几种粘结树脂在粘结失败后的不同牙本质界面进行再粘结的微拉伸粘结强度和形态学观察

目的:研究3种不同树脂在粘结失败后的不同牙本质表面粘结的微拉伸粘结强度及形态学的观察.方法:磨除因正畸拔除的前磨(牙合)面牙釉质暴露中层牙本质,用Single Bond 2进行粘结建立再粘结模型.在打磨机上打磨再粘结模型样本,产生含有混合层的牙本质表面和去除混合层的牙本质表面.用3种粘结树脂分别在正常牙本质表面,含有混合层的牙本质表面和去除混合层的牙本质表面进行粘结.Z250树脂充填.在低速锯下切割样本进行微拉伸测试(μTBS)和扫描电镜观察粘结界面及断裂类型.结果:每种树脂在含有混合层的牙本质表面粘结的μTBS数值及所产生的混合曾的厚度显著低于在正常牙本质表面粘结的数值.而且较正常牙本质产生较多的玷污颗粒.结论:本实验表明混合层及树脂玷污层的存在降低了在牙本质表面进行再粘结的粘结强度.     

冷热循环对牙本质粘结系统与牙釉质粘结强度的影响

目的评价冷热循环对牙本质粘结系统与牙釉质粘结强度的影响。方法选取人离体下颌第三磨牙20颗,使用600目砂纸打磨颊面釉质,分别使用全酸蚀粘结系统AdperTM Single Bond2（SB2）、两步法自酸蚀粘结系统Clearfil SE Bond（CSE）、一步法自酸蚀粘结系统ClearfilS3Bond（CS3）和iBondGI（IB）进行粘结。实验组冷热循环3000次后测定微拉伸粘结强度,对照组不做冷热循环处理直接测试。结果实验组冷热循环后,各粘结系统粘结强度均有所下降,但与对照组相比,仅IB有显著性差异（P〈0.05）。对照组中SB2和CSE的粘结强度相近,明显高于CS3和IB。结论不同牙本质粘结系统与牙釉质的粘结强度存在差异。冷热循环3000次可导致一步法自酸蚀粘结系统IB与牙釉质粘结强度显著性下降。     

冷热循环后4种双固化树脂粘结剂与根管内牙本质粘结性能的对照研究

目的:评价冷热循环前后4种双固化树脂粘结剂与根管内牙本质的粘结性能。方法:40颗健康上前牙随机分为8组。根管预备后选用4种树脂粘结剂(Clearfil DC Core Automix,Calibra esthetic resin cement,DMG LUX-ACORE Smartmix Dual,3M ESPE RelyXTM Unicem)分别粘结直径1.2mm纤维桩。将20颗牙沿垂直牙根长轴方向片切成厚度为1mm的薄片,用万能力学试验机进行微推出测试,体视显微镜观察断裂方式。对粘结强度及断裂类型进行统计学分析。另外20颗牙进行冷热循环处理10000次,放置24h后按同样步骤测试。结果:冷热循环前后粘结强度测试结果分别为:Clearfil DC Core Automix(8.9540±2.85955,7.1212±2.34645)MPa,Calibra esthetic resin cement(6.2314±1.83828,5.4596±1.99693)MPa,DMG LUXACORE Smartmix Dual(7.3410±2.27467,6.4844±1.99055)MPa,3M ESPE RelyXtm Unicem(7.8400±2.37045,6.9804±2.23403)MPa,冷热循环前后各组之间差异有显著性(P<0.05),冷热循环前后断裂方式均为粘结面型断裂为主。结论:4种双固化树脂粘结剂与根管内牙本质粘结强度差异显著。     

