- 學位論文
使用自酸蝕底劑與自黏著劑對矯正樹脂黏著強度的評估
Orthodontic bonding achieved with self-etching primer and self-adhesive systems
摘要
使用傳統矯正托架黏著劑黏著時，需要多個步驟，包括牙釉質的酸蝕，沖洗，吹乾，上底劑，最後用樹脂將矯正托架黏著在牙釉質表面。為了節省臨床的時間，簡化黏著時的步驟，將酸蝕牙釉質，沖洗與上底漆等步驟合而為一，分別出現了自酸蝕底劑與自黏著劑兩種簡化黏著步驟的黏劑。 本篇研究主要是了解自酸蝕底劑與自黏著劑相較於傳統黏著劑之黏著方式其間在 1、 抗張黏著強度的改變，2、 比較合併酸蝕，再用自酸蝕底劑和自黏著劑的黏著強度的變化，3、藉由能量散佈光譜儀斷面分析的方式，來比較以上幾種方式，矯正托架與牙釉質間斷面的變化。 4. 探討抗張黏著強度與斷面發生在樹脂與矯正托架間的相關性。 本研究使用150顆人類小臼齒，隨機分為五組，每組30顆牙齒，分別以傳統方式，自酸蝕底劑，合併酸蝕，再用自酸蝕底劑，自黏著劑，與合併酸蝕，再用自黏著劑將矯正托架黏著在牙齒上，觀察抗張黏著強度與斷裂界面的變化。 結果發現：使用傳統黏著劑的黏著強度明顯比自酸蝕底劑與自黏著劑高，而自酸蝕底劑的黏著強度又明顯較自黏著劑高。在有合併酸蝕及使用自酸蝕底劑黏著系統的組別，使用能量散佈光譜儀觀察斷鍵後的矯正托架底部，顯示大部分的斷面發生在矯正托架和樹脂交界面。 而自黏著劑的組別有明顯偏低的的斷面發生在矯正托架和樹脂交界面，而明顯偏多的斷面發生在複合樹脂－牙釉質或是複合樹脂本身的斷裂。使用自黏著劑在矯正托架底部的鈣分布，明顯比有酸蝕步驟組別偏高。而使用自酸蝕底劑的組別與其它四組則沒有統計上的差異。本實驗所有的組別均未發現牙釉質的斷裂，即使在合併酸蝕的組別也未發現，但有鈣粒子出現。 由本研究結果顯示使用自酸蝕底劑與自黏著劑的黏著強度明顯偏低，而事先以磷酸酸蝕，可以提高抗張黏著強度，與傳統酸蝕得到的抗張黏著強度沒有統計上的差異。抗張黏著強度與發生在矯正托架與樹脂之間的斷面之間，有正相關性(相關係數為44%)。
並列摘要
The purpose of this study was to compare the tensile bonding strengths of orthodontic brackets bonded on the enamel using conventional multi-step adhesive, self-etching primer, and self-adhesive systems. In addition, the effects of pre-etching in the self-etching primer and the self-adhesive systems were examined. Metal brackets were bonded to 150 extracted human premolars according to 5 experimental protocols. Group 1,conventional multi-step adhesive system; group 2, self-etching primer system; group 3, self-etching primer system with 15% H3PO4 pre-etching for 15 seconds; group 4, self-adhesive system; group 5, self-adhesive system with 15% H3PO4 pre-etching for 15 seconds. All specimens were debonded by a universal testing machine, and debonded failure interfaces between the tooth surface and the debonded interfaces of bracket base were observed by scanning electron microscope. Bracket bases were analyzed with mapping of energy dispersive x-ray spectrometer to calculate the distributive percentages of enamel or resin. Results show that the conventional multi-step adhesive system created the greatest bonding strength, followed by the self-etching adhesive system, and then was the self-adhesive system (P<0.05). When the acid-etching was performed, bonding strengths of both the self-etching and the self-adhesive systems increased to the same level as that of the conventional multi-step system. A significantly higher percentage of failure at the bracket-resin interface (54.2%~71.1%, p<0.05) was noted in the groups with pre-etching with 15% H3PO4 and the self-etching primer system. In comparison, more debonded failures at the resin-enamel interface or within the resin were found in the self-adhesive system. No enamel detachment was found in any group.