背景:树脂加强型玻璃离子粘接剂具有良好的粘接强度和持续释放氟的性能,但临床应用预防釉质脱矿的作用有待验证. 目的:对牙齿畸形患者左右侧上颌牙齿采用树脂加强型玻璃离子水门汀粘结剂或复合树脂粘结剂粘结托槽,观察托槽脱落及治疗前后去粘接时牙釉质面的脱矿情况.设计:观察对比试验.单位:河北医科大学第二医院.对象: 选择2002-07/2002-08于河北医科大学第二医院口腔正畸科收治的40 例牙齿畸形患者(358颗) ,女21 例, 男19例,平均16岁,所有患者上前牙正常、完整, 双侧牙齿无明显不同,口腔卫生状况良好.患者均对治疗项目知情同意,实验经过医院伦理委员会许可.实验用粘结材料为RMGI (富士. GC. 日本产,生产批号为0005111) 和复合釉质粘结剂(京津釉质粘结剂,天津生产,生产批号为020402) ,所用托槽为杭州三比燕尾型托槽,所用酸蚀液为37 %磷酸.方法: ①粘结正畸托槽: 抽签法随机将患者分为2组,每组20例.Ⅰ组:左侧用37 %磷酸酸蚀30 s,水潮湿牙面,用光固化RMGI 粘结托槽;右侧37 %磷酸酸蚀60 s,清洁、干燥,用复合树脂粘结托槽.Ⅱ组:右侧用37 %磷酸酸蚀30 s,水潮湿牙面,光固化RMGI 粘结托槽;左侧37 %磷酸酸蚀60 s, 清洁、干燥,用复合树脂粘结托槽.10 min后0.036 cm镍钛丝结扎,患者均不告知两侧粘结材料存在差异,常规医嘱,指导患者固定矫治器治疗期间饭后使用含氟牙膏刷牙,不用含氟漱口液,以统一含氟材料,减少误差.疗程9～26 个月,平均为18个月.②每4 周后复诊观察患者托槽脱落情况,并记录脱落部位. 统一拍摄条件拍摄前牙区照片,10 倍放大后观察牙面的脱矿情况,并根据Gerger等记数法评价并记录粘接前和去粘接时的釉质面白斑形成情况.主要观察指标:①托槽脱落情况及脱落部位.②两种材料粘接托槽治疗前后脱矿情况.结果:40 例患者均进入托槽脱落结果分析, 4 例患者托槽脱落发生在前牙,则此4 颗牙及对侧同名牙除外,其余232 颗牙齿将进行白斑形成情况评价.①托槽脱落情况及脱落部位:树脂加强型玻璃离子水门汀托槽脱落率与复合树脂相近,差异无统计学意义(P > 0.05),脱落位置主要发生在双尖牙区,其次为中切牙.②脱矿情况: 粘结托槽治疗后, 树脂加强型玻璃离子水门汀托槽发生白斑率低于复合树脂,差异有统计学意义(25.9 %,38.8 %,P < 0.05). 结论:树脂加强型玻璃离子水门汀可以明显减少正畸治疗后牙齿白斑发生率的增高,减少酸蚀时间仍可达到类似的粘接成功率.