利用活髓在体牙评测新型牙本质粘结材料

目的 :评测 4种新型牙本质粘结材料 (SingleBond ;Bond l;Prime&BondNT ;One Step)与活髓在体牙本质粘结处理后的强度。方法 :选取 17名志愿者口内 19颗无龋活髓磨牙 (牙周炎牙 ,无保留价值 ) ,局麻下用高速涡轮机、金钢砂车针在喷水降温下磨切咬合面 ,暴露牙本质。分别用 4种牙本质粘结材料按使用说明进行粘结处理 ,即刻拔除 ,贮存于 3 7℃生理盐水中 2 4h后 ,制备成沙漏状试件。粘结界面面积控制在lmm2 左右。测试拉伸强度 ,并作统计学处理。结果 :4种新型牙本质粘结材料与活髓在体牙本质粘结处理后的微拉伸强度分别为 :SingleBond(2 6.18± 3 .67)MPa ;Bond 1(3 0 .0 8± 3 .15)MPa;Prime&BondNT(2 9.70± 3 .0 3 )MPa ;One Step (2 9.91± 3 .51)MPa。结论 :新型牙本质粘结材料与活髓在体牙本质粘结处理后取得了较高的粘结强度值 ,最高微拉伸强度达到了 (3 0 .0 8± 3 .15)MPa ,具有较好的粘结性能     

湿度对"单瓶"牙本质粘结系统微拉伸粘结强度的影响

目的用微拉伸强度检测法评价脱矿牙本质表面的不同"湿度"状态对酒精/水基和丙酮基"单瓶"牙本质粘结系统粘结强度的影响.方法选择40颗健康前磨牙,去除牙合面釉质,随机均分为8个实验组,在过湿、用滤纸吸干、用空气干燥1 s或用空气干燥30 s的脱矿牙本质上分别应用Single Bond或Prime&Bond NT单瓶牙本质粘结系统.将牙齿片切为粘结面积约0.9 mm×0.9 mm的长方体状样本,进行微拉伸粘结强度检测,对结果进行统计学分析.结果对于同一种粘结系统,其吸干组和1 s干燥组间的微拉伸粘结强度值无统计学差异,但均显著高于过湿组和30 s干燥组.结论脱矿牙本质表面的湿度对酒精/水基和丙酮基"单瓶"牙本质粘结系统的粘结强度有极大的影响.     

空气喷砂技术对牙本质表面处理后与树脂粘结效果的影响

目的 :观察空气喷砂技术对牙本质表面处理后与复合树脂粘结的效果。方法 :用 2种树脂分别与牙本质进行粘结 ,按要求制成标本 ,随机分为 4组 ,采用微拉伸技术 ,测试标本断裂时的最大应力 ,并用扫描电镜观察各组树脂突的变化。结果 :牙本质表面经空气喷砂技术处理后与SEBOND树脂粘结微拉伸强度高于Esthet.XTM树脂。结论 :牙本质表面经空气喷砂技术处理后与SEBOND树脂粘结效果好。     

牙本质表面状态对粘结界面影响的激光扫描共聚焦显微镜研究

目的 :研究不同表面状态下形成的牙本质湿粘结界面的异同。方法 :以RhodamineB为荧光剂 ,用激光扫描共聚焦显微镜 (LSCM)分别观察干燥或湿润粘结时形成的牙本质粘结界面的异同。结果 :湿粘结时 5种粘结系统在牙本质粘结界面都有良好的渗透。以丙酮为溶剂的粘结系统干燥粘结时形成的混合层的厚度有明显的降低 ,牙本质小管中树脂突较细 ,中断现象增多 ,长度缩短。结论 :干燥粘结时 5种粘结剂在牙本质表面的渗透性减弱。     

不同酸—盐体系预处理液对粘结强度的影响

粘结材料与牙本质粘结时,牙本质表面的污染层会妨碍粘结,因此在进行牙本质粘结之前,用预处理剂处理牙面以清除污染层,对牙本质粘结强度的提高是非常重要的。但是,尽管单纯柠檬酸、磷酸和硝酸等均能较好地清除牙本质污染层,牙本质的粘结强度仍然很低。本研究通过牙本质粘结强度测试、牙本质表面和粘结界面的扫描电镜观察,对酸-盐体系预处理液(Acid-salt pretreatingsolution system,APSS)促进牙本质粘接的机理进行了探讨。     

