【摘要】：目的：隨著科技發(fā)展,全瓷冠、瓷貼面等修復(fù)方式所帶來的美學(xué)效果逐漸得到患者的普遍認(rèn)可,要求美容修復(fù)的患者日漸增多,同時(shí)活髓牙不能做冠的舊思想逐漸被摒棄,導(dǎo)致活髓牙修復(fù)的病例越來越多,與此同時(shí),越來越多的患者產(chǎn)生牙本質(zhì)過敏,于是醫(yī)師開始嘗試對牙體預(yù)備后的牙本質(zhì)進(jìn)行脫敏,研制出不同種類、不同原理的脫敏劑,并在臨床工作中取得了不錯(cuò)的治療效果,以至于有些醫(yī)生認(rèn)為,活髓牙牙體預(yù)備后不進(jìn)行脫敏是不道德的行為。 勁潤牙本質(zhì)保護(hù)膜是由日進(jìn)齒科研發(fā)的一種新型脫敏劑,其優(yōu)良的牙本質(zhì)脫敏效果得到醫(yī)師的廣泛好評。學(xué)者已經(jīng)證實(shí)涂布牙本質(zhì)保護(hù)膜之后會在牙本質(zhì)表面形成一厚約5μm的硬質(zhì)涂層,表面光滑,質(zhì)地堅(jiān)硬。但這一涂層會阻礙粘結(jié)劑與牙本質(zhì)間的相互作用,其對粘結(jié)劑粘結(jié)強(qiáng)度的影響鮮有報(bào)道。 本實(shí)驗(yàn)擬研究勁潤牙本質(zhì)保護(hù)膜對GIC、 ZPCC、 RMGIC、 RC4種粘結(jié)劑與牙本質(zhì)間剪切強(qiáng)度的影響,為臨床中使用牙本質(zhì)保護(hù)膜并匹配相應(yīng)的粘結(jié)劑提供依據(jù)。 方法：收集40顆因正畸而拔除的人前磨牙,無齲壞及裂紋,未行任何牙科治療,保存于生理鹽水中并定期更換,保存期介于1-2個(gè)月之間。將離體牙包埋于自凝樹脂底座中,高速手機(jī)磨除頰舌側(cè)牙釉質(zhì),形成兩個(gè)相互平行的面,且面積大于4×4mm,隨機(jī)分為GIC、 ZPCC、 RMGIC、 RC4個(gè)組,每組10個(gè)樣本,每組隨機(jī)選取5個(gè)以頰側(cè)為實(shí)驗(yàn)組,其余5個(gè)以舌側(cè)為實(shí)驗(yàn)組。實(shí)驗(yàn)組75%酒精棉球消毒吹干后涂布牙本質(zhì)保護(hù)膜并光固化,對照組75%酒精棉球消毒吹干后不做特殊處理,分別將4×4×2mm硅橡膠圈貼附于牙本質(zhì)表面,每一組按照廠家推薦的粉液比調(diào)拌粘結(jié)劑,充滿硅橡膠圈,待粘結(jié)劑初步凝固后小心去除硅橡膠圈,形成4×4×2mm的粘結(jié)端。37℃水浴鍋中靜置24h后行剪切試驗(yàn),記錄剪切強(qiáng)度及斷離類型。每組隨機(jī)選取1個(gè)樣本噴金后掃描電鏡觀察、拍照。利用SAS9.13軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,X2檢驗(yàn)檢測斷離類型,以P0.05記為有統(tǒng)計(jì)學(xué)意義。 結(jié)果：1.使用牙本質(zhì)保護(hù)膜使GIC的粘結(jié)強(qiáng)度減少3.798MPa,使ZPCC的粘結(jié)強(qiáng)度減少8.389MPa,使RMGIC的粘結(jié)強(qiáng)度增強(qiáng)4。143MPa,使RC的粘結(jié)強(qiáng)度增強(qiáng)5.628MPa, P值均小于0.05,有統(tǒng)計(jì)學(xué)意義。 2.掃描電鏡顯示剪切實(shí)驗(yàn)后,所有實(shí)驗(yàn)組牙本質(zhì)保護(hù)膜層完整,未見牙本質(zhì)小管結(jié)構(gòu),對照組可見牙本質(zhì)小管結(jié)構(gòu),被殘余粘結(jié)劑封閉。 結(jié)論：1.勁潤牙本質(zhì)保護(hù)膜可以降低GIC、 ZPCC的剪切強(qiáng)度。 2.勁潤牙本質(zhì)保護(hù)膜可以增強(qiáng)RMGIC、 RC的剪切強(qiáng)度。 3.牙本質(zhì)保護(hù)膜涂層不會因粘結(jié)劑的使用而破壞,其牙本質(zhì)粘結(jié)性能穩(wěn)定。
[Abstract]:Objective: with the development of science and technology, the aesthetic effect brought by all ceramic crowns and porcelain veneers was generally accepted by the patients, and the old idea that the living pulp teeth could not be used as crowns was gradually abandoned. More and more cases resulted in the restoration of living pulp teeth. At the same time, more and more patients developed dentin allergies. So doctors began to try to desensitize the dentin after dental preparation, and developed different kinds and different principles of desensitizers. Some doctors believe that it is immoral to desensitize a living pulp tooth after preparation. Jinrun dentin protective film is a new desensitizer developed by Japanese dentin department. Its excellent effect of dentin desensitization has been widely praised by doctors. It has been proved that a rigid coating of about 5 渭 m thick is formed on the dentin surface after the coating of dentin protective film, the surface is smooth and the texture is hard. However, this coating will hinder the interaction between binder and dentin, and its influence on bond strength of binder is rarely reported. The purpose of this study was to study the effect of dentine protective film on shear strength between GIC, ZPCC, RMGIC, RC4 binder and dentin, and to provide a basis for clinical use of dentin protective film and matching corresponding binder. Methods: 40 human premolars extracted by orthodontics were collected without caries and cracks. They were preserved in normal saline and changed regularly. The preservation period was between 1 and 2 months. The isolated teeth were embedded in the self-coagulating resin base. The enamel of the buccal and lingual side was ground by high speed mobile phone, and two parallel surfaces were formed, and the surface area was larger than 4 脳 4 mm. The tooth was randomly divided into GIC, ZPCC, RMGIC, RC4 group with 10 samples in each group. Each group randomly selected 5 buccal side as experimental group, the remaining 5 lingual side as experimental group. In the experimental group, 75% alcohol cotton balls were coated with dentin protective film and cured by light after disinfection and drying. In the control group, 75% alcohol cotton balls were disinfected and dried without special treatment, and 4 脳 4 脳 2mm silicone rubber rings were attached to the dentin surface, respectively. Each group was filled with silicone rubber rings according to the powder / liquid ratio recommended by the manufacturer. After the binder was initially solidified, the silicone rubber ring was carefully removed, and the adhesive end of 4 脳 4 脳 2mm was formed in a water bath pot at .37 鈩，

本文編號：2144541