口腔医学研究 ›› 2022, Vol. 38 ›› Issue (7): 659-665.DOI: 10.13701/j.cnki.kqyxyj.2022.07.016

• 儿童牙体修复研究 • 上一篇    下一篇

口内扫描仪辅助下预热树脂充填窝沟龋的微渗漏研究

余帆1, 吕长海1, 马雪婷1, 伏丽林1, 饶南荃1,2*, 刘波1*   

  1. 1.昆明医科大学附属口腔医院儿童口腔科 云南 昆明 650106;
    2.昆明医科大学附属口腔医院 云南省口腔医学重点实验室 云南 昆明 650500
  • 收稿日期:2021-12-30 出版日期:2022-07-28 发布日期:2022-07-22
  • 通讯作者: * 饶南荃,E-mail:raonanquan@kmmu.edu.cn;刘波,E-mail:465926503@qq.com
  • 作者简介:余帆(1997~ ),女,云南宣威人,硕士在读,医师,主要从事儿童口腔的临床及研究工作。
  • 基金资助:
    云南省教育厅科学研究基金项目(编号:2021Y344);云南省科技厅-昆明医科大学应用基础研究联合专项资金项目[编号:2018FE001(-074)]

Effects of Preheating on Marginal Microleakage of Resin Composite Filled Pit and Fissure Caries Measured with Intraoral Scanner

YU Fan1, LV Changhai1, MA Xueting1, FU Lilin1, RAO Nanquan1,2*, LIU Bo1*   

  1. 1. Department of Pediatric Dentistry, School and Hospital of Stomatology, Kunming Medical University, Kunming 650106, China;
    2. Yunnan Key Laboratory of Stomatology, School of Stomatology, Kunming Medical University, Kunming 650500, China
  • Received:2021-12-30 Online:2022-07-28 Published:2022-07-22

摘要: 目的:应用数字化口内扫描仪,比较室温及预热60 ℃ 3M Z350 XT通用树脂充填不同宽度窝洞后充填体边缘的微渗漏情况。方法:51颗离体恒磨牙截去牙根,牙冠自近远中向剖开,颊、舌/腭侧面各形成一牙片,随机分为6组(n=17),根据分组在颊、舌/腭面牙片上制备不同宽度的“L”形窝洞以模拟复杂窝沟[洞长(4.0±0.5) mm,洞深2 mm,洞宽分别为1 mm、1.6 mm、2 mm],窝洞制备前于车针上做标记,以控制洞深,制备中及制备完成后采用相应车针衡量窝洞宽度及长度,随后TRIOS数字化扫描仪测量窝洞三维,选取合格样本。分组如下:A1、A2、A3组(室温Z350 XT通用树脂分别充填1 mm、1.6 mm、2 mm宽的窝洞);B1、B2、B3组(预热60℃ Z350 XT通用树脂分别充填1 mm、1.6 mm、2 mm宽的窝洞)。6组样本充填后进行冷热循环,每组随机抽取16个样本经1%亚甲基蓝溶液染色后于体视显微镜下观察两个不同位点的染料渗漏程度,其余样本用于扫描电镜观察。结果:相同洞宽的室温组与预热组之间的窝洞宽度、长度及洞深均无统计学差异(P>0.05)。充填1 mm宽度的窝洞时,预热组与室温组的微渗漏程度无统计学差异(P>0.05);充填1.6 mm宽度的窝洞时,预热组在位点1、位点2的微渗漏程度均低于室温组(P<0.05);充填2 mm宽度的窝洞时,预热组在位点1的微渗漏程度与室温组无统计学差异(P>0.05),而在位点2的微渗漏程度低于室温组(P<0.05)。SEM观察可见在充填1.6 mm及2 mm宽度的窝洞时,预热组复合树脂与牙体组织粘接界面较室温组更加紧密。结论:(1)数字化口内扫描应用于测量窝洞三维尺寸有一定优势;(2)预热技术可减小复合树脂边缘微渗漏;(3)对于2 mm及以下宽度的窝沟龋而言,预热至60 ℃的Z350 XT通用树脂更适合充填1.6~2 mm宽度的窝洞,尤其对走形复杂的窝洞更占优势。

关键词: 数字化口内扫描, 复合树脂, 预热, 窝沟龋, 微渗漏

Abstract: Objective: To explore the effect of preheating on the marginal microleakage of 3M Z350 XT universal resin in the treatment of dental caries with different widths with the assistance of intraoral scanner. Methods: Fifty-one human permanent molars were collected. The roots of teeth were cut off, and the crowns were split from mesial side to distal side, departing into buccal piece and lingual/palatal piece. One hundred and two samples were randomly divided into 6 groups (n=17). L-shaped cavities with different widths were prepared on samples to simulate natural pits and fissures [the length of cavity was (4.0±0.5) mm, the depth was 2 mm, and the widths were 1 mm, 1.6 mm, and 2 mm, respectively]. The mark was made on the bur before the preparation to determine the depth of the cavity, the different burs were used to roughly measure the width and length of the cavity during the preparation. After the completion, the cavities in three dimensions were measured by TRIOS digital scanner. Only qualified samples were selected. The width of cavities in group A1, A2, and A3 were filled with room temperature Z350 XT universal resin composite, and in group B1, B2 and B3 were filled with 60℃ Z350 XT universal resin composite. All the samples were subjected to thermocycling. Sixteen samples randomly selected from each group were used to dye in 1% methylene blue solution for 24 h and to detect the extent of marginal microleakage quantitatively, while other samples were used for SEM observation. Results: There was no significant differences in the width, length, and depth of the cavities between the room temperature and preheating groups when the cavity was the same width (P>0.05). There was no significant difference between the preheating and non-preheating groups when filling the 1 mm-wide cavity (P>0.05). When filling the 1.6 mm-wide cavity, the degree of microleakage in the preheating group was lower than that in the non-preheating group at both site 1 and site 2 (P<0.05). When filling the 2 mm-wide cavity, although there was no significant difference between the preheating and non-preheating groups at site 1 (P>0.05), the non-preheating group showed more microleakage values compared to the preheating group at site 2 (P>0.05). SEM observation showed that the bonding interface became more compact in the preheating groups compared to the non-preheating groups, when filling the cavities with 1.6 mm and 2 mm width. Conclusion: Digital intraoral scanner has certain advantages to precisely measure the cavities in three dimensional directions. Preheating technology can reduce the marginal microleakage of resin composite. For pit and fissure caries with the width equal to or narrower than 2 mm, 60℃ Z350 universal resin composite is more suitable for filling the cavities with 1.6-2 mm width, especially for the cavities with complex morphology.

Key words: digital intraoral scanner, resin composite, preheating, pit and fissure caries, microleakage