桩道牙本质壁的不同处理对纤维桩粘接强度的影响

摘要

目的：比较使用自粘接型树脂水门汀粘接纤维桩时，经3种不同方法处理桩道牙本质壁后对纤维桩粘接强度的影响。方法：收集30颗因正畸需拔除的健康下颌单根管前磨牙进行截冠、常规根管治疗、桩道预备后随机分为3组，每组10颗；使用不同方法对桩道牙本质壁进行处理：Ⅰ组(对照组)：手动注射器冲洗；Ⅱ组(超声组)：超声冲洗；Ⅲ组(激光组)： Er： YAG激光冲洗。使用自粘接桩核树脂水门汀将纤维桩粘接完毕后切片进行薄片推出实验。采用双因素方差分析检验桩道牙本质壁的不同处理方法及桩道的不同深度(根颈部，根中部，根尖部)对纤维桩粘接强度的影响，并用万能显微镜观察试件的破坏方式，对结果进行Chi-Square检验。设定检验标准α=0.05。结果：各组粘接强度差异有统计学意义，Ⅱ组和Ⅲ组的粘接强度显著高于Ⅰ组(P<0.05)，桩道不同深度纤维桩的粘接强度差异无统计学意义(P=0.082)；各组破坏方式以混合破坏为主，但Ⅱ组和Ⅲ组中桩道牙本质壁—树脂水门汀破坏比例较Ⅰ组明显降低。结论：使用自粘接型树脂水门汀时，经超声或激光处理预备后的桩道可显著提高纤维桩的粘接强度。桩道深度对纤维桩的粘接强度无影响。%Objective:To evaluate the effect of different solutions to post space on bonding strength of fiber post to root canal using a self-adhesive resin cement.Methods:30 healthy extracted mandible premolar teeth with single root canal were treated with decoronation, root canal therapy and preparation of the post space. The teeth were randomly divided into three groups, and each group was subjected to a different preparation of post space: syringe irrigation in Group I (control group), ultrasonic irrigation in Group II (ultrasonic group), Er: YAG laser irrigation in Group III (laser group). After cemen-tation of fiber post with self-adhesive resin cement Embracecore, the thin-slice push-out test was performed. A two-way ANOVA and LSD test were used to analyze the effect of the two different preparations of the post space and different deep-ness (from coronal to apical) of the post space on bonding strength of fiber post to root canal. Fracture mode of fiber posts were observed by universal scope. Data were analyzed using Chi-Square test. The significance level wasα=0.05.Results:There was a significant difference in the mean values of bonding strength among the three groups. Group I was the lowest one compared with Group II and III (P<0.05). There was no significant difference among bonding strength of different deepness of the post space (P=0.082). The majority fracture mode of tested specimens in each group was mixed failure, but the fracture between the resin cement and the dentin wall was significantly reduced in Group II and III compared to that in Group I.Conclusion:ultrasonic or Er: YAG laser treatments after post space preparation when using a self-adhesive resin cement increase the bonding strength of fiber post to root canal. Different deepness of post space has no influence on bond-ing strength of fiber post to root canal.