不同龋缘形成情况下牙釉质与修复材料的黏附密度

Y. Smeyanov, Yu. V. Lakhtyn, A. Romanyuk, O. V. Belonozhko
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引用次数: 0

摘要

介绍。目前,龋齿边缘设计对修复材料与牙釉质黏附密度的影响仍然是一个争论不休的问题;在关于这个主题的开放获取出版物中有一些混淆。目标。研究牙釉质黏附修复材料的密度随龋洞边缘形成的设计而变化。材料和方法。本研究使用30颗完整的第三磨牙,根据临床指征进行拔牙。根据第一类龋齿的形成情况,按Black分类将样品分为三组,每组10个。在第一组中,形成了典型的龋齿,其壁均匀,边缘直,没有形成牙釉质的斜角(褶皱)。第二组牙釉质外斜角与牙釉质边界成45度角。在第三组,牙洞形成内部牙釉质倾斜。采用微杂化复合光固化材料LATELUX (PE“LATUS”,哈尔科夫)修复龋齿。修复时进行一次性垂直机械载荷,力为98.07 N,并在5°C至55°C的温度下进行200个循环的热循环处理,每个温度下暴露60秒。在REM 102低真空室的栅格电子显微镜柱中,研究修复体与牙齿实体组织的接触面积、附着密度和存在间隙,并以微米(μm)表示。第一组样品的电子衍射图显示,修复材料与龋洞牙釉质的粘附密度在整个过程中是不同的:有时很厚,有时在接触区域有一定的空间。此外,在材料的粘合层与珐琅之间形成了空间。空间大小平均为7.90±0.73 μm (95% CI: 6.3: 9.5)。搪瓷棱柱在与材料接触的区域部分呈直线,沿其轴线纵向或横向,斜与一个倾斜的体相连。II组修复材料与牙釉质粘接层接触均匀,粘接层与龋洞牙釉质边缘粘接致密,几乎遍及龋洞。但部分区域牙釉质与粘接层的接触有破坏,出现裂纹(2.76±0.52 μm) (95% CI: 1.6: 3.9)。釉质棱柱在与材料接触的区域更横向地定位于它们的轴线,倾斜地与一个倾斜的身体。在第三组样品中,修复材料对龋齿牙釉质的粘附几乎完全不致密。修复材料与胶粘剂接触均匀。同时,黏合剂与牙釉质之间出现16.50±0.89 μm (95% CI: 14.6: 18.4)的接触破裂。釉质棱柱在与材料接触的区域呈线性,沿其轴线呈纵向。结论。根据布莱克的分类,在第一类龋齿的牙釉质边缘形成外斜角时,修复材料对牙釉质的粘附密度最大。
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DENSITY OF THE ADHERENCE OF RESTORATIVE MATERIAL TO THE ENAMEL OF TEETH WITH DIFFERENT FORMATION OF CARIOUS CAVITY EDGE
Introduction. At present, the question of the influence of carious cavity edge design on the density of the adherence of restorative material to the enamel remains discursive; there is some confusion in the open access publications on this topic. Objectives. To study the density of the adherence of restorative material to the enamel of teeth depending on the design of the formation of carious cavity edge. Materials and methods. The research was carried out using 30 intact third molars extracted upon clinical indications. The samples were divided into three groups, 10 in each, depending on the formation of carious cavities of the 1st class according to Black classification. In group I a classical carious cavity with even, straight-edged walls without the formation of the bevel (folds) of the enamel was formed. In group II, the outer beveling of enamel was made at an angle of 45o to the enamel-dentine border. In group III, the cavity was formed with an internal beveling of enamel. Carious cavities were restored with micro-hybrid composite light cured material LATELUX (PE "LATUS", Kharkiv). One-time vertical mechanical load with a force of 98.07 N was performed on restoration, and treated with thermocycled in a mode of 200 cycles at a temperature from 5 °C to 55 °C with an exposure of 60 seconds at each temperature. The teeth were separated in a medio-distal direction through a center of restoration with diamond disks, placed in a column of a raster electron microscope with a low vacuum chamber REM 102, and the contact area of the restoration with solid tissues of the teeth was studied, the density of their adherence, and the present gaps were measured and expressed in micrometers (μm) Results. Electron diffraction pattern of the samples of group I showed that the density of the adherence of the restorative material to the enamel of the carious cavity was different throughout: sometimes thick, sometimes the space in the contact area was determined. Moreover, the space was formed between the adhesive layer of the material and enamel. The space size averaged 7.90 ± 0.73 μm (95% CI: 6.3: 9.5). Enamel prisms adjoined in the area of contact with the material partly linear, longitudinal along its axis or transversely, obliquely with a slanted body. In the samples of group II restorative material was evenly in contact with the layer of adhesive, adherence of which to the enamel edge of the carious cavity was dense almost throughout. But in some areas there was a violation of the contact of the enamel with the adhesive layer, there were cracks 2.76 ± 0.52 μm (95% CI: 1.6: 3.9). Enamel prisms in the area of contact with the material were located more transversely to their axis, obliquely with a slanted body. In the samples of group III, the adherence of the restorative material to the enamel of the carious cavity was not dense almost throughout. The restorative material had a uniform contact with the adhesive. At the same time, there was a breach of contact in the form of cracks of 16.50 ± 0.89 (95% CI: 14.6: 18.4) μm observed between adhesive and enamel. Enamel prisms in the zone of contact with the material were linear, longitudinal along its axis. Conclusions. The greatest density of the adherence of restorative material to the enamel of teeth occurs when forming the outer beveling of the enamel edge in the carious cavities of the 1st class according to Black classification.
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