纳米金刚石改性核树脂与牙本质的微拉伸粘结强度的研究

目的 检测纳米金刚石填料改性的自行合成的核树脂与牙本质的微拉伸粘结强度.方法 选择10颗因阻生拔除的健康第三磨牙,磨除牙合面釉质,形成牙本质平面.随机分成2组,每组5颗牙齿.采用自行合成的纳米金刚石填料改性的核树脂(UFD-C)和Luxa-Core(L-C)商品核树脂充填并分别粘结于牙本质面上,形成4mm～5mm高的树脂层.将牙齿及上方的粘结树脂样本平行于牙长轴片切成约0.9mm×0.9mm的柱状试件,每组共30个试件.用微拉伸测试仪检测其粘结强度,体视显微镜观察其断裂类型,用扫描电镜观察样本粘结界面和断面的超微形态.结果 UFD-C组与牙本质的微拉伸粘结强度均值为:(36.03±9.25)MPa,L-C组与牙本质的微拉伸粘结强度均值为:(36.80±10.56)MPa,两组的粘结强度差异无显著性.UFD-C组70%为粘结面断裂,L-C组80%为粘结面断裂.扫描电镜显示两种核树脂的粘结界面均有树脂突形成.结论 自行合成的纳米金刚石改性核树脂(UFD-C)与Luxa-Core核树脂(L-C)的微拉伸粘结强度差异无显著性,能达到牙体缺损粘结修复的要求.     

Er:YAG激光不同能量预处理对自粘结树脂水门汀剪切粘结强度的影响

目的探讨Er:YAG激光不同能量预处理对自粘结树脂水门汀剪切粘结强度的影响。方法按照纳入标准收集人离体磨牙70颗,根据对牙本质表面Er:YAG激光预处理能量的不同随机分为7组:A组(空白对照)、B组(50 m J,10 Hz)、C组(100 m J,10 Hz)、D组(150 m J,10 Hz)、E组(200 m J,10 Hz)、F组(250 m J,10 Hz)、G组(300 m J,10 Hz)。每组10颗牙中随机取2颗切取3 mm厚的牙本质片,按相应分组用不同激光能量预处理后扫描电镜观察;每组剩余8颗牙包埋后,制备一致标准牙本质表面,按相应分组要求预处理后,用自粘结树脂水门汀Rely XTMUnicem将其与Everest ZS氧化锆瓷片粘结,24 h后测试各组剪切粘结强度并进行统计学分析。结果扫描电镜观察显示Er:YAG激光预处理后牙本质表面形态改变明显,变得粗糙不平,牙本质小管开放,无玷污层,管周和管间牙本质脱矿,一定能量范围内呈现较好的粘结表面;剪切粘结强度结果显示Er:YAG激光预处理可增强自粘结树脂水门汀Rely XTMUnicem的剪切粘结强度(P<0.01);C、D、E组的剪切粘结强度与A组有显著性差异(P<0.05)。结论粘结强度与牙本质的粘结表面密切相关,合适能量下的Er:YAG激光预处理能获得较好的牙本质粘结表面,提高自粘结树脂与牙本质和氧化锆瓷的剪切粘结强度。     

人工唾液浸泡对牙本质黏结耐久性的影响

目的:研究人工唾液浸泡对牙本质黏结强度和黏结界面纳米渗漏的影响.方法:选取30个无龋损人磨牙,用600目碳化硅砂纸在流水冲洗下预备牙本质黏结面,分别用3种(Prime&Bond NT,Adper Prompt和Contax)黏结剂进行黏结处理,复合树脂充填.制备黏结面积为Imm2的条形树脂牙本质试件,在人工唾液中分别浸泡1天(对照组)、90天、180天,然后进行硝酸银染色后测定微拉伸黏结强度,场发射扫描电镜下比较界面纳米渗漏.结果:唾液浸泡180天后,Prime&Bond NT和Adper Prompt黏结强度显著小于对照组,界面纳米渗漏百分比与对照组相比显著增加,Contax黏结强度和界面纳米渗漏百分比与对照组无显著变化.结论:"2步法"自酸蚀黏结剂Contax牙本质黏结界面的耐久性优于"1步法"自酸蚀黏结剂AdperPrompt和全酸蚀黏结剂Prime&Bond NT.     

