不同表面处理对CAD/CAM树脂陶瓷复合材料弯曲强度及形貌的影响

doi:10.13591/j.cnki.kqyx.2026.04.007

摘要/Abstract

摘要：

目的探讨不同表面处理对CAD/CAM树脂陶瓷复合材料弯曲强度及表面形貌的影响。方法选取润瓷、Shofu Block HC及Vita Enamic 3种树脂陶瓷复合材料,分别进行4种表面处理:对照组(NT)、50 μm Al₂O₃喷砂(SB)、氢氟酸酸蚀(HF)和Er:YAG激光蚀刻(Er:YAG)。按ISO 6872标准测试即刻和10 000次冷热循环后的三点弯曲强度,并通过扫描电镜(SEM)观察表面形貌。三点弯曲强度数据采用单因素方差分析、双因素方差分析及LSD检验(α=0.05)。结果与对照组相比,3种树脂陶瓷复合材料经HF处理后的三点弯曲强度未发生明显变化(P>0.05),经Er:YAG处理和SB处理后的强度降低,差异具有统计学意义(P<0.05)。经冷热循环后的润瓷与Shofu Block HC的强度,各组均降低,差异有统计学意义(P<0.05),但Vita Enamic组冷热循环后的SB组与Er:YAG组的强度降低无统计学意义(P>0.05)。SEM显示冷热循环前后,所有处理组表面形貌均发生改变,其中HF组形貌变化最小。结论对于CAD/CAM树脂陶瓷复合材料,氢氟酸酸蚀对弯曲强度及表面形貌的影响最小,需谨慎选择Er:YAG激光和喷砂处理。但对于Vita Enamic,冷热循环后喷砂和Er:YAG激光两种处理对弯曲强度的影响很小。

关键词: CAD/CAM树脂陶瓷复合材料, 弯曲强度, 冷热循环, 扫描电子显微镜, Er:YAG激光

Abstract:

Objective To investigate the effects of different surface treatments on the flexural strength and surface morphology of CAD/CAM resin-ceramic composites. Methods Three resin-ceramic composites—UPCERA Hyramic, Shofu Block HC, and Vita Enamic were subjected to four surface treatments: no treatment (NT), 50 μm Al₂O₃ sandblasting (SB), hydrofluoric acid etching (HF), and Er:YAG laser etching (Er:YAG). The three-point flexural strength was tested immediately and after 10 000 thermal cycles in accordance with ISO 6872 standards. Surface morphology was examined using scanning electron microscopy (SEM). The flexural strength data were analyzed using one-way ANOVA, two-way ANOVA and LSD post hoc tests (α=0.05). Results Compared with the control group, the three-point flexural strength of all three resin-ceramic composites showed no significant change after HF treatment (P>0.05), while it decreased significantly after Er:YAG treatment and SB treatment, with the differences being statistically significant (P<0.05). After thermocycling, the strength of both Vita Enamic and Shofu Block HC decreased significantly in all groups (P<0.05), whereas the SB and Er:YAG groups of Vita Enamic showed no statistically significant decline (P>0.05). SEM analysis revealed alterations in surface morphology in all treated groups before and after thermocycling, with the HF group displaying the least pronounced changes. Conclusion For CAD/CAM resin-ceramic composites, hydrofluoric acid etching has the least detrimental effect on flexural strength and surface morphology. Caution should be exercised when employing Er:YAG laser etching or sandblasting treatments. However, for Vita Enamic, the influence of both sandblasting and Er:YAG laser treatment on the flexural strength is minimal after thermocycling.

Key words: CAD/CAM resin-ceramic composite, flexural strength, thermal cycling, scanning electron microscopy (SEM), Er:YAG laser

中图分类号:

R783.1

杨雅倩, 张蒙蒙, 任光辉, 毕文雅, 宗敏. 不同表面处理对CAD/CAM树脂陶瓷复合材料弯曲强度及形貌的影响[J]. 口腔医学, 2026, 46(4): 277-282.

YANG Yaqian, ZHANG Mengmeng, REN Guanghui, BI Wenya, ZONG Min. Effects of different surface treatments on flexural strength and morphology of CAD/CAM resin-ceramic composites[J]. Stomatology, 2026, 46(4): 277-282.

