- 學位論文
研發氟化兒茶素改質之牙科複合樹脂
Development of Fluorinated Epigallocatechin Gallate Modified Dental Composite Resin
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摘要
牙科複合樹脂（Composite resin）因在美觀上的優勢，故已漸漸取代汞齊合 金（amlagam）成為臨床填補的主要材料，但材料本身缺乏抗齲蝕能力，無法持 續釋放氟素（Fluoride），氟素有助於鞏固牙齒及防止齲齒的功效，並能減少牙 齒因酸蝕而產生的去礦化作用與促進牙齒再礦化作用。加上在光照聚合之後複合 樹脂會產生體積的收縮(Shinkage)，使牙齒與填補物之間產生縫隙（gap），造成微滲漏(microleackage)，細菌便在此滋長導致材料鬆動，最後在邊緣處造成繼發性齲齒（secondary caries），而使其在應用上受到限制 。 因此本研究目的為研發氟化兒茶素改質之牙科複合樹脂，利用高嶺石(Kaolinite)的層狀結構，其層間對氟離子良好的吸附效果，使材料能釋放並再吸收更多氟素。此外為減少聚合收縮量，基質為改質之環氧丙烯酸樹脂（epoxyacrylate），因分子量較大且此多官能基壓克力單體照光聚合後會形成交聯網狀結構，可使收縮量明顯降低。另一方面加入兒茶素（EGCG）希望能提升材料抵抗去礦化與促進再礦化效果。 本研究分為三部分進行，第一部分為合成氟化兒茶素改質之牙科複合樹脂。包含樹脂有機基質合成、表沒食子兒茶素沒食子酸酯(EGCG)改質、氟化高嶺土無機填料合成與氧化鋁無機填料合成。 第二部分為材料分析與測試：測量氟離子釋放濃度與再釋放濃度、並比較其 機械性質與老化對材料的影響。 第三部分為建立一套標準化檢視人工齲齒模型（Artificial secondary caries model）實驗模式，以去礦化與再礦化（Demineralization and remineralization）循環模擬口內填補材料後之環境，利用微米級電腦斷層掃描、掃瞄式電子顯微儀觀察樣本表面變化，並搭配電腦軟體定量分析計算出去礦化體積（Demineralization volume）與平均病灶深度（Average lesion depth）。藉此評估並比較材料抵抗齲齒的能力。 實驗結果顯示本實驗研發之氟化兒茶素改質之牙科複合樹脂具有比市售材料更高的釋氟量、更低的聚合收縮、更好的抵抗齲蝕能力，故在臨床應用上對於預防繼發性齲齒發展具有相當的潛力。而其物理性質及機械性質略低於市售產品，因此仍須針對使用時機與角色有所調整。
並列摘要
The use of dental composite resin material is increasing rapidly in recent years. This increase is attributed primarily to demand for improved esthetics. Present filling materials are hard to avoid the re-invasion of caries, and the ability of fluoride release was limited. The role of fluoride in the prevention of caries is well known in dentistry, which is generally thought to help teeth remineralization, inhibit teeth demineralization, antibacterial effects and even anti erosion effects. Otherwise, because of its polymerization shrinkage to cause marginal leakage, and easily for bacteria adhesion, it still didn’t have the resistant ability to secondary caries. And it limited the success of composite restoration. The object of this study was to development a novel Fluorinated Epigallocatechin Gallate Modified Dental Composite Resin. Kaolinite (Al2Si2O5(OH)4), a clay mineral, has been known for its ability to carry and absorption of fluoride due to its layered aluminosilicate structure. And urethane-modified epoxy acrylates was used as resin matrix to form low-shrinking composites, because of their relatively high molecular weight and cohesive energy density resulting from the presence of the urethane group. We also add epigallocatechin gallate(EGCG) to increase the ability of remineralization. This study was carried out in three parts： Part 1: Development of Fluorinated Epigallocatechin Gallate Modified Dental Composite Resin. Including matrix formation, EGCG modification , and synthesis of fluorinited fillers and aluminum oxide fillers. Part 2 : To assess the fluoride release and recharge, and the physical properties, including the aging effect. Part 3: An artificial caries model was established for the demineralization and remineralization test. We qualitatively and quantitatively examine the demineralization and remineralization of the restorative teeth sample by the high-resolution micro computed tomography (Micro-CT) and scanning electron microscope (SEM). We calculate the demineralization volume and average lesion depth with the software to compare the anti-demineralization ability of these materials. With the results, we can conclude that the Fluorinated Epigallocatechin Gallate Modified Dental Composite Resin has more fluoride release and recharge, lower polymerization shrinkage, and great potential for caries prevention. Because the mechanical properties is not ideal , more studies should be explored.
參考文獻
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