Carisolv去龋对牙本质粘结界面影响的实验研究

目的:研究Carisolv去龋对牙本质粘结界面的影响。方法:24颗新鲜拔除的中度龋损的第三磨牙,随机分成ABCD4组。每个牙的龋洞分成两半,一半用Carisolv去龋,另一半用涡轮车针去龋后,做如下处理:A组不处理;B组320ml/L磷酸酸蚀,扫描电镜观察牙本质表面形态;C组不酸蚀,DyractAP复合体充填;D组320ml/L磷酸酸蚀后复合树脂充填,扫描电镜观察牙本质-充填体界面。结果:A组:Carisolv去龋后牙本质表面玷污层少,大部分牙本质小管口开放,清晰可见,表面粗糙不平;涡轮车针去龋后牙本质表面覆盖较厚玷污层,牙本质小管口堵塞,很少见到开口。B组:Carisolv去龋组和涡轮车针去龋组均去除了玷污层,牙本质小管口开放,但Carisolv组牙本质小管无管塞,而涡轮车针组牙本质小管残留部分管塞。C组:观察牙本质-复合体界面见Carisolv去龋组有较多树脂突形成,深入牙本质小管及管周;而涡轮车针去龋组未见明显树脂突起形成。D组:观察牙本质-树脂界面见2组树脂突的密度和长度无明显差异,但Carisolv去龋组树脂突之间的侧枝连接较涡轮车针去龋组多见。结论:Carisolv去龋后牙本质表面玷污层少,牙本质小管口开放,表面粗糙不规则,利于粘结,尤其在使用不需酸蚀的复合体充填时优势突出。     

牙本质龋损下牙本质-牙髓复合体的反应

目的 探讨牙本质龋损进展过程中,牙本质-牙髓复合体的变化特点及规律.方法 选择即刻拔除的第三磨牙65颗,其中牙本质浅龋27颗(急性龋15颗,慢性龋12颗);牙本质深龋28颗(急性龋16颗,慢性龋12颗);无龋损的正常牙10颗.常规固定、脱钙、切片(厚4 μm),光学显微镜下观察牙本质龋病损下方牙髓的组织病理学改变,并用多功能图象分析仪对相应部位的成牙本质细胞的数目、浆核比、前期牙本质面积等进行测量分析.结果 随龋损深度的增加,成牙本质细胞数目显著减少,细胞形态由高柱状变为立方状直至扁平状,前期牙本质变薄甚至消失,第三期牙本质变厚且发生率增加,血管扩张充血,炎症细胞增多,主要为淋巴细胞与浆细胞;牙本质浅龋阶段,成牙本质细胞浆核比显著下降,慢性龋成牙本质细胞样细胞分化、迁移活跃,胶原纤维增多.牙本质深龋阶段出现修复性牙本质,急性龋炎症细胞聚集明显.结论 牙本质-牙髓复合体对龋损的反应与龋损深度及活动性有关;龋损深度增加,损伤反应加重;龋损活动性降低时修复与防御反应加强.     

Carisolv去龋对龋损内层牙本质粘接修复的影响

目的：评价Carisolv化学机械去龋对龋损内层牙本质与复合树脂之间粘接强度的影响。方法：12个牙合面中龋离体恒磨牙,随机等分为2组,分别用Carisolv化学机械法和牙钻机械法去龋,去龋后用复合树脂充填,低速切片机将牙齿切割成0.9mm×0.9mm×8mm的条形试件,微拉伸测试仪检测粘接强度,扫描电镜观察断裂模式。结果：Carisolv化学机械去龋和牙钻机械去龋后龋损内层牙本质与复合树脂之间的粘接强度分别为：22.98±4.17MPa,20.01±3.97Mpa,差异具有显著性意义（P〈0.05）;试件断裂以混合破坏为主。结论：Carisolv化学机械去龋可增加复合树脂与龋损内层牙本质的粘接强度。     

