基于光学相干断层成像的树脂-牙釉质界面早期脱矿研究

doi:10.13591/j.cnki.kqyx.2025.08.003

摘要/Abstract

摘要：

目的评估扫频光学相干断层成像技术(swept-source optical coherence tomography,SS-OCT)检测树脂-牙釉质粘接界面早期脱矿的灵敏性以及不同树脂(Filtek Z350 XT、Filtek Bulk Fill、Tetric N-Ceram Bulk Fill)修复体周围釉质脱矿差异。方法选取离体第三磨牙27颗,制备成5 mm厚的试件,并在咬合面制备3 mm × 3 mm × 4 mm的Ⅰ类洞,随机分成3组,每组9颗,分别充填Filtek Z350 XT(分层充填4 mm)、Filtek Bulk Fill(一次充填4 mm)、Tetric N-Ceram Bulk Fill(一次充填4 mm),在非实验区域涂布耐酸指甲油后,置于脱矿溶液中脱矿4周,在脱矿前及脱矿后每周对树脂-牙釉质粘接界面进行SS-OCT和Micro-CT(micro computed tomography)扫描,监测粘接界面脱矿进展并定量分析脱矿深度的变化。结果 SS-OCT与Micro-CT均能无损监测树脂周围釉质脱矿,脱矿后树脂-牙釉质粘接界面呈现4种类型。在不同脱矿阶段,无论使用SS-OCT还是Micro-CT检测脱矿深度,3种树脂之间均无显著差异。SS-OCT与Micro-CT在各脱矿阶段检测脱矿深度结果具有较高的一致性(ICC:0.760~0.897)。结论 SS-OCT可以无创检测并量化树脂-牙釉质粘接界面脱矿情况,3种树脂在树脂周围牙釉质脱矿表现上无显著差异。

关键词: 光学相干断层成像, 大块充填树脂, 树脂-牙釉质界面脱矿

Abstract:

Objective To evaluate the sensitivity of swept-source optical coherence tomography(SS-OCT) in detecting early demineralization at the resin-enamel bonding interface, and the differences in enamel demineralization around restorations among different resins(Filtek Z350 XT, Filtek Bulk Fill, TetricN-Ceram Bulk Fill). Methods Twenty-seven extracted third molars were selected and prepared into 5-mm-thick specimens, and Class Ⅰ cavities measuring 3 mm × 3 mm × 4 mm were created on the occlusal surfaces. The specimens were randomly divided into three groups, with nine teeth in each group, and were respectively filled with Filtek Z350 XT(layered filling of 4 mm), Filtek Bulk Fill(bulk filling of 4 mm in one step), and Tetric N-Ceram Bulk Fill(bulk filling of 4 mm in one step). After applying acid-resistant nail varnish to non-experimental areas, the specimens were placed in a demineralizing solution for 4 weeks. SS-OCT and Micro-CT scans of the resin-enamel bonding interface were performed before demineralization and weekly thereafter to monitor the progression of demineralization and changes in demineralization depth were quantitatively analyzed. Results Both SS-OCT and Micro-CT were capable of non-destructive dynamic monitoring of demineralization at the resin-enamel bonding interface. After demineralization, four types of patterns were observed at the resin-enamel bonding interface. At different stages of demineralization, no significant differences in demineralization depth were detected among the three resins using either SS-OCT or Micro-CT. There was a high level of agreement between the demineralization depth measurements obtained from SS-OCT and Micro-CT at each demineralization stage(ICC: 0.760-0.897). Conclusion The early demineralization of resin-enamelbonding interface can be noninvasively detected by SS-OCT, and there was no significant differenceamong three resins in their ability to resist enamel demineralization around the restoration.

Key words: optical coherence tomography, bulk fill resin, resin-enamel interface demineralization

中图分类号:

R783.1

单雨菲, 何婕, 周恋祺, 丁宇洁, 吴彤, 孙志达. 基于光学相干断层成像的树脂-牙釉质界面早期脱矿研究[J]. 口腔医学, 2025, 45(8): 576-584.

SHAN Yufei, HE Jie, ZHOU Lianqi, DING Yujie, WU Tong, SUN Zhida. Early demineralization of the resin-enamel interface based on optical coherence tomography[J]. Stomatology, 2025, 45(8): 576-584.

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组别	树脂	检测仪器	简称
Z350	Filtek Z350XT	SS-OCT	Z350O
Z350	Filtek Z350XT	Micro-CT	Z350M
FBF	FiltekBulkFill	SS-OCT	FBFO
FBF	FiltekBulkFill	Micro-CT	FBFM
TNF	TetricN-CeramBulkFill	SS-OCT	TNFO
TNF	TetricN-CeramBulkFill	Micro-CT	TNFM

材料	主要成分	填料重量比/体积比	一次充填厚度
Z350	Bis-GMA、Bis-EMA、UDMA、TEGDMA、氧化锆/二氧化硅填料	78.5%/63.3%	2 mm
FBF	ERGPDMA、AUDMA、UMDA、DDDMA、AFM-1、氧化锆/二氧化硅填料和氟化镱填料	76.5%/58.4%	4 mm
TNF	Bis-GMA、Bis-EMA、UDMA、钡玻璃填料、预聚物	75%~77% /53%~55%	4 mm
SBU	HEMA、Bis-GMA、乙醇、水、硅烷化硅分子、光引发剂

类型	表现	定义
Ⅰ型		脱矿深度在近修复体区较远修复体区浅,树脂-牙釉质粘接界面封闭性最好,界面破坏速度小于釉质脱矿速度
Ⅱ型		脱矿深度在近修复体区和远修复体区相等,树脂-牙釉质粘接界面封闭性较好,界面破坏速度等于釉质脱矿速度
Ⅲ型		脱矿深度在近修复体区较远修复体区深,树脂-牙釉质粘接界面封闭性较差,界面破坏速度大于釉质脱矿速度
Ⅳ型		在前三型的基础上,粘接界面深层可见与表面脱矿区分离的脱矿区

组别	Ⅰ型	Ⅱ型	Ⅲ型	Ⅳ型
Z350	27.27	36.36	12.12	24.24
FBF	21.21	45.46	12.12	21.21
TNF	21.21	45.46	12.12	21.21

组别	脱矿1周	脱矿2周	脱矿3周	脱矿4周
Z350O	111.04±35.04	158.99±65.22	190.29±77.34	236.27±111.50
Z350M	104.20±33.28	150.03±56.22	170.23±61.36	214.71±92.80
FBFO	109.94±32.28	152.76±35.48	172.14±57.94	209.29±69.79
FBFM	106.15±26.51	145.68±28.34	163.76±55.58	196.42±55.39
TNFO	112.24±24.37	154.34±59.01	183.42±78.29	214.06±108.41
TNFM	105.98±28.22	143.98±53.31	166.58±64.35	198.46±92.42