【作者】 林艺翚；

【导师】 史建陆；

【作者基本信息】 福建医科大学 ， 口腔临床医学， 2010， 硕士

【摘要】 目的:初步研究不同处理方法对不同底面设计的陶瓷托槽再粘接抗剪切强度的影响,为临床应用提供依据。方法:219颗因正畸原因拔除的健康双尖牙分成两部分,120颗用于粘接实验,99颗用于制备脱落陶瓷托槽。实验部分:将120颗牙根据不同的托槽随机分成三组:A微隐窝底面陶瓷托槽组,B微晶体底面陶瓷托槽组,C聚合体网底陶瓷托槽组,每组40颗牙。每个测试组再根据不同的处理方法分成4组:新陶瓷托槽组(n),烧灼处理组(b),喷砂处理组(sb),硅涂层处理组(sc),每组10颗牙。分别从三种不同底面设计的陶瓷托槽中随机各取出33个陶瓷托槽粘接于未经酸蚀处理的微湿的离体牙上,然后用去托槽钳小心取下,形成脱落托槽,然后将不同底面设计的脱落托槽各分成三组,分别对陶瓷托槽底面进行烧灼处理、喷砂处理、硅涂层处理;不同方法处理后,各组托槽底面常规涂硅烷偶联剂。每组离体牙经常规牙面处理后,分别粘接新陶瓷托槽及脱落后处理的陶瓷托槽,托槽粘接30分钟后经37°C恒温恒湿箱水浴孵化24小时,测定样本的抗剪切强度,并统计牙面粘接剂残留指数ARI。用扫描电镜观察不同底面设计的陶瓷托槽经不同方法处理后底面的显微结构改变。结果:1.不同底面设计对陶瓷托槽抗剪切强度的影响具有统计学意义(P<0.01),不同处理方法对陶瓷托槽抗剪切强度的影响具有统计学意义(P<0.01),不同底面设计和处理方法的交互作用对抗剪切强度的影响具有统计学意义(P<0.01)。2.不同底面设计陶瓷托槽不同底面处理方法间的抗剪切强度比较:烧灼处理组b和喷砂处理组sb处理后抗剪切强度均下降,差别具有统计学意义(P<0.01);硅涂层处理组sc抗剪切强度大于烧灼处理组b和喷砂处理组sb,差别具有统计学意义(P<0.01);硅涂层处理组sc处理后抗剪切强度和新陶瓷托槽组n相近,但两者差别无统计学意义(P>0.05)。其中聚合体网底陶瓷托槽经烧灼处理后的抗剪切强度低于正畸临床最低粘接强度。3.不同底面处理方法后陶瓷托槽间抗剪切强度的比较:初次粘接和烧灼处理后,微隐窝底面陶瓷托槽和微晶底面陶瓷托槽抗剪切强度大于聚合体网底陶瓷托槽,差别具有统计学意义(P<0.01);喷砂处理后,微隐窝底面陶瓷托槽的抗剪切强度大于微晶体底面陶瓷托槽和聚合体网底陶瓷托槽的抗剪切强度,差别有统计学意义(P <0.05);微晶体底面陶瓷托槽和聚合体网底陶瓷托槽两者的抗剪切强度有差别,但无统计学意义(P >0.05);硅涂层处理后,微隐窝底面陶瓷托槽的抗剪切强度大于微晶体底面陶瓷托槽和聚合体网底陶瓷托槽,但三者差别统计学意义(P >0.05)。4.ARI积分在2.2-3.0之间,各组的ARI值差别无统计学意义(α>0.05)。5.扫描电镜显示不同处理方法对不同底面陶瓷托槽的影响不同。结论:1.硅涂层处理适合不同底面陶瓷托槽的再粘接,三种底板设计的陶瓷托槽经硅涂层处理后再粘接,其抗剪切强度与新陶瓷托槽相近。2.三种底板设计的陶瓷托槽经喷砂处理后再粘接,其抗剪切强度下降,但高于正畸临床所需的最低抗剪切强度值。其中微隐窝底面与微晶底面和聚合体网底相比,抗剪切强度下降最少,更适合喷砂处理。3.三种底板设计的陶瓷托槽经烧灼处理后再粘接,其抗剪切强度下降,除聚合体网底陶瓷托槽外,其余两种均高于正畸临床所需的最低抗剪切强度值。烧灼处理不适用于聚合体网底陶瓷托槽的再粘接。4.初次粘接时微隐窝底面和微晶体底面陶瓷托槽抗剪切强度大于聚合网底体陶瓷托槽。更多还原