全酸蚀与自酸蚀粘结系统与正常牙本质粘结强度的比较

目的本研究选取了3种知名品牌的全酸蚀和自酸蚀粘结剂,比较其与正常牙本质的粘结强度及相同品牌树脂粘结剂与不同品牌树脂粘结剂的粘结强度。方法选择60颗新鲜拔除的人第三磨牙,去除牙合面釉质层,随机分为12组,选用3种品牌全酸蚀和自酸蚀粘结剂Excite、AdheSE;Prime&BondNT、XenoⅢ;Singlebond2、Adper Prompt,分别应用于暴露的表层牙本质上,再用树脂恢复牙冠。将牙齿片切成横截面积约为1mm2的长方体状样本,检测其粘结强度。结果结果显示Excite与AdheSE、Prime&Bond NT与XenoⅢ、Singlebond2与Adper Prompt之间的粘结强度无显著差异(P>0.05),Prime&Bond NT、Singlebond2与TPH树脂,XenoⅢ、Adper Prompt与TPH树脂粘结强度无显著差异(P>0.05);Prime&Bond NT、Singlebond2与Z-250树脂,XenoⅢ、Adper Prompt与Z-250树脂粘结强度无显著差异(P>0.05)。结论全酸蚀/自酸蚀粘结系统与正常牙本质间的粘结强度无显著差异;不同品牌间的粘结剂和树脂一起应用不影响其粘结强度。     

人工唾液浸泡对两种自酸蚀粘接剂粘接界面的影响

目的探讨含细菌的人工唾液对两种自酸蚀粘接剂粘接界面纳米渗漏的影响。方法选用自酸蚀粘接剂Adper Prompt（AP）和Contax分别与正常牙本质粘接并制备微拉伸试件,之后将试件浸泡于含细菌的人工唾液中,分别在即刻、1周、1月、3月时取出进行硝酸银染色,用扫描电镜（SEM）观察粘接界面银沉积情况,并用NlH图像分析软件量化处理,以界面银沉积面积占断裂界面的百分比来评价界面纳米渗漏程度。结果粘接界面在即刻、1周、1月、3月时的银沉积面积百分比分别为AP：（17.00±5.40）%、（18.71±6.94）%、（22.81±5.60）%、（26.79±5.77）%;Contax：（11.90±5.17）%、（12.41±4.42）%、（14.73±3.46）%、（17.64±5.39）%。结论无论浸泡人工唾液与否,粘接试件都无法避免纳米渗漏的产生;含细菌的人工唾液浸泡会影响粘接的稳定性,其中以AP组的稳定性较差,浸泡三个月即表现出界面银渗漏程度的显著增加。     

三种粘接剂粘接不同牙本质的微拉伸粘接强度比较

目的采用微拉伸粘接强度实验测定3种牙本质粘接剂粘接楔状缺损处硬化牙本质的粘接强度。方法选择有典型楔状缺损并因牙周病拔除的上颌前磨牙30颗作为实验组，正常上颌前磨牙30颗作为对照组，使用粘接剂A（全酸蚀粘接剂Scotchbond Multi—Purpose）、B（一步法自酸蚀粘接剂Adper Prompt L-Pop）和C（两步法自酸蚀粘接剂Contax）处理硬化牙本质和正常牙本质表面，相应树脂修复。测试两组试件的微拉伸粘接强度。结果粘接剂A、B、C粘接硬化牙本质的微拉伸粘接强度分别为46．805MPa、39．045MPa、29．852MPa。粘接剂A和C与硬化牙本质的微拉伸粘接强度低于正常牙本质，而粘接剂B与之相反，差异有统计学意义（P〈0．05）。结论牙颈部楔状缺损处硬化牙本质由于结构上的特殊性可造成粘接困难。酸性强有利于粘接剂与硬化牙本质的粘接。     

Microtensile bond strength of one- and two-step self-etching adhesives on sclerotic dentin: the effects of thermocycling

