中国实用口腔科杂志

中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (3): 306-312.DOI: 10.19538/j.kq.2024.03.008

• 论著 • 上一篇    下一篇

Er∶YAG激光脱粘接处理对全瓷修复材料性能影响研究

蔡春燕1，2，钟冰洁1，2，李小婷1，2，江    磊1，3，卢枳岑1，3，于    皓1，2，3   

  1. 1. 福建医科大学口腔医学院，福建 福州 350004；2. 福建省口腔疾病研究重点实验室，福建省口腔生物材料工程技术研究中心，福建省高校口腔医学重点实验室，福建 福州 350004；3. 福建医科大学附属口腔医院修复科，福建 福州 350002
  • 出版日期:2024-05-01 发布日期:2024-05-30
  • 通讯作者: 于皓
  • 基金资助:
    福建省自然科学基金项目（2021J01808；2022J01269）

  • Online:2024-05-01 Published:2024-05-30

摘要： 目的    研究Er∶YAG激光脱粘接处理对全瓷修复材料颜色、半透明性、表面显微硬度及弯曲强度的影响。方法    研究于2023年3—10月在福建省口腔疾病研究重点实验室进行。分别使用氧化钇稳定的四方多晶氧化锆（3Y-TZP、5Y-TZP）和氧化锆加强型硅酸锂玻璃陶瓷（zirconia-reinforced lithium silicate，ZLS）制作10.0 mm × 10.0 mm × 1.5 mm短试件各40个，制作20.0 mm × 4.0 mm × 1.5 mm长试件各20个，并对全瓷试件进行表面处理。将所有试件随机分为研究组和对照组，每组不同类型全瓷短试件各20个、长试件各10个。收集2023年1—3月于福建医科大学附属口腔医院口腔颌面外科门诊因牙周病或正畸治疗拔除的完整、无龋的第三磨牙60颗进行牙本质试件制备。研究组行牙本质粘接与Er∶YAG激光脱粘接处理，对照组不做其他处理。采用电子比色仪测量2组试件L*、a*、b*值，并计算研究组相对于对照组的颜色变化（ΔE00）和半透明性变化（ΔTP00）；分别采用显微维氏硬度仪及万能材料试验机测量2组试件的表面显微硬度及弯曲强度；采用扫描电子显微镜（scanning electron microscope，SEM）观察2组试件外表面及粘接面的微观形貌。结果    3Y-TZP、5Y-TZP试件的ΔE00值分别为0.54 ± 0.07、1.13 ± 0.36，均小于颜色变化的可感知阈值（1.30）；ΔTP00值分别为0.22 ± 0.23、0.33 ± 0.63，均小于半透明性变化的可感知阈值（0.62）。ZLS试件的ΔE00值为1.76 ± 0.78，ΔTP00值为0.80 ± 0.90，大于颜色及半透明性变化的可感知阈值，但均未超过其可接受阈值（ΔE00 = 2.25，ΔTP00 = 2.62）。2组相同类型全瓷试件的表面显微硬度及弯曲强度比较，差异均无统计学意义（均P > 0.05）。SEM观察示，研究组ZLS试件外表面轻微烧蚀状改变，ZLS试件粘接面及3Y-TZP和5Y-TZP试件外表面和粘接面与对照组比较无明显改变。结论    Er∶YAG激光脱粘接处理对3Y-TZP、5Y-TZP的颜色和半透明性影响较小，未对3Y-TZP、5Y-TZP和ZLS的硬度及强度产生影响。经Er∶YAG激光脱粘接处理后的全瓷修复体可在临床中二次使用。

关键词: Er∶YAG激光, 全瓷修复材料, 脱粘接处理, 光学性能, 力学性能

Abstract: Objective    To evaluate the influence of Er∶YAG laser debonding on the color，translucency，surface microhardness，and flexural strength of all-ceramic materials. Methods    The research was conducted between March to October 2023 at the Fujian Key Laboratory of Oral Diseases. Totally 40 short specimens measuring 10.0 mm × 10.0 mm × 1.5 mm and 20 long specimens measuring 20.0 mm × 4.0 mm × 1.5 mm were fabricated using yttria-stabilized tetragonal zirconia polycrystals（3Y-TZP and 5Y-TZP）and zirconia-reinforced lithium silicate（ZLS），respectively. The specimens received surface treatment and were then randomly divided into control and experimental groups，with each group containing 20 short specimens and 10 long specimens of different types of all-ceramic materials. Totally 60 complete，caries free human third molars extracted because of periodontitis or orthodontic treatment in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Fujian Medical University from January to March 2023 were collected for dentin specimens preparation. The specimens in the experimental group were adhesives bonding to dentin and Er∶YAG laser debonding treatment，while the control group received no further processing. The L*，a*，and b* values of both experimental and control groups were measured using a spectrophotometer，and the color differences（ΔE00）and translucency differences（ΔTP00）between the two groups were calculated. The surface microhardness and flexural strength of the specimens in both groups were measured using a microhardness tester and universal testing machine，respectively. Scanning electron microscopy（SEM）was used to observe the microstructures of the surfaces and bonding interfaces of the specimens before and after debonding. Results    The ΔE00 values between the experimental and control groups of 3Y-TZP and 5Y-TZP were 0.54 ± 0.07，and 1.13 ± 0.36，respectively. These values were below the perceptibility thresholds of color change（1.30）. Similarly，the ΔTP00 values for the same groups were 0.22 ± 0.23 and 0.33 ± 0.63，respectively，falling below the perceptibility thresholds of translucency differences（0.62）. For ZLS，the ΔE00 values and ΔTP00 values were 1.76 ± 0.78 and 0.80 ± 0.90，respectively. Both of these values were exceed the perceptibility thresholds but below the acceptable thresholds（ΔE00 = 2.25，ΔTP00 = 2.62）. There were no significant differences in surface microhardness and flexural strength of the specimens in the experimental and control groups for all materials（P > 0.05）. SEM images revealed minor ablation-like surface alterations on the outer surface of ZLS in the study group，while no notable changes were observed on the bonding interfaces of ZLS specimens，as well as the outer surface and bonding interfaces of 3Y-TZP and 5Y-TZP specimens compared to the control group. Conclusion    The Er∶YAG laser debonding treatment exhibited no discernible impact on the color and translucency of 3Y-TZP and 5Y-TZP. Moreover，the treatment did not affect the surface microhardness and flexural strength of 3Y-TZP，5Y-TZP，and ZLS. These findings indicated that all-ceramic restorations can be reused clinically after undergoing Er∶YAG laser debonding.

Key words: Er∶YAG laser, all-ceramic materials, debonding, optical properties, mechanical properties