Carisolv去龋对牙本质黏结强度影响的实验研究

目的：研究Carisolv去龋对牙本质黏结强度的影响：方法：选择30颗新鲜拔除的[牙合]面中度龋损的第三磨牙，每个牙的龋洞分成两半，一半用Carisolv去龋，另一半用慢速球钻去龋，而后随机分成3组，分别使用Prime＆Bond NT＋Dyract AP复合体黏结；Uni—Etch（320ml／L磷酸）＋One—Step Plus＋Renew树脂黏结：Prompt—L—Pop＋Z100树脂黏结。测试微抗拉强度（MTBS）：结果：Cafisolv组3种黏结系统MTBS分别为：（17．22±7．95）MPa、（25．40±8．44）MPa、（17．66±8．33）MPa，车针组分别为：（16．01±7．43）MPa、（23.45±7．55）MPa、（16.26±7.97）MPa：2种去龋方法间差异无显著性。结论：Carisolv去龋法对以上3种黏结系统与牙本质的黏结强度无不利影响：     

Carisolv去龋及酸蚀后牙本质表面形态扫描电镜观察

目的 通过扫描电镜观察比较车针和Carisolv去龋及酸蚀后牙本质表面形态的差异。方法 24颗拔除的中度龋坏的第三磨牙,随机分成A、B、C、D 4组,每个牙先分别用涡轮车针和Carisolv去龋制备两个窝洞后,做如下处理:A组不处理,B组35%磷酸酸蚀,C组32%磷酸酸蚀,D组Tyrian SPE自酸蚀剂处理。扫描电镜观察牙本质表面形态。结果 Carisolv去龋后牙本质表面玷污层少,大部分牙本质小管口开放,表面粗糙不平;涡轮车针去龋后整个表面覆盖较厚玷污层,牙本质小管口堵塞。35%或32%磷酸酸蚀处理后Carisolv组和车针组均去除了玷污层,但Carisolv组牙本质小管无管塞,而车针组牙本质小管残留少量管塞。Tyrian SPE自酸蚀处理后,Carisolv组与车针组玷污层都被溶解,牙本质小管口部分开放。结论 Carisolv去龋后的牙本质表面利于树脂的粘结,不影响酸蚀剂处理玷污层的能力。     

Carisolv去龋技术减少局部麻醉使用的效果观察

目的研究Carisolv去龋技术治疗儿童乳磨牙面龋时使用局部麻醉的情况。方法将195例387颗面龋的乳磨牙分为2组,试验组258颗使用Carisolv去龋技术治疗,对照组129颗使用牙钻钻磨去龋。统计2组患牙使用局麻情况。结果试验组患牙和对照组患牙使用局麻的差异具有统计学意义（χ^2=229.65,P〈0.001）。其中111例患儿同时接受2种去龋方式治疗,试验组207颗患牙,对照组117颗患牙,接受2种去龋方法的患牙使用局麻的差异有统计学意义（χ2^=175.72,P〈0.001）。结论Carisolv去龋技术用于治疗乳磨牙面龋可以减少局麻使用。     

简化乙醇湿粘结对龋影响牙本质粘结强度的影响

目的:评估简化乙醇湿粘结技术对龋影响牙本质粘结强度的影响。方法:选取人慢性龋离体第三磨牙36颗去龋备洞后保留龋影响牙本质。随机分为6组,分别使用自制疏水性粘结剂,Prime & Bond NT(PB),Adper Single bond plus(SB)进行粘结,堆砌树脂厚度约4~5 mm。实验组采用简化乙醇湿粘结法,对照组采用传统水湿粘结法。制作1 mm ×1 mm ×8 mm的条形微拉伸强度试件,每组选取8个。采用万能材料试验机测试微拉伸强度并记录,观察断裂界面。结果:在自制疏水性粘结剂组中,实验组粘结强度较对照组有显著提高(P<0.05)。结论:简化乙醇湿粘结技术可以提高CAD界面的粘结强度,尤其是在与疏水性粘结剂联合运用时,有显著提高。     

