用于隐形矫治器附件的牙科复合材料的多参数性能比较

Multiparametric performance comparison of dental composites for clear aligner attachments.

作者信息

Guan Yunlin, Xu Jiarong, Qiu Junhong, Cai Hao, Xia Wenxuan, Ye Zhou, Sang Ting

机构信息

School of Stomatology, Jiangxi Medical College, Nanchang University, Nanchang, 330000, Jiangxi, China.

Jiangxi Provincial Key Laboratory of Oral Diseases and Jiangxi Provincial Clinical Research Center for Oral Diseases, 688 Honggu North Avenue, Honggutan District, Nanchang, 330000, Jiangxi, China.

出版信息

BMC Oral Health. 2025 Jul 19;25(1):1206. doi: 10.1186/s12903-025-06623-w.

DOI:10.1186/s12903-025-06623-w

PMID:40684167

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12276693/

Abstract

BACKGROUND

As clear aligner technology (CAT) gains prominence, the performance of composite attachments - critical devices for optimizing aligner retention and tooth movement control - require systematic evaluation. This study assesses three light-cured composites (Filtek™ Z250 XT, Z350 XT, and P60; 3 M ESPE) regarding color stability, shear bond strength (SBS), and durability to establish evidence-based selection criteria.

METHODS

Attachments were bonded to mandibular premolars, simulating the clinical process, and materials were tested for color changes (after immersion in coffee, cola, or iced tea), SBS, and durability (wear volume, surface roughness, morphology, post-aging SBS). The data obtained from the study were statistically evaluated via the Shapiro-Wilk test, the Levene test, t-tests, one-way analysis of variance and chi-square test. A p-value < 0.05 was considered statistically significant.

RESULTS

Z250 showed significantly higher coffee - induced discoloration than Z350 (p < 0.05) and P60 (p < 0.01), exceeding clinical acceptability (ΔE ≥ 3.3). Z250 also emerged similar trends with cola and iced tea. Z350 exhibited the highest immediate SBS (p < 0.05 vs. Z250) that may cause enamel damage. P60 demonstrated superior wear resistance, with significantly lower surface roughness (Sq / Sa) than Z250 (p < 0.001) and Z350 (p < 0.01), and the smallest post-wear defect volume (p < 0.01 vs. Z250). The SBS differences in immediate groups were eliminated through aging treatment.

CONCLUSIONS

Z250 underperformed in color stability, SBS, and durability versus Z350/P60, though demonstrated cost-effectiveness. Z350 offers outstanding color durability and higher SBS but risks enamel damage from interfacial delamination. P60 excels with color stability, acceptable adhesive remnants, and exceptional wear resistance, serving diverse clinical needs. Clinical decisions could prioritize P60 for function-aesthetic balance, with targeted Z350/Z250 use in special scenarios.

摘要

背景

随着透明矫治器技术（CAT）的日益普及，复合附件作为优化矫治器固位和控制牙齿移动的关键装置，其性能需要进行系统评估。本研究评估了三种光固化复合材料（Filtek™ Z250 XT、Z350 XT和P60；3M ESPE）在颜色稳定性、剪切粘结强度（SBS）和耐久性方面的表现，以建立基于证据的选择标准。

方法

将附件粘结到下颌前磨牙上，模拟临床过程，并对材料进行颜色变化测试（浸泡在咖啡、可乐或冰茶中后）、SBS测试和耐久性测试（磨损量、表面粗糙度、形态、老化后SBS）。通过Shapiro-Wilk检验、Levene检验、t检验、单因素方差分析和卡方检验对研究获得的数据进行统计学评估。p值<0.05被认为具有统计学意义。

结果

Z250在咖啡诱导的变色方面显著高于Z350（p<0.05）和P60（p<0.01），超过了临床可接受性（ΔE≥3.3）。Z250在可乐和冰茶中也呈现出类似趋势。Z350表现出最高的即时SBS（与Z250相比，p<0.05），这可能会导致牙釉质损伤。P60表现出卓越的耐磨性，其表面粗糙度（Sq/Sa）显著低于Z250（p<0.001）和Z350（p<0.01），且磨损后缺陷体积最小（与Z250相比，p<0.01）。即时组中的SBS差异通过老化处理得以消除。

结论

与Z350/P60相比，Z250在颜色稳定性、SBS和耐久性方面表现欠佳，不过具有成本效益。Z350具有出色的颜色耐久性和较高的SBS，但存在因界面分层而导致牙釉质损伤的风险。P60在颜色稳定性、可接受的粘结残余物和卓越的耐磨性方面表现出色，可满足不同的临床需求。临床决策可以优先选择P60以实现功能美学平衡，在特殊情况下有针对性地使用Z350/Z250。