Er:YAG激光和Nd:YAG激光辅助的牙漂白对树脂充填体粘接强度和边缘微渗漏的影响  

Effect of bleaching combined with Er:YAG or Nd:YAG laser on shear bond strength and microleakage of resin restoration

作　　者：侯秀秀 苑克勇[1] 黄正蔚[1] 马瑞[1] HOU Xiu-xiu;YUAN Ke-yong;HUANG Zheng-wei;MA Rui(Department of Endodontics,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology.Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院牙体牙髓病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海口腔医学研究所,上海200011

出　　处：《上海口腔医学》2023年第4期351-355,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金面上项目(82071104/81570964);上海交通大学口腔医学院研究型学科基金(KQYJXK2020)。

摘　　要：目的评价Er:YAG激光和Nd:YAG激光辅助的牙漂白对釉质表面树脂充填体粘接强度和边缘微渗漏的影响。方法将离体牙制备成釉质测试试件(n=64)后随机分为4组(n=16),包括对照组、传统漂白组、Er:YAG激光辅助的漂白组和Nd:YAG激光辅助的漂白组。4组试件分别处理后,检测其釉质表面树脂充填体的剪切粘接强度(n=8)和微渗漏深度(n=8),利用体视显微镜观察各组试件的断裂模式。采用SPSS 26.0软件包对数据进行统计学分析。结果与对照组相比,传统漂白后釉质表面树脂充填体的粘接强度显著下降,边缘微渗漏显著增加(P<0.05);Er:YAG激光辅助的漂白后釉质表面充填体的剪切粘接强度和微渗漏深度与对照组相比无显著差异(P>0.05),Nd:YAG激光辅助的漂白后树脂充填体的剪切粘接强度显著下降(P<0.05),但其边缘微渗漏深度与对照组相比无显著差异(P>0.05)。4组试件的粘接断裂模式主要为粘接界面断裂。结论相比传统漂白方法,激光辅助的牙漂白对树脂充填体粘接强度和微渗漏的影响较小,具有一定的临床优势。PURPOSE:To evaluate the effects of bleaching combined with Er:YAG laser or Nd:YAG laser on bond strength and microleakage of resin fillings on enamel surface.METHODS:Sixty-four pieces of enamel specimens prepared from isolated teeth were randomly divided into 4 groups(n=16):control group,simple bleaching group,bleaching combined with Er:YAG laser group and bleaching combined with Nd:YAG laser group.Then the shear bond strength and the depth of microleakage were tested,and the fracture mode of the specimen was observed under microscope.SPSS 26.0 software package was used for statistical analysis.RESULTS:After bleaching simply,the bond strength of the restoration was significantly decreased,and the marginal microleakage was significantly increased(P<0.05).There was no significant difference in shear bond strength and microleakage depth between the group bleaching combined with Er:YAG laser and control group(P>0.05).The shear bond strength after bleaching combined with Nd:YAG laser was significantly reduced(P<0.05),but there was no significant difference in the depth of microleakage compared with unbleached microleakage(P>0.05).Bonding interface fracture was the main fracture mode for all groups.CONCLUSIONS:Compared to traditional bleaching,bleaching combined with laser has certain clinical advantages due to its less influence on bond strength and microleakage of resin fillings.

关 键 词：漂白 ER:YAG ND:YAG 粘接强度 微渗漏 

分 类 号：R781.05[医药卫生—口腔医学]