劲润牙本质保护膜防治牙体预备后牙本质敏感的近期疗效观察

目的评价劲润牙本质保护膜(Hybrid coat)对活髓基牙预备后牙本质敏感的防治效果。方法将54例(共115颗)进行固定桥修复行牙体预备的基牙,对缺牙区两侧基牙随机分组,试验组在牙体预备后表面用劲润牙本质保护膜处理,对照组牙体预备后不做任何处理,所有基牙均采用暂时冠修复,备牙后和10天试戴修复体时观察治疗效果,评定疗效,并对戴牙前评定的疗效进行统计学分析。结果经劲润牙本质保护膜处理过的基牙牙本质敏感症状明显改善,两次疗效比价,有效率差别有统计学意义(P<0.05)。结论劲润牙本质保护膜可以有效防治活髓基牙预备后的牙本质敏感症状,值得在临床上推广应用。     

牙本质保护膜防治活髓基牙牙本质过敏的观察

目的 评价在全瓷固定桥修复治疗中牙本质保护膜防治活髓基牙牙本质过敏的效果.方法 选择118例患者,236颗进行全瓷固定桥修复治疗的活髓基牙,平均分为2组,试验组基牙采用牙本质保护膜处理,对照组基牙采用质量分数75％氟化钠甘油处理,暂时冠桥修复,7d后观察应用效果.结果 牙本质保护膜的有效率为96.61％,75％氟化钠甘油的有效率为66.10％,2组有效率差异具有统计学意义(X2=18.10,P＜0.05).结论 在全瓷固定桥修复中,牙本质保护膜对防治活髓基牙牙本质过敏有较好的临床效果.     

即刻牙本质封闭对预备后牙本质敏感程度的影响

目的评价牙本质即刻封闭技术对牙体预备后活髓基牙牙本质敏感程度的影响。方法30例患者行后牙三单位固定义齿修复,每例口内有2颗活髓后牙参与实验,基牙随机分为实验组和对照组。实验组在基牙预备后行即刻牙本质封闭,随后取模。对照组在基牙预备后常规取模,不进行即刻牙本质封闭。1周后行最终修复,全冠粘接后1周、1个月、6个月、12个月和18个月时检查记录患者的牙本质敏感程度,并进行统计学分析。结果固定义齿粘接后1周及1个月,实验组出现敏感基牙数少于对照组（1周：Z=-1.88,P=0.03;1个月：Z=-2.15,P=0.02）。粘接后6、12及18个月两组敏感发生率间差异无统计学意义（6个月：Z=-0.69,P=0.30;12个月：Z=-0.41, P=0.69;18个月：Z=-0.42,P=0.52）。比较两组敏感程度结果显示,实验组敏感的基牙,敏感程度主要为1度;对照组主要为1度及2度。1周及1个月观察点两组疼痛程度差异有统计学意义（1周：P＜0.05,1个月P=0.027）。结论活髓基牙牙体预备后行即刻牙本质封闭,可有效降低术后短期内牙本质过敏的发生率,减小患者的术后不适感。     

舒适达牙膏治疗活髓基牙预备后牙本质敏感症的疗效观察

目的：探讨舒适达牙膏治疗活髓基牙预备后牙本质敏感症的疗效。方法：采用自身配对设计将63例患者126颗基牙随机分为舒适达牙膏治疗组和普通牙膏对照组,观察即刻、10d后、3个月后的临床疗效。结果：实验组各阶段的治疗有效率均显著高于对照组（P〈0.05）。结论：舒适达牙膏能有效缓解活髓基牙预备后的牙本质敏感症状。     

氟保护漆治疗基牙预备后牙本质过敏症124例疗效观察

目的    评价氟保护漆在治疗金属烤瓷全冠（PFM）修复中活髓基牙预备后牙本质过敏症的疗效。方法    选择2009年5月至2010年11月来德阳市口腔医院口腔修复科就诊的拟行PFM修复的患者124例（活髓基牙226颗）,按就诊顺序随机分为两组：试验组（65例,基牙116颗）采用氟保护漆脱敏;对照组（59例,基牙110颗）采用Gluma脱敏剂脱敏。分别于戴用PFM后即刻及3个月检测牙本质敏感状况。结果    戴用PFM后即刻,试验组有效率为84.48%,对照组有效率为80.91%,二者差异无统计学意义（P > 0.05）;3个月时,试验组有效率为93.97%,明显优于对照组（84.55%）（P＜0.05）。结论    氟保护漆可有效缓解PFM修复中活髓基牙预备后的敏感症状,值得临床广泛应用。     