图/表 5

表1

表2

表3

图1

图2

参考文献 25

[1]	Bajraktarova-Valjakova E, Korunoska-Stevkovska V, Kapusevska B, et al. Contemporary dental ceramic materials, a review: Chemical composition, physical and mechanical properties, indications for use[J]. Open Access Maced J Med Sci, 2018, 6(9): 1742-1755. doi: 10.3889/oamjms.2018.378 pmid: 30338002
[2]	Fouquet V, Lachard F, Abdel-Gawad S, et al. Shear bond strength of a direct resin composite to CAD-CAM composite blocks: Relative contribution of micromechanical and chemical block surface treatment[J]. Materials(Basel), 2022, 15(14): 5018.
[3]	Alqerban A. Lithium di silicate ceramic surface treated with Er, Cr: YSGG and other conditioning regimes bonded to orthodontic bracket[J]. Saudi Dent J, 2021, 33(4): 188-193. doi: 10.1016/j.sdentj.2019.11.012
[4]	裴挫萍. 不同激光蚀刻技术对陶瓷与复合树脂材料粘接强度的影响研究[J]. 化学与粘合, 2022, 44(6): 491-495,521.
[5]	Tekçe N, Tuncer S, Demirci M, et al. Microtensile bond strength of CAD/CAM resin blocks to dual-cure adhesive cement:The effect of different sandblasting procedures[J]. J Prosthodont, 2019, 28(2): e485-e490.
[6]	Usta Kutlui I, Yerliyurt K. The impact of various surface treatments and Er-YAG laser irradiation on the bond strength of resin matrix CAD/CAM ceramics to resin cement[J]. Lasers Med Sci, 2025, 40(1): 201. doi: 10.1007/s10103-025-04460-5
[7]	Muhammed HA, Mahmoud EM, Fahmy AE, et al. The effect of sandblasting versus acid etching on the surface roughness and biaxial flexural strength of CAD/CAM resin-matrix ceramics(In vitro study)[J]. BMC Oral Health, 2023, 23(1): 169. doi: 10.1186/s12903-023-02883-6 pmid: 36964539
[8]	Kurtulmus-Yilmaz S, Cengiz E, Ongun S, et al. The effect of surface treatments on the mechanical and optical behaviors of CAD/CAM restorative materials[J]. J Prosthodont, 2019, 28(2): e496-e503.
[9]	International Organization for Standardization. Dentisry ceramic materials: ISO 6872: 2015[S]. Switzerland: ISO, 2015: 7-16.
[10]	Kassotakis EM, Stavridakis M, Bortolotto T, et al. Evaluation of the effect of different surface treatments on luting CAD/CAM composite resin overlay workpieces[J]. J Adhes Dent, 2015, 17(6): 521-528. doi: 10.3290/j.jad.a35256 pmid: 26734676
[11]	da Silva PNF, Martinelli-Lobo CM, Bottino MA, et al. Bond strength between a polymer-infiltrated ceramic network and a composite for repair: Effect of several ceramic surface treatments[J]. Braz Oral Res, 2018, 32: e28.
[12]	Cho SD, Rajitrangson P, Matis BA, et al. Effect of Er, Cr: YSGG laser, air abrasion, and silane application on repaired shear bond strength of composites[J]. Oper Dent, 2013, 38(3): E1-E9.
[13]	杜亚鑫, 王强, 仇丽鸿. 不同表面处理方式对润瓷与树脂水门汀黏结强度的影响研究[J]. 中国实用口腔科杂志, 2020, 13(3): 157-161. doi: 10.19538/j.kq.2020.03.005
[14]	孙硕遥. 氧等离子体处理对树脂纳米陶瓷粘接性能的影响[D]. 济南: 山东大学, 2024.
[15]	Motevasselian F, Amiri Z, Chiniforush N, et al. In vitro evaluation of the effect of different surface treatments of a hybrid ceramic on the microtensile bond strength to a luting resin cement[J]. J Lasers Med Sci, 2019, 10(4): 297-303. doi: 10.15171/jlms.2019.48 pmid: 31875122
[16]	Poosti M, Jahanbin A, Mahdavi P, et al. Porcelain conditioning with Nd: YAG and Er: YAG laser for bracket bonding in orthodontics[J]. Lasers Med Sci, 2012, 27(2): 321-324. doi: 10.1007/s10103-010-0878-6
[17]	Akin H, Tugut F, Akin GE, et al. Effect of Er: YAG laser application on the shear bond strength and microleakage between resin cements and Y-TZP ceramics[J]. Lasers Med Sci, 2012, 27(2): 333-338. doi: 10.1007/s10103-011-0883-4
[18]	Yoshihara K NagaokaN, Maruo Y, et al. Sandblasting may damage the surface of composite CAD-CAM blocks[J]. Dent Mater, 2017, 33(3): e124-e135.
[19]	Barutcigil K, Barutcigil Ç, Kul E, et al. Effect of different surface treatments on bond strength of resin cement to a CAD/CAM restorative material[J]. J Prosthodont, 2019, 28(1): 71-78. doi: 10.1111/jopr.12574 pmid: 27880028
[20]	Jung SN, Rüttermann S. Influence of mechanical and chemical pre-treatments on the repair of a hybrid ceramic[J]. Dent Mater, 2022, 38(7): 1140-1148. doi: 10.1016/j.dental.2022.05.003 pmid: 35672161
[21]	Peumans M, Valjakova EB, De Munck J, et al. Bonding effectiveness of luting composites to different CAD/CAM materials[J]. J Adhes Dent, 2016, 18(4): 289-302. doi: 10.3290/j.jad.a36155 pmid: 27222889
[22]	Prochnow C, Venturini AB, Grasel R, et al. Effect of etching with distinct hydrofluoric acid concentrations on the flexural strength of a lithium disilicate-based glass ceramic[J]. J Biomed Mater Res B Appl Biomater, 2017, 105(4): 885-891. doi: 10.1002/jbm.b.v105.4
[23]	El-Damanhoury HM, Elsahn NA, Sheela S, et al. Adhesive luting to hybrid ceramic and resin composite CAD/CAM Blocks: Er: YAG Laser versus chemical etching and micro-abrasion pretreatment[J]. J Prosthodont Res, 2021, 65(2): 225-234. doi: 10.2186/jpr.JPOR_2020_50
[24]	Dursun MN, Ergin E, Ozgunaltay G. The effect of different surface preparation methods and various aging periods onmicrotensile bond strength for composite resin repair[J]. Niger J Clin Pract, 2021, 24(2): 282-291. doi: 10.4103/njcp.njcp_83_20 pmid: 33605921
[25]	Çakmak G, Subaşı MG, Yilmaz B. Effect of thermocycling on the surface properties of resin-matrix CAD-CAM ceramics after different surface treatments[J]. J Mech Behav Biomed Mater, 2021, 117: 104401. doi: 10.1016/j.jmbbm.2021.104401

