不同粘结方案后CAD/CAM树脂复合冠的留存情况。
Retention of CAD/CAM resin composite crowns following different bonding protocols.
作者信息
Nejat Amir H, Lee Jinwhan, Shah Shreya, Lin Chee Paul, Kulkarni Prajakta, Chavali Ramakiran, Lawson Nathaniel C
机构信息
Department of Prosthodontics, Louisiana State University, New Orleans, Louisiana, USA.
Glidewell Laboratories, Newport Beach, California, USA.
出版信息
Am J Dent. 2018 Apr;31(2):97-102.
PURPOSE
To evaluate the effect of different surface treatments and primers with a CAD/CAM resin composite block on its crown retention.
METHODS
120 human molars were prepared with a 24° total convergence angle, 1.5 mm height, and axial walls in dentin. Surface area was measured by digital microscopy. Crowns were machined from CAD/CAM resin composite blocks. Teeth were randomly allocated to 12 groups (n= 10) based on possible combinations of three surface treatments: [Control, Alumina air abrasion (50-µm Al₂O₃ at 0.28 MPa) ]; 5% hydrofluoric acid etch (20-second scrub); silane application (with or without Kerr Silane primer); and adhesive application (with or without Optibond XTR Adhesive). Optibond XTR Adhesive was applied to the tooth preparations and crowns were bonded with MaxCem Elite cement. Crowns were fatigued for 100,000 cycles at 100 N in water and debonded in tension (1 mm/minute). Crown retention strength (maximum load/surface area) values were analyzed using a three-way ANOVA with Tukey's post-hoc tests (α= 0.05).
RESULTS
Surface treatment, silane and adhesive applications independently affect retention force (P< 0.05). All interactions were not significant (P> 0.05). Alumina airborne abrasion surface treatment, silane and adhesive applications all improve retention strength. Therefore, CAD/CAM resin composite crowns can withstand debonding while undergoing mechanical fatigue. Although all forms of surface treatment and primer application improve bond strength, the highest mean retention strength values were recorded when the crowns were alumina particle abraded and coated with adhesive (with or without silane).
CLINICAL SIGNIFICANCE
In order to improve the bonding of resin composite crowns, application of alumina airborne particle abrasion and a coat of adhesive (proceeded by an optional coat of silane) is recommended. If hydrofluoric acid is utilized, the crowns should be treated with a coat of silane followed by adhesive application.
目的
评估不同表面处理和底漆对CAD/CAM树脂复合材料块制作的全冠固位力的影响。
方法
制备120颗人磨牙，全冠聚合角为24°，高度为1.5 mm，轴壁位于牙本质内。通过数码显微镜测量表面积。全冠由CAD/CAM树脂复合材料块加工而成。根据三种表面处理的可能组合，将牙齿随机分为12组（n = 10）：[对照组、氧化铝气磨（0.28 MPa压力下50-µm Al₂O₃）]；5%氢氟酸蚀刻（20秒擦洗）；硅烷应用（使用或不使用Kerr硅烷底漆）；以及粘结剂应用（使用或不使用Optibond XTR粘结剂）。将Optibond XTR粘结剂应用于牙齿预备体，并用MaxCem Elite水门汀粘结全冠。全冠在水中100 N力下疲劳循环100,000次，然后进行拉伸脱粘（1 mm/分钟）。使用三因素方差分析和Tukey事后检验（α = 0.05）分析全冠固位强度（最大载荷/表面积）值。
结果
表面处理、硅烷和粘结剂应用均独立影响固位力（P < 0.05）。所有交互作用均无统计学意义（P > 0.05）。氧化铝气磨表面处理、硅烷和粘结剂应用均能提高固位强度。因此，CAD/CAM树脂复合材料全冠在承受机械疲劳时能够抵抗脱粘。虽然所有形式的表面处理和底漆应用均能提高粘结强度，但当全冠经过氧化铝颗粒磨损并涂覆粘结剂（使用或不使用硅烷）时，记录到的平均固位强度值最高。
临床意义
为提高树脂复合材料全冠的粘结效果，建议采用氧化铝气磨颗粒处理并涂覆一层粘结剂（可选择先涂覆一层硅烷）。如果使用氢氟酸，全冠应先涂覆一层硅烷，然后再涂覆粘结剂。
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