Gluma脱敏剂和Nd:YAG激光脱敏对充填体边缘密合性影响的对比研究

Microleakage Evaluation of the Use Gluma Desensitizer and Nd:YAG Laser Radiation before Filling Wedge Shaped Defects

目的:通过微渗漏实验和超微结构观察,比较Gluma脱敏剂和Nd:YAG激光脱敏对流体树脂充填楔状缺损后边缘密合性的影响。方法:选取30颗正畸拔除前磨牙随机分为对照组、Gluma组和Nd:YAG激光组,并制作楔状缺损洞型,对照组牙本质不作任何处理,Gluma组和Nd:YAG激光组分别用Gluma脱敏剂和Nd:YAG激光脱敏处理,涂布自酸蚀粘接剂,流体树脂充填,经热循环后用1%亚甲蓝染色,24h后将每个离体牙由颊舌侧沿牙体长轴切成三部分,体式显微镜下观察微渗漏情况,并用扫描电镜观察粘接界面的超微结构。结果:Gluma组微渗漏值最小,Nd:YAG激光组微渗漏值小于对照组,3组间充填体微渗漏差异均具有统计学意义(P<0.05)。扫描电镜下观察可见,对照组:树脂与牙体间结合较紧密,部分处可见小缝隙,粘接剂渗入牙本质小管间形成大量锯齿状的短突和少量细长圆柱形树脂突;Gluma组:树脂与牙体间结合紧密,无缝隙,牙本质小管被致密的栓塞样凝集物封闭,粘接剂层与凝集物层融为一体,混合层较宽;Nd:YAG激光组:树脂与牙体间结合紧密,可见一薄层粘接剂,未见明显树脂突。结论:Gluma脱敏剂和Nd:YAG激光脱敏均可减小楔状缺损充填后边缘微渗漏情况,增强流体树脂与牙体间的密合性,Gluma脱敏剂影响最大,Nd:YAG激光在减小龈壁微渗漏方面具有优势。

Objective：To evaluate the microleakage and internal seal of using Gluma desensitizer and Nd：YAG laser radiation be- fore filling wedge shaped defects. Methods：30 caries-free premolar teeth with wedge shaped defect cavity were randomly divid- ed into 3 groups. The experimental groups were treated with Gluma desensitizer and Nd..YAG laser radiation before filling, while the control group without any treatment of dentin surface. After thermo-cycling 10 teeth of each group were immersed in 1% methylene blue solution for 24 hours. The teeth were sectioned for evaluation of microleakage. Three teeth of each group were analyzed by SEM for internal adaptation between filling and dentin. Results：Gluma group showed the least microleakage and the best internal seal. Nd：YAG laser leaked less than the control group. The difference among 3 groups is significant（P（ 0.05）. Conclusion：Gluma desensitizer and Nd：YAG laser radiation can reduce the microleakage and improve the internal adap- tation between filling and dentin. Gluma desensitizer shows optimal effects. Nd..YAG laser is better in reducing the microleak- age of gingival margins.