材料名称	材料品牌	生产国	材料类型	组成成分
材料名称	材料品牌	生产国	材料类型	有机成分	无机成分
润瓷	爱尔创	中国	RNC	Bis-GMA、UDMA、TEGDMA	55%~85%,硅酸盐玻璃填料
Shofu Block HC	Shofu	日本	RNC	UDMA、TEGDMA	61%,SiO₂、微气相SiO₂以及ZrSiO₄等填料
Vita Enamic	Vita	德国	PICN	UDMA、TEGDMA	86%,富含氧化铝的精细结构长石陶瓷

材料	是否老化	表面处理
材料	是否老化	NT	SB	HF	Er:YAG
润瓷	否	(215.64±17.36)^Aa	(158.88±8.03)^Ab	(203.23±7.22)^Aa	(158.69±5.36)^Ab
	是	(161.77±13.58)^Ba	(131.69±7.32)^Bb	(159.02±12.49)^Ba	(121.94±9.25)^Bb
Shofu Block HC	否	(160.20±12.53)^Aa	(135.72±17.68)^Aa	(148.22±10.88)^Aa	(92.60±8.98)^Ab
	是	(131.78±7.72)^Ba	(110.21±7.86)^Bb	(127.90±9.98)^Ba	(71.76±12.02)^Bc
Vita Enamic	否	(146.28±12.67)^Aa	(124.53±6.24)^Ab	(142.72±7.37)^Aa	(130.19±12.10)^Ab
	是	(127.07±8.11)^Ba	(122.07±6.58)^Aa	(124.02±8.47)^Ba	(123.88±3.48)^Aa

变量(源)	材料	平方和	自由度	均方	F	P
表面处理	润瓷	36 295.776	3	12 098.592	104.493	<0.001^*
	Shofu Block HC	48 398.852	3	16 132.951	124.848	<0.001^*
	Vita Enamic	2 189.502	3	729.834	9.843	<0.001^*
冷热循环	润瓷	32 810.913	1	32 810.913	283.382	<0.001^*
	Shofu Block HC	11 305.954	1	1 105.954	87.494	<0.001^*
	Vita Enamic	2 724.420	1	2 724.420	36.744	<0.001^*
表面处理×冷热循环	润瓷	1 919.854	3	639.951	5.527	<0.001^*
	Shofu Block HC	225.592	3	75.197	0.582	0.629
	Vita Enamic	1 099.642	3	366.547	4.944	0.004^*
误差	润瓷	8 336.397	72	115.783
	Shofu Block HC	9 303.865	72	129.220
	Vita Enamic	5 338.474	72	74.145