牙釉质表面残留粘接剂的不同去除方法对托槽再粘接的影响  

Effects of different removal methods of residual adhesive on enamel surface on the reattachment of brackets

作　　者：朱熙俊 唐旭炎[1] ZHU Xijun;TANG Xuyan(Stomatological College of Anhui Medical University/Affiliated Stomatological Hospital of Anhui Medical University/Anhui Province Key Laboratory of Oral Diseases Research,Hefei 230032,China)

机构地区：[1]安徽医科大学口腔医学院/安徽医科大学附属口腔医院/安徽省口腔疾病研究重点实验室,安徽合肥230032

出　　处：《临床医学研究与实践》2023年第9期89-92,共4页Clinical Research and Practice

摘　　要：目的探讨牙釉质表面残留粘接剂的不同去除方法对托槽再粘接的影响,为临床安全去除粘接剂并保证再粘接效果提供参考。方法选取安徽医科大学附属口腔医院因正畸治疗拔除的健康上颌前磨牙51颗,按照去除牙釉质表面残留粘接剂的不同方法随机分为喷砂组、激光组和矽粒子打磨轮组,每组17颗。在常规粘接托槽后,测试托槽初次粘接的剪切粘接强度;再分别用喷砂、Er:YAG激光、矽粒子打磨轮对粘接牙面进行处理,并进行再次粘接。比较三组样本初次、再次粘接时托槽和牙面间的剪切粘接强度。粘接剂处理后,三组各选取2颗牙进行扫描电镜下评估。评估并比较三组样本的粘接剂残留指数(ARI)评分。结果初次粘接时,三组托槽和牙面间的剪切粘接强度比较,差异无统计学意义(P=0.50);再次粘接时,三组托槽和牙面间的剪切粘接强度比较,差异具有统计学意义(P=0.04);再次粘接时,激光组托槽和牙面间的剪切粘接强度高于初次粘接时(P=0.00);再次粘接时,激光组托槽和牙面间的剪切粘接强度高于喷砂组(P=0.02);再次粘接时,激光组和矽粒子打磨轮组、喷砂组和矽粒子打磨轮组的托槽和牙面间的剪切粘接强度比较,差异均无统计学意义(P>0.05)。扫描电镜结果显示,喷砂组和激光组基本看不到粘接剂的残余,但喷砂组对牙釉质产生了严重的破坏,激光组牙釉质破坏最少且粘接剂残余最少;矽粒子打磨轮组残余粘接剂最多,牙釉质破坏介于激光组和喷砂组之间。三组的ARI评分比较,差异无统计学意义(P=0.77)。结论Er:YAG激光处理后的再次剪切粘接强度高于初次粘接时,并且相对于喷砂和矽粒子打磨轮更能保护牙釉质表面。Er:YAG激光更适合用于临床去除牙釉质表面残余粘接剂。Objective To explore the effects of different removal methods of residual adhesive on the surface of enamel on the reattachment of brackets,and to provide reference for clinical safe removal of adhesive and ensuring the effect of rebonding.Methods Fifty-one healthy maxillary premolars extracted for orthodontic treatment in the Affiliated Stomatological Hospital of Anhui Medical University were randomly divided into sandblasting group,laser group and silicon particle grinding wheel group according to different methods of removing residual adhesive on enamel surface,with 17 teeth in each group.After conventional bonding brackets,the shear bond strength of the first bonding brackets was tested;then,the bonded tooth surface was treated with sandblasting,Er:YAG laser and silicon particle grinding wheel respectively,and were re-bonded.The shear bonding strength between the brackets and teeth surfaces of samples of the three groups during primary and secondary bonding was compared.After the adhesive treatment,two teeth were selected from each of the three groups for evaluation under the scanning electron microscope.The Adhesive Remnant Index(ARI)score in the three groups of samples was evaluated and compared.Results At the first bonding,there was no significant difference in the shear bond strength between brackets and teeth surfaces among the three groups(P=0.50);at the rebonding,the shear bond strength between brackets and tooth surfaces in the three groups was statistically significant(P=0.04);at the rebonding,the shear bond strength between brackets and teeth surfaces in the laser group was higher than that of the first bonding(P=0.00);at the rebonding,the shear bond strength between brackets and teeth surfaces in the laser group was higher than that in the sandblasting group(P=0.02);there were no significant differences in the shear bond strength between brackets and teeth surfaces between the laser group and the silicon particle grinding wheel group,the sandblasting group and the silicon particle grinding wheel gr

关 键 词：粘接 ER:YAG激光 扫描电镜 剪切粘接强度 托槽 牙釉质 

分 类 号：R783[医药卫生—口腔医学]