格鲁玛用于活髓基牙预脱敏的疗效观察

格鲁玛 (Ｇｌｕｍａ)脱敏剂在牙本质过敏症的临床治疗中已经得到了广泛的应用 ,其疗效也得到很多口腔科医师的认可。烤瓷附熔金属全冠及其固定桥修复 ,基牙需要磨除较多牙体组织 ,引起牙本质暴露 ,活髓基牙往往可产生牙本质过敏症状。我科采用格鲁玛 (Ｇｌｕｍａ)脱敏剂对牙体制备后的活髓基牙进行预脱敏处理 ,并对疗效进行观察 ,结果如下 :材　料　与　方　法1　资料来源 :　选择 1998年 5月～ 1999年 5月来口腔修复科门诊做烤瓷附熔金属全冠和固定桥修复的患牙 82例 ,共 192颗活髓牙 (其中对照组 94颗 ) ,牙体制备后均对冷热刺激或机械刺…     

氟保护漆预防活髓基牙预备后牙本质过敏的临床观察

目的:评价氟保护漆对活髓基牙预备后牙本质过敏的治疗效果。方法:将56例176颗基牙随机分为两组,氟保护漆组90颗基牙用氟保护漆治疗,氟化钠甘油组86颗患牙用75%氟化钠甘油治疗。结果:氟保护漆组有效率为91.11%,氟化钠甘油组有效率为77.90%,两者之间比较有显著性差异(P<0.05)。结论:氟保护漆对活髓基牙预备后牙本质过敏有较好的治疗效果。     

氟保护剂和极固宁TM对活髓基牙预备后牙本质过敏症的防治效果

目的评价氟保护剂和极固宁TM对烤瓷冠桥活髓基牙预备后牙本质过敏症的防治效果.方法对118例246颗活髓基牙预备后,随机分为3组,即氟保护剂组(实验Ⅰ组)、极固宁TM组(实验Ⅱ组)和临时冠组(对照组),分别用氟保护剂+临时冠、极固宁TM+临时冠和临时冠处理,观察其处理后的脱敏效果.采用F检验进行统计学分析(DPS数据处理系统V6.01).结果脱敏后1周,烤瓷冠桥黏固时和1个月后的疗效,实验Ⅰ、Ⅱ组与对照组均有着显著性差异(P＜0.05);而实验Ⅰ组和实验Ⅱ组均无显著性差异(P＞0.05).结论氟保护剂和极固宁TM对预防烤瓷冠桥活髓基牙预备后牙本质过敏有着较为理想的疗效,其操作简单,值得推广应用.     

可乐丽菲露SE BOND防治固定义齿基牙牙本质过敏的疗效观察

目的 探讨评价可乐丽菲露SE BOND对活髓基牙预备后牙本质过敏症的防治效果。方法 将118例(共238颗基牙)行冠桥固定修复的患者随机分为可乐丽菲露SE BOND组、Gluma脱敏剂组(对照组)、75%NaF组(对照组)3组,所有基牙采用暂时冠修复、氧化锌丁香油酚粘固剂粘固。7～10d后试戴修复体,观察治疗效果,并进行统计学分析。结果 经3种药物处理过的基牙过敏症状均有明显改善,可乐丽菲露SE BOND组(有效率95.18%)的疗效优于75%NaF组(有效率56.58%,P<0.05),而可乐丽菲露SE BOND组和Gluma脱敏剂组(有效率92.41%)间则无统计学差异(P>0.05)。结论 可乐丽菲露SE BOND可以有效防治全冠活髓基牙预备后牙本质过敏症的发生。     

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目的评价氟保护漆在治疗金属烤瓷全冠（PFM）修复中活髓基牙预备后牙本质过敏症的疗效。方法选择2009年5月至2010年11月来德阳市口腔医院口腔修复科就诊的拟行PFM修复的患者124例（活髓基牙226颗）。按就诊顺序随机分为两组：试验组（65例,基牙116颗）采用氟保护漆脱敏;对照组（59例,基牙110颗）采用Gluma脱敏剂脱敏。分别于戴用PFM后即刻及3个月检测牙本质敏感状况。结果戴用PFM后即刻,试验组有效率为84．48％,对照组有效率为80．91％,二者差异无统计学意义（P〉0．05）;3个月时,试验组有效率为93．97％,明显优于对照组（84．55％）（P〈0．05）。结论氟保护漆可有效缓解PFM修复中活髓基牙预备后的敏感症状,值得临床广泛应用。     

Early bond strength of luting cements to a precious alloy.