This study evaluated the effects of thermocycling on the microtensile bond strength (microTBS) of one- and two-step self-etch adhesives (SEAs) to sclerotic dentin. Two adhesives, Clearfil S3 Bond (S3), a one-step self-etch adhesive (1-SEA), and Clearfil SE Bond (SE), a two-step self-etch adhesive (2-SEA), were applied on cervical lesions in human premolars with sclerotic or normal dentin. After adhesive application, the lesions were restored and built up using a resin composite (Clearfil AP-X). After 24 hours in water storage, the restored teeth were sectioned into 0.7 x 0.7 mm composite-dentin beams. The beams were then aged with 0, 5,000 or 10,000 thermocycles. The use of two adhesives, two substrate types and three thermocycling regimens yielded 12 experimental groups of 14-19 beams each. The beams were subsequently subjected to microTBS testing at a crosshead speed of 1 mm/minute and statistical analyses were computed with three-way ANOVA and Tukey's post hoc test at p < 0.05. Three-way ANOVA showed statistically significant effects on bonding effectiveness by lesion type, adhesive system, thermocycling or combinations of the adhesive system and thermocycling (p < 0.05). With sclerotic dentin, although S3 and SE provided comparable microTBS after 24 hours of water storage, S3 showed significantly lower microTBS than SE after thermocycling (p < 0.05). Regardless of lesion type, the microTBS for S3 decreased significantly after 5,000 or 10,000 thermocycles, while the microTBS for SE showed a significant decrease only after 10,000 thermocycles. Regardless of the extent of thermocycling, the microTBS values for either SE or S3 bonded to sclerotic dentin were significantly lower than to normal dentin (p < 0.05). The results suggested that thermocycling had a significant negative effect on the bond strength of the two SEAs tested. In contrast to 2-SEA, 1-SEA might not be a good choice for sclerotic dentin when seeking durability of the resin-dentin bond.     

Effect of thermal aging on the tensile bond strength at reduced areas of seven current adhesives

The purpose of this study was to determine the micro-tensile bond strength (MTBS) to dentin of seven adhesive systems (total and self-etch adhesives) after 24 h and 5,000 thermocycles. Dentin surfaces of human third molars were exposed and bonded with two total-etch adhesives (Adper Scotchbond 1 XT and XP Bond), two two-step self-etch adhesives (Adper Scotchbond SE and Filtek Silorane Adhesive System) and three one-step self-etch adhesives (G-Bond, Xeno V and Bond Force). All adhesive systems were applied following manufacturers’ instructions. Composite buildups were constructed and the bonded teeth were then stored in water (24 h, 37 °C) or thermocycled (5,000 cycles) before being sectioned and submitted to MTBS test. Two-way ANOVA and subsequent comparison tests were applied at α = 0.05. Characteristic de-bonded specimens were analyzed using scanning electron microscopy (SEM). After 24 h water storage, MTBS values were highest with XP Bond, Adper Scotchbond 1 XT, Filtek Silorane Adhesive System and Adper Scotchbond SE and lowest with the one-step self-etch adhesives Bond Force, Xeno V and G-Bond. After thermocycling, MTBS values were highest with XP Bond, followed by Filtek Silorane Adhesive System, Adper Scotchbond SE and Adper Scotchbond 1 XT and lowest with the one-step self-etch adhesives Bond Force, Xeno V and G-Bond. Thermal aging induced a significant decrease in MTBS values with all adhesives tested. The resistance of resin–dentin bonds to thermal-aging degradation was material dependent. One-step self-etch adhesives obtained the lowest MTBS results after both aging treatments, and their adhesive capacity was significantly reduced after thermocycling.     

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目的评价不同表面处理方法对激光预备牙本质形态学变化和黏结强度的影响。方法2013年5月至7月在中国医科大学附属口腔医院收集20～40岁新鲜拔除的活髓第三磨牙20颗及根尖发育完全的前磨牙8颗,铒、铬：钇钪镓石榴石（Er,Cr：YSGG）激光处理暴露的牙争面牙本质,然后按照不处理、37％磷酸酸蚀、自酸蚀及0．5mol／LEDTA调节各自分为4组,使用扫描电子显微镜（SEM）观察前磨牙牙本质处理面形态;第三磨牙使用Adper easy bond或Single bond 2黏结,Z350树脂逐层堆积树脂冠后,制作哑铃型试件进行微拉伸黏结强度测试,采用单因素方差分析进行组间差异比较。结果SEM观察发现：前磨牙激光预备后不处理组（对照组）牙面不规则,无玷污层,牙本质小管开放;磷酸酸蚀组牙本质表面最规则,自酸蚀组和EDTA处理组处理后表面变化不如磷酸酸蚀组明显。微拉仲黏结强度测试结果显示,第三磨牙分组后的3种处理方式牙本质黏结强度均显著高于对照组（P〈0．05）,磷酸酸蚀组黏结强度最强（P〈0．05）,而自酸蚀组及EDTA处理组差异无统计学意义（P〉0．05）。结论37％磷酸酸蚀、自酸蚀及0．5mol／LEDTA调节3种处理均可提高激光预备的牙本质黏结强度,37％磷酸酸蚀组获得最佳短期黏结效果。     

