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CAD/CAM 及直接复合树脂材料表面染色的诊室漂白效果。

In-office bleaching efficacy on stain removal from CAD/CAM and direct resin composite materials.

机构信息

Division of Cariology and Endodontology, University Clinic of Dental Medicine, University of Geneva, Switzerland.

Department of Restorative Dentistry, Al-Nakheel Medical Center, Riyadh, Saudi Arabia.

出版信息

J Esthet Restor Dent. 2018 Jan;30(1):51-58. doi: 10.1111/jerd.12344. Epub 2017 Nov 11.

Abstract

OBJECTIVE

To evaluate the efficacy of in-office bleaching on stain removal from stained resin composite and ceramic computer-assisted design/computer-assisted manufacturing (CAD/CAM) blocks and direct resin composites.

METHODS

Forty disk-shaped samples were fabricated from each of nine materials: six CAD/CAM (VITABLOCS Mark II, Paradigm MZ100, Exp Vita Hybrid Ceramic, VITA ENAMIC, Exp Kerr, and LAVA Ultimate) and three direct resin composites (Filtek Supreme, Venus Diamond, and Filtek Silorane). Samples were randomly divided into five groups (n = 8), each stained with a particular staining solution. Using a calibrated spectrophotometer and a black background, Lab* values were assessed before and after 120 days of staining. Samples were subjected to in-office bleaching using 40% hydrogen peroxide gel for one hour. At subsequent assessment, color change (ΔE) was calculated as the difference between Lab* values. Both ANOVA and the Duncan test were used to identify differences between groups (α = 0.05).

RESULTS

Bleaching resulted in significant differences in ΔE values for all materials (P < .001). Bleaching efficacy was highly influenced by material composition and staining solution. Residual color values after bleaching for ceramic and hybrid ceramics ranged from -0.49 to 2.35, within the clinically acceptable maximum of 3.3. Values after bleaching for resin-based CAD/CAM ranged from -0.7 to 7.08 while direct resin composites values ranged from -1.47 to 25.13. Coffee left the greatest residual color on all materials.

CONCLUSIONS

Based on material nature, 40% hydrogen peroxide bleaching can remove staining. The new resin-based CAD/CAM blocks showed promising results in terms of color stability.

CLINICAL SIGNIFICANCE

Bleaching using 40% hydrogen peroxide can be an effective method to remove stains from dental restorations. In this way, restoration replacement as a result of discoloration may no longer be necessary.

摘要

目的

评估诊室漂白对染色树脂复合及陶瓷计算机辅助设计/计算机辅助制造(CAD/CAM)块和直接树脂复合材料上污渍去除的效果。

方法

从九种材料中各制作 40 个圆盘形样本:六种 CAD/CAM(VITABLOCS Mark II、Paradigm MZ100、Exp Vita Hybrid Ceramic、VITA ENAMIC、Exp Kerr 和 LAVA Ultimate)和三种直接树脂复合材料(Filtek Supreme、Venus Diamond 和 Filtek Silorane)。样本随机分为五组(n=8),每组用特定的染色溶液染色。使用校准分光光度计和黑色背景,在染色 120 天后评估 Lab值。用 40%过氧化氢凝胶进行诊室漂白 1 小时。随后评估时,计算颜色变化(ΔE)作为 Lab值之间的差异。采用方差分析和 Duncan 检验来确定组间差异(α=0.05)。

结果

漂白对所有材料的ΔE 值均有显著影响(P<0.001)。漂白效果受材料组成和染色溶液的影响很大。漂白后陶瓷和混合陶瓷的残余颜色值在-0.49 到 2.35 之间,在临床可接受的最大值 3.3 内。基于树脂的 CAD/CAM 漂白后的颜色值在-0.7 到 7.08 之间,而直接树脂复合材料的值在-1.47 到 25.13 之间。咖啡在所有材料上留下的残余颜色最大。

结论

基于材料性质,40%过氧化氢漂白可以去除污渍。新型基于树脂的 CAD/CAM 块在颜色稳定性方面表现出良好的效果。

临床意义

用 40%过氧化氢进行漂白可以是去除牙齿修复体上污渍的有效方法。这样,由于变色而更换修复体可能不再必要。

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