Previous studies have reported that glass-ionomer and adhesive resin cements can bond to various alloys, while zinc phosphate cements lack this adhesive property. This study evaluated the bonding properties of three luting cements during the first seven days after cementation. Thirty cylinders were cast with a high-noble porcelain-fused-to-metal (PFM) alloy and luted in pairs with one of the cements. The joints were stored in water at 37 degrees C for one, two, or seven days before being fractured in shear. The cylinders were re-used to provide 40 joints within each test group. The data were subjected to a Weibull analysis, a curve-fitting method shown to be appropriate for comparing the bond strengths of dental materials. The results showed that the zinc phosphate cement was the weakest material, whereas the adhesive resin produced the strongest joints. Microscopic observations of the fractured samples did not reveal any specific differences between the samples in terms of their mechanism of fracture. The glass-ionomer cement reached its maximum bond strength after two days, whereas storage time had no influence on the zinc phosphate cement. The adhesive resin cement was slightly, but not significantly, weaker after one week in water. We suggest that excessive loading of restorations cemented with glass ionomer should be avoided for the first two days after the placement. The use of an adhesive resin cement can be recommended on endodontically treated teeth, but further studies are needed to evaluate its biocompatibility and adhesion to dentin.     

Retention of CAD/CAM All‐Ceramic Crowns on Prefabricated Implant Abutments: An In Vitro Comparative Study of Luting Agents and Abutment Surface Area

Purpose: Previous studies considering retention of cast metal restorations to implant abutments incorporated some degree of frictional fit due to internal surface nodules and roughness of the restoration. In comparison, CAD/CAM restorations have minimal surface irregularities, possibly impacting retention. There is insufficient knowledge of retentive force of CAD/CAM restorations to titanium abutments, and therefore the topic warrants further investigation. This in vitro study investigated the retention of all‐ceramic CAD/CAM restorations to three different prefabricated implant abutments using five different cements. Materials and Methods: A total of 150 Astra Tech dental implant abutments were used, with each group of 50 being subdivided into five groups of 10. An optical impression of each size of abutment was made with the CEREC 3D intraoral camera. A full‐coverage restoration was designed and milled with an enlarged, conical‐shaped occlusal surface, which served to secure the restoration into a brass jig used with a universal testing machine. Five different cements were used with three different‐sized abutments. Following cementation, the implant/abutment/restoration assemblies were stored for 24 hours at 37°C in 100% humidity. A pull‐out test using a universal testing machine, set at a 0.5 mm/min crosshead speed, was used to evaluate retention of the individual restorations. The load required to remove each all‐ceramic restoration was recorded. Retention values were analyzed using ANOVA and Fisher's PLSD multiple comparisons test at the 0.05 level of significance. Results: Peak loads for two provisional cements and a resin‐modified glass ionomer cement ranged from 56 N to 127 N. Peak loads for two resin cements ranged from 184 N to 318 N. Two‐way ANOVA showed significant effects upon retentive forces for both the cement and abutment design. Post hoc Fisher's PLSD multiple comparisons test found significant differences in retention for 7 of the 10 pairings of cements at a 0.05 level of significance. In addition, Fisher's PLSD multiple comparisons test found significant differences between Astra Tech Direct Abutments 4 and Astra Tech Direct Abutments 5 as well as Astra Tech Direct Abutments 4 and Astra Tech Direct Abutments 6 at a 0.05 level of significance. No significant difference was found between Astra Tech Direct Abutments 5 and Astra Tech Direct Abutments 6. Conclusions: Of the five cements tested, the most retrievable CAD/CAM restorations were luted with Temp Bond NE and Improv Temporary Cement. Resin‐modified glass ionomer retentive forces were closer to those of the “temporary cements” than those of the permanent adhesive‐resin cements. The abutment surface area became less important when using adhesive‐resin cements. Retention of CAD/CAM all‐ceramic restorations to prefabricated abutments has not been reported in the literature. This in vitro study demonstrated clinically significant variation among the selected cements used to retain all‐ceramic CAD/CAM restorations to implant abutments. In addition, abutment size influenced the retention of all‐ceramic CAD/CAM restorations.     

