超高分子量聚乙烯纤维结合不同树脂修复缺损乳磨牙的断裂载荷及边缘密闭性研究

Fracture resistance and marginal adaptation of primary molar defects repaired with ultra-high-molecular-weight polyethylene combined with various restorative materials

摘要

目的 评估超高分子量聚乙烯纤维——Ribbond纤维结合不同树脂修复离体缺损乳磨牙的断裂载荷及边缘密闭性能，为临床提供参考。方法 本研究已通过单位伦理委员会批准。收集新鲜拔除、牙冠完整的乳磨牙72颗，随机选取66颗作为实验组用于断裂载荷实验和微渗漏实验，根据充填时是否添加Ribbond纤维及树脂类型随机分为6组（n = 11），A1组：3M Z250树脂+Ribbond纤维、A2组：3M Z250树脂；B1组：Beautifil Ⅱ LS树脂+Ribbond纤维、B2组：BeautifilⅡLS树脂；C1组：3M大块树脂+Ribbond纤维、C2组：3M大块树脂，A1、B1、C1组为纤维强化复合树脂组，A2、B2、C2组为复合树脂直接充填组；空白对照组D组不作任何处理（n = 6），用于断裂载荷实验。断裂载荷实验分为6个实验组和1个空白对照组，每组6颗，实验组乳磨牙行Ⅱ类洞制备、充填，所有样本热循环老化后检测断裂载荷，分析断裂模式。微渗漏实验分为6个实验组，每组5颗，每颗于𬌗面近中和远中边缘嵴内制备2个直径3 mm、深度2.5 mm的Ⅰ类洞、充填，热循环老化后进行微渗漏检测。结果 断裂载荷实验结果显示，纤维强化复合树脂组各组断裂载荷均明显大于传统复合树脂直接充填组：A1组>A2组、B1组>B2组、C1组>C2组（P<0.05），纤维强化复合树脂组较复合树脂直接充填组断裂载荷增加了37.08%~39.34%，断裂模式纤维强化复合树脂组A1、C1组较复合树脂直接充填组A2、C2组牙体断裂占比明显减少，可修复模式发生率明显增加（P<0.05）；纤维强化复合树脂组A1组断裂载荷明显大于B1、C1组（P<0.05）。微渗漏实验结果显示，纤维强化复合树脂组各组微渗漏深度均小于复合树脂直接充填组：A1组<A2组、B1组<B2组、C1组<C2组（P<0.05），纤维强化复合树脂组较复合树脂直接充填组微渗漏深度降低了53.90%~66.96%。纤维强化复合树脂组B1组微渗漏深度明显小于A1、C1组（P<0.05）。结论 Ribbond纤维结合不同树脂材料均可增加离体缺损乳磨牙的断裂载荷，降低微渗漏深度，改善边缘密闭性。

Abstract

Objective To evaluate the impact of ultra-high-molecular-weight polyethylene (UHMWPE)-Ribbond fibers, when combined with different restorative materials, on fracture resistance and marginal adaptation of isolated primary molar defects, to provide a reference for clinical practice. Methods This study was approved by the Ethics Review Committee. A total of 72 extracted primary molars with complete crowns were collected, and 66 primary molars were randomly assigned as experimental groups for the fracture resistance and microleakage tests. The molars were divided into six groups (n = 11) based on the type of restorative materials and the application of Ribbond fibers: Group A1, 3M Filtek Z250 + Ribbond; Group A2, 3M Filtek Z250; Group B1, Beautifil II LS + Ribbond; Group B2, Beautifil II LS; Group C1, 3M Filtek Bulk Fill + Ribbond; and Group C2, 3M Filtek Bulk Fill. Groups A1, B1 and C1 received the fiber-reinforcing technique, whereas Groups A2, B2 and C2 received the direct restorative technique; the remainings were in Group D (blank control group), which did not receive treatment for the fracture resistance test. The fracture resistance test was divided into six experimental groups and one blank control group (n = 6). Primary molar teeth in each experimental group were prepared with Class II cavities and filled. The fracture load of all samples was detected, and the fracture mode was analyzed after thermal cycling. The microleakage test was divided into six experimental groups, with five in each group. Class I cavities with a diameter of 3 mm and depth of 2.5 mm were prepared within the mesial and distal marginal ridges on the occlusal surface and filled for primary molars in each group. Marginal microleakage was assessed after thermal cycling. Results The fracture resistance test results showed that the fracture resistance in groups that received the fiber-reinforcing technique was greater than that in groups that received the direct restorative technique: Group A1>Group A2, Group B1>Group B2, Group C1>Group C2 (P<0.05). The application of Ribbond fibers increased fracture resistance to all tested restorative materials by 37.08% to 39.34%. The proportion of tooth frac-ture decreased significantly in groups A1, C1 compared with A2, C2, with a significant increase in the occurrence rate of “Repairable” (P<0.05). The fracture resistance in Group A1 was significantly greater than that in Group B1 and Group C1 (P<0.05). The marginal microleakage test results showed that the microleakage depth in groups that received the fiber-reinforcing technique was smaller than that in groups that received the direct restorative technique: Group A1<Group A2, Group B1<Group B2, Group C1<Group C2 (P<0.05). The microleakage depth in groups that received the fiber-reinforcing technique decreased by 53.90% to 66.96% compared to that in groups that received the direct restorative technique. The microleakage depth in Group B1 was significantly less than that in Group A1 and Group C1. Conclusion The application of Ribbond fibers combined with various restorative materials could enhance fracture resistance and diminish the microleakage depth to improve marginal adaptation.

关键词

乳磨牙 / 牙体缺损 / 纤维强化复合树脂技术 / 超高分子量聚乙烯纤维 / 断裂载荷 / 边缘密闭性 / 微渗漏 / 仿生化修复

Key words

primary molar teeth / tooth defect / fiber-reinforing composite restoration technique / ultra-high-molecular-weight polyethylene (UHMWPE) / fracture resistance / marginal adaptation / microleakage / biomimetic restoration

Author summay

董鑫荷，医师，硕士，Email：[e-mail]