3M Single Bond Universal粘接系统对前牙E-max铸瓷贴面修复的远期疗效观察

目的:探究观察3M Single Bond Universal粘接系统对前牙E-max铸瓷贴面修复的远期疗效。方法:选择2017年5月-2019年5月笔者医院收治的需前牙E-max铸瓷贴面修复患者63例(患牙113颗)为研究对象,均行经典贴面修复,根据粘接系统的不同将患者分为观察组(患者21例,患牙40颗,采用3M Single Bond Universal粘接系统)、对照1组(患者21例,患牙36颗,采用VariolinkⅡ粘接系统)、对照2组(患者21例,患牙37颗,采用BISCO CHOICE 2粘接系统)。治疗后三组均于1周、3个月、12个月时进行随访,观察三组治疗后1周、3个月、12个月内贴面修复效果、贴面修复失败率及不良反应发生率。结果:术后1周,三组患者均无失败案例;对照1组存在2颗修复体保存完整度为Ⅰ级的患牙,对照2组存在3颗修复体保存完整度为I级的患牙,观察组未存在该类患者;术后12个月,观察组存在1颗修复体保存完整度Ⅱ级患牙,对照1组存在1颗保存完整度I级患牙,3颗修复体保存完整度Ⅱ级患牙,对照2组存在2颗保存完整度I级患牙,3颗修复体保存完整度Ⅱ级患牙。三组患者治疗效果比较,差异无统计学意义(P>0.05);术后1周、3个月、12个月三组贴面修复失败率比较,差异无统计学意义(P>0.05);随访期间内,三组患者不良反应情况比较差异均无统计学意义(P>0.05)。结论:对于前牙E-max铸瓷贴面修复患者,选取合适的适应证,并做好备牙步骤,3M Single Bond Universal与经典VariolinkⅡ粘接系统及BISCO CHOICE 2粘接系统治疗效果并无显著差异,值得在临床推广使用。

Exploration and preliminary clinical investigation of an adhesive approach for primary tooth restoration

The current study aims to investigate a suitable adhesive for primary tooth enamel. Shear bond strength(SBS)of primary teeth and the length of resin protrusion were analyzed using one-way ANOVA with Bonferroni multiple comparison tests after etching with 35% H_(3)PO_(4). SBS and marginal microleakage tests were conducted with Single Bond Universal(SBU)/Single Bond 2(SB2) adhesives with or without pre-etching using a nonparametric Kruskal-Wallis test. Clinical investigations were performed to validate the adhesive for primary teeth restoration using Chi-square tests. Results showed that the SBS and length of resin protrusion increased significantly with the etching time. Teeth in the SBU with 35% H_(3)PO_(4)pre-etching groups had higher bond strength and lower marginal microleakage than those in the SB2 groups. Mixed fractures were more common in the 35% H_(3)PO_(4)etched 30 s + SB2/SBU groups. Clinical investigations showed significant differences between the two groups in cumulative retention rates at the 6-, 12-and 18-month follow-up evaluations, as well as in marginal adaptation, discoloration, and secondary caries at the 12-and 18-month follow-up assessments.Together, pre-etching primary teeth enamel for 30 s before SBU treatment improved clinical composite resin restoration, which can provide a suitable approach for restoration of primary teeth.

不同浓度单宁酸在不同酸蚀模式下对通用型粘接剂粘接强度的影响

目的研究不同浓度单宁酸在全酸蚀与自酸蚀条件对通用型粘接剂在牙本质表面粘接强度的影响。方法将60颗无龋离体人磨牙置于存储盒中随机盲取分成2组(全酸蚀A组与自酸蚀B组,n=30),再将每组随机分为5个亚组(n=6)。在使用通用型粘接剂Single Bond Universal(SBU)前,在牙本质面分别涂抹浓度为0%(对照组)、25%、50%、75%和100%的单宁酸3 min并冲洗吹干。实验试件在37℃水中保存24 h后进行微拉伸强度测试(μTBSt)。使用Two-Way ANOVA与Games-Howell对数据进行统计学分析。用体式显微镜观察断裂面模式并在扫描电镜(SEM)下观察微拉伸试件的牙本质断端。结果在全酸蚀模式下,75%单宁酸组粘接强度[(34.51±8.43)MPa]与100%单宁酸组粘接强度[(36.16±5.20)MPa]显著高于其他各组(F=32.301,P<0.001);在自酸蚀模式下,25%单宁酸[(31.06±3.41)MPa]可显著提升SBU与牙本质粘接强度(F=23.570,P<0.001)。双因素分析结果证实,单宁酸浓度(F=23.134,P<0.001)与酸蚀模式(F=4.465,P=0.036)对粘接强度具有显著影响且两要素间显著相关(F=28.231,P<0.001)。断裂模式分析与电镜观察结果表明,在牙本质表面不同酸蚀模式与不同浓度单宁酸所形成的界面形态差异显著。结论在不同酸蚀模式下,不同浓度的单宁酸均可显著改善SBU与牙本质的粘接强度。