Retention of cast crown copings cemented to implant abutments

Background: The cementation of crowns to dental implant abutments is an accepted form of crown retention that requires consideration of the properties of available cements within the applied clinical context. Dental luting agents are exposed to a number of stressors that may reduce crown retention in vivo, not the least of which is occlusal loading. This study investigated the influence of compressive cyclic loading on the physical retention of cast crown copings cemented to implant abutments. Methods: Cast crown copings were cemented to Straumann synOcta titanium implant abutments with three different readily used and available cements. Specimens were placed in a humidifier, thermocycled and subjected to one of four quantities of compressive cyclic loading. The uniaxial tensile force required to remove the cast crown copings was then recorded. Results: The mean retention values for crown copings cemented with Panavia‐F cement were statistically significantly greater than both KetacCem and TempBond non‐eugenol cements at each compressive cyclic loading quantity. KetacCem and TempBond non‐eugenol cements produced relatively low mean retention values that were not statistically significantly different at each quantity of compressive cyclic loading. Compressive cyclic loading had a statistically significant effect on Panavia‐F specimens alone, but increased loading quantities produced no further statistically significant difference in mean retention. Conclusions: Within the limitations of the current in vitro conditions employed in this study, the retention of cast crown copings cemented to Straumann synOcta implant abutments with a resin, glass ionomer and temporary cement was significantly affected by cement type but not compressive cyclic loading. Resin cement is the cement of choice for the definitive non‐retrievable cementation of cast crown copings to Straumann synOcta implant abutments out of the three cements tested.     

Comparative Analysis of Postcementation Hypersensitivity with Glass Ionomer Cement and a Resin Cement: An in vivo Study

Aim: The aim of this clinical study was to compare the postoperative sensitivity of abutment teeth restored with full coverage restorations retained with either conventional glassionomer cement (GIC) or resin cement. Materials and methods: Fifty patients received full-coverage restorations on vital abutment teeth. Of these, 25 were cemented with GIC (GC Luting and Lining cement) and the other 25 using an adhesive resin cement (Smartcem 2). A randomized single blind study was undertaken for acquiring and evaluating the data. The teeth were examined before cementation, after cementation, 24 hours postcementation and 7 days postcementation. A visual analog scale was used to help the patient rate hypersensitivity. Results: The statistical analysis of the result was done using students paired t-test. No statistically significant difference between Smartcem 2 and GIC was observed, when tested immediately and 24 hours after cementation. Statistically significant difference was seen between Smartcem 2 and GIC when tested 7 days postcementation with a significance level of 0.05. Higher postoperative sensitivity was seen with GIC when compared to resin cement. Conclusion: In this study, the incidence of postoperative hypersensitivity after cementation of full-crown restorations with GIC and resin cement was similar when tested immediately. However, 7 days postcementation, abutments with GIC showed higher response compared to resin cement. Clinical significance: A self-adhesive resin cement can be the material of choice for luting if presence of postoperative sensitivity is of prime consideration. In case GIC is being used, patient should be informed about the presence of sensitivity for a more prolonged period than with resin cement. Keywords: Resin cement, Hypersensitivity, Visual analog scale, Full-coverage restoration. How to cite this article: Shetty RM, Bhat S, Mehta D, Srivatsa G, Shetty YB. Comparative Analysis of Postcementation Hypersensitivity with Glass Ionomer Cement and a Resin Cement: An in vivo Study. J Contemp Dent Pract 2012;13(3): 327-331. Source of support: Nil Conflict of interest: None declared.     

Cytotoxicity of substances leached or dissolved from pulp capping materials

AIM: To evaluate the cytotoxic effects of substances leached or dissolved from pulp capping materials on human pulp fibroblasts. METHODOLOGY: The substances were applied to cell cultures in conditioned media. The experimental groups were: GI (control; n = 24)--cultures treated with fresh medium; GII (n = 24)--cultures treated with calcium hydroxide cement; GIII (n = 24)--cultures treated with adhesive resin and GIV (n = 24)--cultures treated with 37% orthophosphoric acid. The media were conditioned by placing the crude materials in contact with fresh culture medium for 1 h. The cytotoxicity analysis was performed using the Trypan blue dye exclusion assay at times of 0, 6, 12 and 24 h for cell viability assay, and at 1, 3, 5 and 7 days for survival assay. Data were treated by anova (P < 0.05) and Tukey's test (P < 0.05). RESULTS: GI and II presented similar cell viability and cell growth. GIII and IV exhibited statistically significant lower percentages of cell viability: GIV only at the 0 h experimental time, whereas in GIII this viability markedly diminished reaching values of 10% by 12 h. Cell growth was impaired only in cultures of GIII. CONCLUSIONS: Substances dissolved from the adhesive system tested were cytotoxic for human dental pulp fibroblasts in culture, whilst substances leached from calcium hydroxide were biocompatible.     