龋影响牙本质粘接强度的研究进展

对于大多数粘接剂而言,龋影响牙本质的粘接强度均低于正常牙本质的粘接强度。本文回顾近几年有关龋影响牙本质粘接强度的文献,着重介绍不同去龋方法、表面处理和粘接剂对龋影响牙本质粘接强度的影响。     

Carisolv化学机械去龋后恒牙牙本质表面形态的扫描电镜观察

目的：观察用Carisolv化学机械去龋后恒牙牙本质的表面形态.方法：新鲜离体的中、深龋恒磨牙10个,沿龋洞中心纵剖为两部分,并随机分为2组,实验组用Carisolv去龋,对照组用慢速球钻去龋,然后在扫描电镜下放大500、1000倍, 各选择3个视野观察, 用3级标准对牙本质表面的碎屑和玷污层进行盲法评分比较.结果：与对照组相比,Carisolv组牙本质表面的碎屑和玷污层较少, 差异具有显著性意义（P＜0.01）.结论： 用Carisolv能有效去除龋损牙本质和玷污层,并形成有利于复合树脂黏结的界面.     

釉质龋牙髓损伤反应的观察

目的观察釉质龋阶段牙髓的组织病理学改变,并探讨牙髓损伤与龋损活动性的关系。方法选用拔出的患釉质龋的第三磨牙22颗（其中急性龋12颗,慢性龋10颗）,无龋第三磨牙10颗作为对照,脱钙、切片、常规染色。光镜下观察釉质龋损下牙髓的组织病理改变。用多功能图象分析仪测量此区内成牙本质细胞的浆核面积之比（简称浆核比）、数目及前期牙本质的面积,血管数目与横截面积,炎症细胞数目。结果慢性的釉质龋未见明显的病理改变。急性釉质龋牙髓的病理变化有：前期牙本质变窄,成牙本质细胞排列紊乱,细胞体积缩小,胞核向前期牙本质区移位;少细胞层见少量成纤维细胞与炎症细胞侵入;多细胞层可见血管轻度扩张,成纤维细胞增殖。少量炎症细胞主要为淋巴细胞和单核细胞。结论釉质龋时牙髓可以出现成牙本质细胞的损伤性变化,而这种变化与龋损活动性相关。     

Adhesion to Dentin

The bond strengths of dentinal bonding systems to dentin and the microleakage at the dentinal bonding system to dentin interface are often determined in laboratory studies prior to the clinical evaluation of these systems. The shear bond strengths of some of the third generation dentinal bonding systems to dentin and the microleakage at the dentinal bonding system to dentin interface are discussed. In addition, the shear bond strengths of fluoride-containing liners/bases and the fluoride release from these systems are evaluated.     

冷热循环对牙本质粘结耐久性的影响

目的:研究冷热循环对牙本质粘结强度和粘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粘结面,分别用3种(Prime&Bond NT,Adper Prompt和Contax)粘结剂进行粘结处理,复合树脂充填.纵向片切牙齿,制备粘结面积为1 mm2的条形树脂牙本质试样.冷热循...     

Dentin Adhesion and MMPs: A Comprehensive Review

This review examines the fundamental processes responsible for the aging mechanisms involved in the degradation of resin‐bonded interfaces, as well as some potential approaches to prevent and counteract this degradation. Current research in several research centers aims at increasing the resin–dentin bond durability. The hydrophilic and acidic characteristics of current dentin adhesives have made hybrid layers highly prone to water sorption. This, in turn, causes polymer degradation and results in decreased resin–dentin bond strength over time. These unstable polymers inside the hybrid layer may result in denuded collagen fibers, which become vulnerable to mechanical and hydrolytical fatigue, as well as degradation by host‐derived proteases with collagenolytic activity. These enzymes, such as matrix metalloproteinases and cysteine cathepsins, have a crucial role in the degradation of type I collagen, the organic component of the hybrid layer. This review will also describe several methods that have been recently advocated to silent the activity of these endogenous proteases.     

