用树脂加强型玻璃离子粘接剂粘接托槽后照射。血液污染3组:自酸蚀底胶涂布30s,在牙面上滴1滴血液,用气枪吹5s,自酸蚀底胶涂布30s,用树脂加强型玻璃离子粘接剂粘接托槽后照射。主要观察指标:微渗漏值。结果:磷酸复合树脂组微渗漏值明显高于无污染对照组及血液污染组(P<0.05),无污染对照组与血液污染组间比较无明显差异(P=0.121)。龈端总体微渗漏值明显高于切端(P<0.000)。碱性品红溶液染色后去除托槽,在粘接剂-托槽界面上发生了贯通整个托槽的微渗漏。结论:与传统的磷酸复合树脂比较,自酸蚀底胶+树脂加强型玻璃离子粘接剂联合应用能明显降低托槽的微渗漏,且血液污染对其粘接托槽时的微渗漏无显著影响,龈端渗漏比切端严重。

BACKGROUND： Microleakage increases the likelihood of recurrent caries and postoperative sensitivity, which also increase the possibility of leukoplakia between the tooth or adhesive junction and interface. However, studies concerning microleakage of orthodontic bracket bonding materials are few. OBJECTIVE： To evaluate the effect of blood contamination on microleakage beneath brackets with newly adhesive system. DESIGN, TIME AND SETTING： The comparative observation was performed at the Second Hospital of Hebei Medical University in February of 2008. MATERIALS： Fifty extracted human premolars for orthodontic purposes; self-etching primer （SEP）; resin-modified glass ionomer cement （RMGIC）; 37% phosphoric acid; Composite resin adhesive; and 10 mL fresh human blood from a volunteer. METHODS： Fifty premolars were randomly divided into 5 groups, with 10 specimens in each group. Phosphoric-etching composite resin group： treated with 37% phosphoric acid for 30 seconds, jet gun spraying 5 seconds, followed by 5 seconds blow-dry; A, B base rubber were spread on porcelain surfaces and bonding with composite resin cement after 10 seconds. SEP-RMGIC control group： SEP treated for 30 seconds, and bonding with RMGIC; SEP-etching after contamination RMGIC group： blood contamination, jet gun spraying 5 seconds, SEP 30 seconds, and bonding with RMGIC; contamination after SEP-etching RMGIC group： SEP treated for 30 seconds, blood contamination, jet gun spraying 5 seconds, and bonding with RMGIC; contamination after SEP-etching and re-etched RMGIC group： SEP treated for 30 seconds, blood contamination, jet gun spraying 5 seconds, SEP 30 seconds, and bonding with RMGIC. MAIN OUTCOME MEASURES： The microleakage score. RESULTS： The micro-leakage score of phosphoric-etching composite resin group was higher than other groups （P 〈 0.05）, which was no significant difference between blood-contaminated groups and RMGIC control group （P =0.121）. The gingival microleakage was significant greater than the incisal one （P 〈 0.000）. There was more leakage between adhesive-bracket interfaces. CONCLUSION： Compared to conventional phosphoric-etching combined with composite resin, the SEP bonded with RMGIC can significantly decrease the microleakage, in addition, the Gingival microleakage is significant stronger than the incisal one, and blood-contamination has not affect the microleakage beneath brackets bonding with SEP and RMGIC.