揹景:樹脂加彊型玻璃離子粘接劑具有良好的粘接彊度和持續釋放氟的性能,但臨床應用預防釉質脫礦的作用有待驗證. 目的:對牙齒畸形患者左右側上頜牙齒採用樹脂加彊型玻璃離子水門汀粘結劑或複閤樹脂粘結劑粘結託槽,觀察託槽脫落及治療前後去粘接時牙釉質麵的脫礦情況.設計:觀察對比試驗.單位:河北醫科大學第二醫院.對象: 選擇2002-07/2002-08于河北醫科大學第二醫院口腔正畸科收治的40 例牙齒畸形患者(358顆) ,女21 例, 男19例,平均16歲,所有患者上前牙正常、完整, 雙側牙齒無明顯不同,口腔衛生狀況良好.患者均對治療項目知情同意,實驗經過醫院倫理委員會許可.實驗用粘結材料為RMGI (富士. GC. 日本產,生產批號為0005111) 和複閤釉質粘結劑(京津釉質粘結劑,天津生產,生產批號為020402) ,所用託槽為杭州三比燕尾型託槽,所用痠蝕液為37 %燐痠.方法: ①粘結正畸託槽: 抽籤法隨機將患者分為2組,每組20例.Ⅰ組:左側用37 %燐痠痠蝕30 s,水潮濕牙麵,用光固化RMGI 粘結託槽;右側37 %燐痠痠蝕60 s,清潔、榦燥,用複閤樹脂粘結託槽.Ⅱ組:右側用37 %燐痠痠蝕30 s,水潮濕牙麵,光固化RMGI 粘結託槽;左側37 %燐痠痠蝕60 s, 清潔、榦燥,用複閤樹脂粘結託槽.10 min後0.036 cm鎳鈦絲結扎,患者均不告知兩側粘結材料存在差異,常規醫囑,指導患者固定矯治器治療期間飯後使用含氟牙膏刷牙,不用含氟漱口液,以統一含氟材料,減少誤差.療程9～26 箇月,平均為18箇月.②每4 週後複診觀察患者託槽脫落情況,併記錄脫落部位. 統一拍攝條件拍攝前牙區照片,10 倍放大後觀察牙麵的脫礦情況,併根據Gerger等記數法評價併記錄粘接前和去粘接時的釉質麵白斑形成情況.主要觀察指標:①託槽脫落情況及脫落部位.②兩種材料粘接託槽治療前後脫礦情況.結果:40 例患者均進入託槽脫落結果分析, 4 例患者託槽脫落髮生在前牙,則此4 顆牙及對側同名牙除外,其餘232 顆牙齒將進行白斑形成情況評價.①託槽脫落情況及脫落部位:樹脂加彊型玻璃離子水門汀託槽脫落率與複閤樹脂相近,差異無統計學意義(P > 0.05),脫落位置主要髮生在雙尖牙區,其次為中切牙.②脫礦情況: 粘結託槽治療後, 樹脂加彊型玻璃離子水門汀託槽髮生白斑率低于複閤樹脂,差異有統計學意義(25.9 %,38.8 %,P < 0.05). 結論:樹脂加彊型玻璃離子水門汀可以明顯減少正畸治療後牙齒白斑髮生率的增高,減少痠蝕時間仍可達到類似的粘接成功率.
배경:수지가강형파리리자점접제구유량호적점접강도화지속석방불적성능,단림상응용예방유질탈광적작용유대험증. 목적:대아치기형환자좌우측상합아치채용수지가강형파리리자수문정점결제혹복합수지점결제점결탁조,관찰탁조탈락급치료전후거점접시아유질면적탈광정황.설계:관찰대비시험.단위:하북의과대학제이의원.대상: 선택2002-07/2002-08우하북의과대학제이의원구강정기과수치적40 례아치기형환자(358과) ,녀21 례, 남19례,평균16세,소유환자상전아정상、완정, 쌍측아치무명현불동,구강위생상황량호.환자균대치료항목지정동의,실험경과의원윤리위원회허가.실험용점결재료위RMGI (부사. GC. 일본산,생산비호위0005111) 화복합유질점결제(경진유질점결제,천진생산,생산비호위020402) ,소용탁조위항주삼비연미형탁조,소용산식액위37 %린산.방법: ①점결정기탁조: 추첨법수궤장환자분위2조,매조20례.Ⅰ조:좌측용37 %린산산식30 s,수조습아면,용광고화RMGI 점결탁조;우측37 %린산산식60 s,청길、간조,용복합수지점결탁조.Ⅱ조:우측용37 %린산산식30 s,수조습아면,광고화RMGI 점결탁조;좌측37 %린산산식60 s, 청길、간조,용복합수지점결탁조.10 min후0.036 cm얼태사결찰,환자균불고지량측점결재료존재차이,상규의촉,지도환자고정교치기치료기간반후사용함불아고쇄아,불용함불수구액,이통일함불재료,감소오차.료정9～26 개월,평균위18개월.②매4 주후복진관찰환자탁조탈락정황,병기록탈락부위. 통일박섭조건박섭전아구조편,10 배방대후관찰아면적탈광정황,병근거Gerger등기수법평개병기록점접전화거점접시적유질면백반형성정황.주요관찰지표:①탁조탈락정황급탈락부위.②량충재료점접탁조치료전후탈광정황.결과:40 례환자균진입탁조탈락결과분석, 4 례환자탁조탈락발생재전아,칙차4 과아급대측동명아제외,기여232 과아치장진행백반형성정황평개.①탁조탈락정황급탈락부위:수지가강형파리리자수문정탁조탈락솔여복합수지상근,차이무통계학의의(P > 0.05),탈락위치주요발생재쌍첨아구,기차위중절아.②탈광정황: 점결탁조치료후, 수지가강형파리리자수문정탁조발생백반솔저우복합수지,차이유통계학의의(25.9 %,38.8 %,P < 0.05). 결론:수지가강형파리리자수문정가이명현감소정기치료후아치백반발생솔적증고,감소산식시간잉가체도유사적점접성공솔.
