去托槽脱粘力和牙面残余粘接剂对牙釉质裂纹的影响  

Effect of the bracket debonding force and residual adhesives on enamel cracks

作　　者：范皓 袁瑞 张欢 司敏敏 高美雅 冯志远 Fan Hao;Yuan Rui;Zhang Huan;Si Minmin;Gao Meiya;Feng Zhiyuan(ShanXi Medical University School and Hospital of Stomatology,Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials,Taiyuan 030001,China;Department of Orthodontics,The Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学口腔医学院,口腔疾病防治与新材料山西省重点实验室,太原030001 [2]山西医科大学第五临床医学院口腔正畸科,太原030001

出　　处：《中华口腔正畸学杂志》2023年第2期92-96,共5页Chinese Journal of Orthodontics

基　　金：中华口腔医学会中西部口腔正畸临床研究项目(CSA-MW02021-14)。

摘　　要：目的探讨在不同固化方式的正畸托槽粘接剂的作用下,与体外去托槽过程中脱粘力和牙面残余粘接剂相关的力学因素对牙釉质裂纹变化的影响。方法收集50颗离体前磨牙分为两组进行随机对照研究,记录初始牙釉质裂纹数量和总长度。应用不同固化方式的粘接剂构建金属托槽脱粘的体外模型:A组(化学固化),B组(光固化),每组各25例。采用万能试验机为去托槽钳加力的方式体外模拟托槽脱粘时单向受力的力学模式。记录去托槽时的脱粘力、牙面粘接剂残余指数(adhesive remnant index,ARI)及牙釉质裂纹数量和总长度变化值。比较A、B组间去托槽脱粘力和牙面粘接剂残余指数的差异及两组间牙釉质裂纹数量和总长度变化值的差异。根据托槽脱粘后牙齿颊面釉质裂纹数量有无增加,A、B两组各分为2个亚组:A1、A2,B1、B2(1组为牙釉质裂纹数量无增加组,2组为有增加组)。探讨体外可能导致牙釉质裂纹数量增加的危险因素。结果 A组去托槽脱粘力的均值大于B组[A组:(208.37±30.51)N,B组:(178.31±30.13)N,P<0.001]。A、B组间牙面粘接剂残余指数、牙釉质裂纹数量和总长度的变化值比较差异均无统计学意义。A1组牙面粘接剂残余指数的中位数大于A2组[A1组:5.00(1.00),A2组:3.00(2.00),P=0.016],B1组牙面粘接剂残余指数的中位数也大于B2组[B1组:5.00(1.00),B2组:4.00(1.25),P=0.035],差异均有统计学意义。结论应用化学固化和光固化方式的粘接剂组间去托槽时脱粘力大小的差异对牙釉质裂纹的变化无明显影响。利用去托槽钳去托槽时应小心谨慎地双向均匀加力,应尽量增加牙面残余粘接剂的面积,减少牙面直接承受的力来避免由力学因素对牙釉质裂纹造成的影响。Objective The aim of this study is to investigate the effects of mechanical factors related to the debonding force and residual adhesives on the change of enamel cracks in the vitro process under the different curing modes of orthodontic bracket adhesives.Methods Fifty isolated premolars were collected and divided into two groups for a randomized controlled trial.The number and total length of initial enamel cracks were recorded.In vitro models of metal bracket debonding were constructed with different curing methods of orthodontic bracket adhesives:group A(chemical-cured)and group B(light-cured),25 cases in each group.The universal testing machine was used to apply force to the bracket removal plier in vitro to mimic the uini-direction force during debonding.The force of bracket debonding,adhesive remnant index(ARI)of tooth surface and the number and total length of enamel cracks were recorded.The difference of debonding force,Adhesive Remnant Index and the change of number and total length of cracks between group A and group B were compared.Respectively,Group A and B were divided into two subgroups,A1,A2,B1 and B2,according to whether the number of enamel cracks on the tooth surface increased after the bracket debonding.(Group 1 with no increase in the number of enamel cracks,and group 2 with increase).The risk factors of increasing the number of enamel cracks in vitro were discussed.Results The mean debonding force of group A was higher than that of group B[group A:(208.37±30.51)N,group B:(178.31±30.13)N,P<0.001].There was no statistical significance between group A and group B regarding the ARI and the change of number and total length of enamel cracks.The median ARI of group A1 was higher than group A2[group A1:5.00(1.00),group A2:3.00(2.00),P=0.016],the median ARI of group B1 was also higher than group B2[group B1:5.00(1.00),group B2:4.00(1.25),P=0.035],and the differences were statistically significant.Conclusions The difference of debonding force between the Chemical-cured and Light-cured adhesive group

关 键 词：金属托槽 托槽脱粘 釉质裂纹 粘结剂残余指数 

分 类 号：R783.1[医药卫生—口腔医学]