冷热循环对粘接剂与种植固定桥粘接力的影响

目的:研究冷热循环对不同粘接剂与种植体支持的双端固定桥粘接力的影响。方法:3D打印制作种植体支持的钴铬合金双端固定桥共48个,分为复合树脂粘接剂(SAC)组即A组和树脂加强型玻璃离子水门汀 (Luting 2)组即B组,每个粘接剂组又按冷热循环次数分为0次(A1、B1)、2500次(A2、B2)、5000次(A3、B3)、10000次(A4、B4)等4个亚组。将基台固定于替代体上,完成固定桥的粘接后将所有试件浸泡于人工唾液中,37℃恒温水浴24h.A1、B1,A2、B2,A3、B3,A4、B4实验组分别冷热循环0次、2500次、5000次、10000次后进行拉伸试验测试粘接力(N)。结果:冷热循环前后SAC的粘接力均大于Luting 2 (P＜0.05);冷热循环2500次后两种粘接剂的粘接力下降不明显(P＞0.05);冷热循环5000次、10000次后两种粘接剂的粘接力均明显下降(P＜0.05)。结论:本实验条件下,SAC的粘接性能优于Luting 2。     

Implant‐Supported Fixed Dental Prostheses with CAD/CAM‐Fabricated Porcelain Crown and Zirconia‐Based Framework

Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porcelain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed. The aim of this report was to describe the clinical application of a newly developed implant‐supported FDP fabrication system, which uses PAZ, and to evaluate the outcome after a maximum application period of 36 months. Implants were placed in three patients with edentulous areas in either the maxilla or mandible. After the implant fixtures had successfully integrated with bone, gold‐platinum alloy or zirconia custom abutments were first fabricated. Zirconia framework wax‐up was performed on the custom abutments, and the CAD/CAM zirconia framework was prepared using the CAD/CAM system. Next, wax‐up was performed on working models for porcelain crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive resin cement, and the PAZ was cemented. Cementation of the implant superstructure improved the esthetics and masticatory efficiency in all patients. No undesirable outcomes, such as superstructure chipping, stomatognathic dysfunction, or periimplant bone resorption, were observed in any of the patients. PAZ may be a potential solution for ceramic‐related clinical problems such as chipping and fracture and associated complicated repair procedures in implant‐supported FDPs.     

Fatigue resistance and failure mode of CAD/CAM composite resin implant abutments restored with type III composite resin and porcelain veneers

Objectives: This study assessed the fatigue resistance and failure mode of type III porcelain and composite resin veneers bonded to custom composite resin implant abutments. Material and methods: Using the CEREC 3 machine, 28 composite resin implant abutments (Paradigm MZ100) were fabricated along with non‐retentive type III veneers, milled either in ceramic Paradigm C (n=14) or in composite resin Paradigm MZ100 (n=14). The intaglio surfaces of the veneers were hydrofluoric acid etched and silanated (Paradigm C) or airborne‐particle abraded and silanated (MZ100). The fitting surface of the abutments was airborne‐particle abraded, cleaned, silanated and inserted into a bone level implant (10 mm, BLI RC). All veneers were luted with adhesive resin (Optibond FL) and a preheated light curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz, 30° angle) was simulated, starting with a load of 40 N, followed by stages of 80, 120, 160, 200, 240 and 280 N (20,000 cycles each). Samples were loaded until fracture or to a maximum of 140,000 cycles. Groups were compared using the life table survival analysis (Log rank test at P=0.05). Previously published data using same‐design zirconia abutments were included for comparison. Results: Paradigm C and MZ100 specimens fractured at an average load of 243 and 206 N (survival rate of 21% and 0%), respectively, with a significant difference in survival probability (P=0.02). Fractured specimens presented mixed failure modes and solely adhesive failures were not observed. The survival of composite resin abutments was similar to that of identical zirconia abutments from a previous study (P=0.76). Conclusions: Non‐retentive porcelain veneers bonded to custom composite resin implant abutments presented a higher survival rate when compared with composite resin veneers. Survival of composite resin abutment did not differ from zirconia ones. To cite this article:
Magne P, Oderich E, Boff LL, Cardoso AC, Belser UC. Fatigue resistance and failure mode of CAD/CAM composite resin implant abutments restored with type III composite resin and porcelain veneers.
Clin. Oral Impl. Res. 22 , 2011; 1275–1281.
doi: 10.1111/j.1600‐0501.2010.02103.x     

复合树脂嵌体经离体光照固化后修复牙体严重缺损的临床研究

目的：探讨一种适宜的修复牙体严重缺损的方法。方法:复合树脂嵌体经离体光固化后再黏结修复，并与其它传统修复方法比较。结果：1－1．5年临床效果显示：离体光照优于在体光照、银汞合金充填或离子充填。结论：光固化复合树脂嵌体离体固化黏结修复牙体严重缺损是一种值得临床推广的好方法。