BACKGROUND: Resin-modified glass ionomer (RMGI) cements have higher bond strength, especially can release fluoride. But there are fewer reports of the clinical application for the prevention of decalcification.OBJECTIVE: To test the benefit from using RMGI cement instead of a conventional composite resin in bracket bonding for patients with malocclusion, and observe bracket-failure rates and decalcification on enamel surfaces at pretreatment and at debonding.DESIGN: Observational and comparative trial.SETTING: The Second Hospital Affiliated to Hebei Medical University.PARTICIPANTS: Forty successive patients (358 teeth) with malocclusion admitted to the Department of Orthodontics in the Second Hospital Affiliated to Hebei Medical University, were selected for the study from July to August in 2002. All the patients (21 females and 19 males, mean age 16 years) had normal and complete anterior teeth, good oral hygiene. There were no obvious differences in bilateral teeth. Informed consents were obtained from all the subjects. The experiment was also approved by the ethical committee of the hospital. Experimental materials were RMGI adhesive (Fuji, GC, Japan, Lot 0005111) and composite resin cement (enamel adhesive of Beijing and Tianjin, Tianjin product, Lot 020402). Brackets produced from Hangzhou 3B and 37% phosphoric acid were used.METHODS: ①Bonding brackets: Subjects selected according to random procedure were divided into two groups, each with 20. GroupⅠ: The left buccal surfaces bonded with light-cure RMGI were etching for 30 seconds with 37% phosphoric acid, rinsed with water; the right buccal surfaces bonded with composite resin cement were etching for 60 seconds with 37% phosphoric acid, rinsed with water and dried; Group Ⅱ: After etching for 30 seconds with 37% phosphoric acid, the right buccal surfaces were rinsed with water and bonded brackets with light-cure RMGI. The left buccal surfaces were bonded brackets with composite resin cement after etching for 60 seconds with 37% phosphoric acid, rinsing with water and drying; Attachment of 0.036-cm NiTi wires with ligature to the brackets was conducted 10 minutes after light-curing. The information about differences in bilateral bonding materials was not told to patients. To ensure an equal bonding materials containing fluoride and minimize the error, all the patients were instructed to use toothpaste containing fluoride, a fluoride mouthwash was not prescribed. The treatment period was 9-26 months (mean 18 months).②Patients were rechecked at intervals of 4 weeks postoperatively. Each bonded tooth was checked for loose or missing brackets, and failures were recorded. A color transparency of anterior teeth area was taken using a standardized photographic technique. The enamel surface conditions were classified at a magnification of ×10. The condition of enamel surface recorded was made according to the scoring system by Geiger before treatment and at debonding.MAIN OUTCOME MEASURES: ①The number and site of bonding failures.②Enamel surface conditions at before treatment and debonding.RESULTS: Forty patients were all involved in the result analysis. Eliminating 4 teeth occurring bond failure and 4 teeth of opposite side at anterior teeth, a total of 232 teeth were evaluated.①The number and sit of bonding failures: There was no significant difference between the failure rates of RMGI adhesive and composite resin cement (P > 0.05). Significantly more premolar brackets failed than incisor brackets.②Decalcification of enamel surface: At debonding after treatment, the incidence rates of white spots in the surfaces bonded with the RMGI were significantly lower than that in the composite resin (25.9%, 38.8%, P < 0.05).CONCLUSION:The use of RMGI for brackets bonding results in a significant reduction in the incidence of white spot at debonding. Reducing etching time may obtain a similar survival rate with the routine etching time.