氯已定预处理对两步法自酸蚀粘接剂牙本质粘接界面稳定性的影响

目的：探讨氯已定预处理对两步法自酸蚀粘接剂的牙本质粘接界面稳定性的影响.方法：40颗离体人磨牙沿垂直于牙长轴的方向切割,暴露冠中部牙本质作为粘接面,牙本质试件随机分为两组,一组在粘接处理前涂布0.2％氯已定为实验组,一组无预处理为对照组,两组经两步法自酸蚀粘接剂SE Bond处理后,堆积复合树脂制备成粘接试件.每组随机抽取2个试件借助微拉曼光谱仪分析粘接剂的双键转化率,剩余的18个试件随机分为两个亚组,分别于即刻和冷热循环5000次后检测微拉伸粘接强度和界面的纳米渗漏情况.结果：0.2％氯已定预处理对SE Bond的树脂双键转化率无显著性影响（P＞0.05）.即刻测试时,对照组和实验组间的微拉伸粘接强度和纳米渗漏差异无统计学意义（PP ＞0.05）.冷热循环老化处理后,实验组的微拉伸粘接强度显著高于对照组,纳米渗漏程度显著低于对照组（P＜0.05）.结论：0.2％氯已定预处理不会干扰SE Bond的树脂聚合,且可提高其与牙本质粘接界面的稳定性.     

乙醇润湿在牙本质疏水性粘接的应用研究

目的：研究乙醇润湿技术应用于牙本质疏水性粘接的效果。方法：20颗无龋第三磨牙去除冠部釉质后,随机分成4组。实验组用无水乙醇润湿牙面30s或用梯度乙醇润湿牙面后进行疏水性粘接;阳性对照组采用AdperScotchbond Multi-Purpose粘接;阴性对照组在水润湿的牙面进行疏水性粘接。固化24h后进行微拉伸粘接强度检测和扫描电镜观察。结果：梯度乙醇润湿组的粘接强度和阳性对照组相比无显著性差异,所形成的混合层均匀致密,树脂突较多;而乙醇润湿30s组的粘接强度低于对照组（P〈0.05）,其混合层不均匀,树脂突短而少。结论：在牙本质疏水性粘接中使用梯度乙醇润湿的方法可获得良好的粘接效果。     

Conversion of one-step to two-step self-etch adhesives for improved efficacy and extended application

PURPOSE: One-step self-etch adhesives have restricted use due to their acid-base incompatibility with autocured composites and their behavior as permeable membranes after polymerization. This study examined the feasibility of their conversion to two-step self-etch adhesives via the adjunctive use of a non-solvented, relatively hydrophobic resin coating. METHODS: iBond, Xeno III and Adper Prompt were used either in multiple coats, or in a single coat followed by the use of a layer of Scotchbond Multi-Purpose Plus bond resin for coupling to light- and auto-cured composites. Four types of experiments were performed. Bonded specimens were examined with TEM after immersion in an ammoniacal silver nitrate tracer. Fluid flow measurements of iBond were conducted using the two application protocols to compare the permeability of the bonded dentin with the original smear layer. Permeability of vital dentin bonded with both application protocols were compared for the transudation of dentin fluid across the bonded dentin. Microtensile bond strengths of dentin bonded with the two protocols were examined for their compatibility with an auto-cured composite. RESULTS: The results of the four experiments were complementary. iBond and Xeno III exhibited "apparent incompatibility" to auto-cured composites that resulted from their inherent permeability. This was confirmed by the presence of dentin fluid transudate on the adhesive surfaces when they were bonded to vital dentin. Conversely, Adper Prompt exhibited "true incompatibility" to auto-cured composites that was caused by adverse acid-base interaction, masking the inherent permeability of this adhesive. "True" and "apparent" incompatibility issues were eliminated upon their conversion to two-step self-etch adhesives.