Introduction to the Symposium on Minimal Intervention Techniques for Caries

Although dental caries has declined precipitously in many industrialized countries, this disease has escalated in less developed countries. Moreover, dental caries remains a public health problem even in most industrialized countries because the disease frequently is more prevalent among subpopulations without access to preventive regimens and treatment. In some developing countries where dental facilities and providers are rare, alternative measures for managing frank lesions are being used. One example of these minimal intervention techniques is "Atraumatic Restorative Treatment" (ART). This procedure, endorsed and actively promoted by the World Health Organization, requires no anesthetic and its costs are minimal. This symposium addresses several aspects and issues of minimal intervention techniques for caries management.     

Current perspectives on dental adhesion: (3) Adhesion to intraradicular dentin: Concepts and applications

Adhesion science is one of the greatest contributions to restorative dentistry. Adhesion not only established the current principles of tissue preservation, but also allowed for the production of more hermetic and long-lasting restorations. Although adhesive strategies are routinely used in most clinical situations, adhesion to root dentin is still a major challenge. The presence of humidity together with less intertubular dentin are factors that limit the adhesive potential of root dentin. This situation is more unfavorable in endodontically treated teeth prepared for prefabricated or custom-made intraradicular posts; these procedures may alter the mechanical properties of teeth by modifying the viable dentin surface for adhesion. Also, contaminants deposited on the dentin surface are difficult to remove through conventional techniques. Moreover, root canal morphology has a very unfavorable C-factor, bringing undesirable effects resulting from polymerization contraction of resin-based materials. However, the differences between coronal and root dentin are not a barrier for dentin adhesion. Standardization of procedures and care during clinical steps are fundamental to the success of adhesion to coronal or intraradicular dentin. Thus, it is essential to know the anatomy of the root structure, the factors that interfere with intraradicular adhesion, as well as the current adhesive materials and techniques.     

Carisolv去龋技术对儿童牙科畏惧症的影响

目的 探讨2种去龋方法 充填乳磨牙邻牙合洞时对儿童牙科畏惧症(dental fear,DF)的影响.方法 选择160例首次接受治疗的乳磨牙邻牙合面龋患儿,随机分为试验组和对照组,每组80例.试验组采用Carisolv化学机械去龋,对照组采用常规牙钻去龋, 2组均采用自酸蚀黏接剂加后牙光固化树脂充填.采用Frankl行为分级法进行DF评定.结果 试验组DF发生率为60.00%,对照组为93.75%,试验组DF发生率明显低于对照组(P＜0.05).结论 在乳磨牙邻牙合面龋治疗中采用Carisolv化学机械去龋技术,能有效降低儿童DF发生率,且安全、有效、无痛,患儿容易接受.     

纳米银干预牙本质表面粪肠球菌粘附的实验研究

目的:研究纳米银对牙本质表面粪肠球菌粘附的干预作用。方法:制备牙本质片42个,随机均分成3组,分别置于0.1%纳米银溶液、1.313%次氯酸钠溶液和生理盐水内浸泡30min后,于200μL粪肠球菌悬液中培养1h,用扫描电镜观察牙本质表面形态和粪肠球菌粘附情况,荧光显微镜分析牙本质表面粘附的粪肠球菌数量并拍照记录,Image pro plus 6.0软件计算粪肠球菌总菌数、活菌数和活菌百分比。结果:0.1%纳米银溶液组和生理盐水组牙本质表面形态清晰无破坏,1.313%次氯酸钠溶液组牙本质溶融坍塌,胶原溶解破坏。牙本质经0.1%纳米银溶液处理后,其表面粘附的粪肠球菌总菌数、活菌数和活菌百分比均低于1.313%次氯酸钠溶液组和生理盐水组(P﹤0.01)。结论:0.1%纳米银溶液可有效减少粪肠球菌对牙本质的粘附,对牙本质表面形态无明显破坏。