【Abstract】 Objective The purposes of this study was to evalute the effects of various surface conditioning methods on shear bond strength (SBS)of rebonded ceramic brackets with different base designs.Methods 219 human premolars extracted for orthodontic purpose were collected and divided randomly into two parts:one part(120 teeth)for the bond strength test;the other part(99 teeth) for getting debonded ceramic bracksts. For experimental part:120 human premolars were divided randomly into three groups(40 teeth in each group) according to different base designs:(A) round pits base,(B) microcrystalline lock base,(C) polymer mesh base. Then each test group was divided into four groups(10 teeth in each group)according to different treatment conditions:new brackets as controls (N),burning treatment (B),sandblasting (SB),silica coating (SC).33 teeth were selected respectively from three different base designs of ceramic brackets and were bonded to unetched and slightly wet tooth surfaces,then separated from the tooth surface easily with a tweezer with light pressure.Then different base designs of debonded brackets were divided to three groups with different kinds of treatments: burning treatment (B), sandblasting (SB), silica coating (SC).After that,a silane coupling agent was applied to different groups of bases.The teeth in each group were treated by conventional treatment,then were bonded with new brackets,burned brackets,sandblasted brackets,or siliac coated brackets. After 30 minutes,the samples were stored in distilled deionized water for 24 hours at 37°C in an incubator. Shear force test was performed and then the shear bond strength and the adhesive remnant index(ARI) were measured. Observe the change of the bracket base and the slot base by using SEM.Results 1.There were statistically significant differences in the shear bond strength of ceramic brackets with different base designs(P<0.01). There were statistically significant differences in the shear bond strength of ceramic brackets with different treament(P<0.01). There was an interactive relation between different base designs and different treament(P<0.01).2. Comparison of different treatment of the shear bond strength,the shear bond strength of burning group and sandbliasting group were significantly lower(P<0.01), the shear bond strength of silica coating group was significantly higer than that of burning group and sandbliasting group(P<0.01), the shear bond strength of silica coating group was close to new brackets group ,but there were no statistically significant difference between them(P>0.05).In all groups,the shear bond strength of polymer mesh base ceramic brackets with burning treament was lower than the minimum bond strength required.3. Comparison of different base designs of the shear bond strength:in new bracket group and burning group, the shear bond strength of round pits base and microcrystalline lock base were significantly higher than polymer mesh base (P<0.01).In sandblasting group, the shear bond strength of round pits base and microcrystalline lock base were significantly higher than microcrystalline lock base and polymer mesh base (P<0.05). There were no statistically significant difference between microcrystalline lock base and polymer mesh base(P>0.05).In silica coating group, there were no statistically significant difference between round pits base ,microcrystalline lock base and polymer mesh base (P>0.05).4. The score of ARI in all groups was between 2.2-3, There were no statistically significant difference among all groups (α>0.05).5.The results of SEM showed that some micro-structural changes of debonded ceramic brackets bases could be observed after different treament on debonded ceramic brackets with different base designs.Conclution:1.Silica coating is suitable for rebonding ceramic brackets with different base designs.Silica coating applications on debonded ceramic brackets base can produce bond strengths comparable with new brackets.2.After sandblasting,the shear bond strength of rebonded ceramic brackets with different base designs decreased, but was higer than the minimum bond strength required.In three cersmic brackets with different base designs, round pits base and microcrystalline lock base were more suitable for sandblasting treament.3.After burning, the shear bond strength of rebonded ceramic brackets with different base designs also decreased,but was higer than the minimum bond strength required,except for ceramic brackets with polymer mesh base.Burning on debonded ceramic brackets base can’t be recommended for ceramic brackets with polymer mesh base.4.In the initial bonding, the shear bond strength of ceramic brackets wih round pits base and microcrystalline lock base was higer than that with polymer mesh base.更多还原