摘要
目的目前临床上对如何快速高效地修复高C因素窝洞仍无定论,文中旨在研究大块充填术和分层充填术在充填此类窝洞时对树脂黏结强度的影响。方法选取2016年1月至2016年3月于南京市口腔医院口腔颌面外科就诊的40例患者,共收集因阻生拔除的第三磨牙42颗,随机选取其中36颗牙齿制备标准I类洞,按窝洞充填方式不同随机分为2组(n=18):大块充填组(一次性充填固化)和分层充填组(以2 mm为一层,分两层充填固化)。大块充填组按充填材料不同再分为3个亚组(n=6):SF大块亚组为Sonic Fill系统超声一次性充填;SDR大块亚组为Sure Fil SDR Flow系统注射头一次性注射充填;Z350大块亚组为传统复合树脂Filtek Z350一次性堆积充填,3组均光固化20s。分层充填组按充填材料不同随机分为3个亚组(n=6):SF分层亚组材料为Sonic Fill,SDR分层亚组材料为Sure Fil SDR Flow,Z350分层亚组为传统复合树脂Filtek Z350;均采用分层充填技术,分2层充填固化,每层2 mm,每次光固化20 s。随后进行微拉伸强度测试和断裂模式观察。余下6颗离体磨牙进行电子显微镜观察黏结界面形态。结果采用Fitek Z350充填时,分层充填组微拉伸强度较大块填充组增大,显著提升树脂-牙本质之间的黏结力强度[(25.43±5.71)MPa vs(0±0)MPa,P<0.05]。大块充填组Sonic Fill、Sure SDR flow微拉伸强度[(28.02±6.98)、(26.60±7.13)MPa]较Fitek Z350[(0±0)MPa]显著提高(P<0.05)。复合树脂内断裂模式在各亚组出现的频次差异有统计学意义,SDR大块亚组中出现的频次最多(P<0.05),其次是SDR分层亚组(P<0.05)。Z350大块亚组的标本在预备过程中断裂,树脂-牙本质黏结界面完全分离。其余各亚组电镜下表现基本一致,大部分区域树脂-牙本质黏结紧密,仅在局部可见不同程度的混合层瓦解断裂。结论传统复合树脂不适用于大块充填术,大块充填树脂在分层充填或大块充填的应用中均可取得理想的黏结效果。
Objective For the time being there is no final conclusion on how to repair C-factor cavities quickly and efficiently. The article was to evaluate effects of stratification and bulk fill tech-niques on the resin bond strength. Methods From 40 patients who consulted from January to March 2006 in the department of oral-maxil-lofacial surgery in Nanjing Stomatological Hospital, 42 fresh extracted third molars were collected, among which 36 teeth were randomly se-lected and prepared with Standardized Class I cavities and divided into 2 groups randomly： bulk fill group （ one-time filling and curing） and stratification fill group （2 layers, 2 mm, filling and curing）. Ac-cording to different filling composites, bulk fill group was subdivided into three groups： SF bulk fill group （one-time filling with Sonic- Fill system ultrasound） , SDR bulk fill group （ one-time filling with SureFil SDR Flow injection） , Z350 bulk fill group（ one-time filling with conventional composite resin Filtek Z350） , and all three groups were light-cured for 20 seconds after filling. Stratification fill group were also subdivided into 3 groups： SonicFill stratification group, SureFil SDR Flow stratification group and Filtek Z350 stratifi-cation group, and all three groups were light-cured for 20 seconds after stratification filling. Microtensile strength test and fracture mode examination were followed in both groups. Bonding interface of the rest 6 extracted molars were measured by electron microscopy. Results When filling with Filtek Z350, the microtensile strength of stratification group was increased in comparison to bulk fill group, which significantly promoted the bond strength between resin and detin[ （25.43±5.71） MPa P （ 0 ± 0 ） MPa,P 〈 0 .0 5 ] . The microten-sile strength of SF bulk fill group（28.02±6.98）MPa and SDR bulk fill group（26.60±7.13）MPa was significantly increased in compari-son to Filtek Z350 bulk group[ （0±0） MPa,P〈0.05]. Significant difference was found in the frequency of each subgroup as to the frac-ture mode in composite resin, in which SDR bulk fill group had the most frequency（P〈0.05）. The sample of Z350 bulk fill group frac-tured during the preparation and the resin-detin bonding interface completely separated. The examination of all the other subgroups wasbasically the same under electron microscopy, with tense resin-detin bond strength in most regions and different degrees of mixed layer fracture in partial regions. Conclusion Conventional composite resin is not applicable in bulk fill technique because of their low transmittance and high polymerization shrinkage. Bulk-fill resin achieves satisfactory bond strength in both stratification and bulk fill techniques.
出处
《医学研究生学报》
北大核心
2016年第12期1304-1308,共5页
Journal of Medical Postgraduates
作者简介
丁梦（医学硕士）
通讯作者：牟永斌,E-mail：yongbimnou@163.com
