Advance in fiber post surface treatment technology

doi:10.3969/j.issn.2095-4344.2014.25.024

Abstract

Abstract:

BACKGROUND: How to improve effective connection strength between fiber post and resin, to reduce the failure rate of repairing, has become the focus of current researches. Without surface treatment, the fiber post surface bonding strength is relatively low, is prone to appear adhesive failure, so the surface treatment of fiber post to increase the fiber post-resin bonding strength is the key to achieve a successful repair.
OBJECTIVE: To review the progress of fiber post surface treatment technology in the crown restoration.
METHODS: A computer-based retrieval was performed among CNKI and PubMed databases between 2003 and 2013, by using the key words of fiber-reinforced post, surface treatment, bond strength in English and Chinese. The recent literatures concerned with the fiber post surface treatment were extensively reviewed, 32 ones were summarized and analyzed.
RESULTS AND CONCLUSION: The failure of bonding between fiber post and resin is a major problem in fiber posts restoration techniques. In recent years, scholars try to use a variety of methods for processing fiber post surface, the fiber post-resin bonding strength is significantly improved. Mechanical or (and) chemical treatment on the surface of fiber post can significantly improve fiber post-resin bonding strength, which could increase the success rate of the crown restoration. Among them, H2O2+silicane coupling agent achieved the best effects. However, long-term clinical observations are needed to verify these methods.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: biocompatible materials, dental materials, metalloids, dental bonding

CLC Number:

R318

Dong Yi, Deng Jiu-peng, Wang Shu-jun, Chen Yan-qing. Advance in fiber post surface treatment technology[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(25): 4073-7077.

Figures/Tables 1

2.1 纤维桩表面的粗糙化纤维桩的最大优点是其弹性模量与牙质接近，因而能够有效降低应力集中导致的根折的发生率。但是由于桩脱离导致的修复失败却时有发生，其主要原因是纤维桩表面的环氧树脂基质和甲基丙烯酸基树脂复合材料间化学结合力较弱。环氧树脂是一种惰性材料，它有优良的耐碱性、耐酸性和耐溶剂性，化学性质较为稳定，具有高转化率及高度交联结构等特点。纤维桩和树脂之间的连接涉及化学作用和机械作用，而未经特殊表面处理的纤维桩表面结构致密，相对平滑，化学活性低，结合能力差，纤维桩表面和树脂树脂的化学结合能力和机械内锁作用较弱，界面上的粘接强度低，所以未经处理的单纯粘接容易失败[10]。为了加强树脂与纤维桩之间的黏结强度，不少学者提出在修复时对纤维桩表面进行适度处理[11-15]。在修复时对纤维桩表面进行化学或机械处理可以使纤维桩表面粗糙化，进而增加二者之间微观物理交锁结构、提高纤维桩表面的粗糙程度或使纤维桩表面活性化以增强其化学连接强度，显著提高修复成功率[9, 16-19]。目前对纤维桩表面粗糙化处理方法主要有机械处理、化学腐蚀两种方式。 2.1.1 机械处理对纤维桩表面的机械处理方法有打磨法和喷砂法。王琳等[20]用1 000目细砂纸打磨处理纤维桩表面，用酸蚀凝胶加自粘接材料对纤维桩进行粘接，与纤维桩表面不进行任何处理的对照组比，砂纸打磨可以提高纤维桩在根管内的黏结强度。相较于打磨法，目前喷砂法更为常见，这一方法在过去已广泛用于增强金属桩与树脂之间的黏结强度。目前齿科常用的砂质材料为氧化铝，在一定范围压强下磨料的粒度决定了纤维桩表面的粗糙度。研究发现，对光滑碳纤维桩表面进行喷砂处理后纤维桩与树脂核的固位显著加强，且与预成的锯齿状碳纤维桩相比，其固位状况无显著性差异，因此改善纤维桩冠部表面的光滑形态可以增加桩与树脂核的固位[21]。 Balbosh等[13]研究了在人工老化的条件下喷砂对纤维桩粘接固位的影响，结果发现喷砂后的纤维桩对树脂树脂的粘接强度高于对照组。肖月等[22]用粒度100目的三氧化二铝在0.2 MPa压力下对玻璃纤维桩及石英纤维桩表面进行喷砂粗化处理，结果显示玻璃纤维桩表面喷砂处理组的黏结强度为(18.63±0.54) MPa，大于烷偶联剂组和对照组(P < 0.05)；而喷砂处理后石英纤维桩黏结强度最大，达(23.68±0.53) MPa，说明喷砂处理能提高纤维桩的黏结强度；扫描电镜观察可见处理后内部纤维之间空隙内的环氧树脂仍然完整，有些区域在纤维之间形成了较深的空隙，但纤维桩本身没有被破坏(图2)。然而有学者认为机械处理会对纤维桩产生负面影响。Monticelli等[11]指出机械处理对纤维桩损伤过大，使其与根管的匹配度降低。Braga等[23]发现喷砂处理对纤维桩的外形发生不良影响，纤维桩直径降低，弹性模量增高。D’Arcangelo等[7]在电镜下对无处理和喷砂处理的纤维桩表面进行观察发现，喷砂处理的纤维桩表面明显粗糙，且有部分纤维断裂，但其认为这些断裂的纤维有助于纤维桩与黏结剂之间结合并且对纤维桩的抗折强度和弹性模量影响不大。目前，对这一问题尚缺乏远期临床预后或力学实验的相关证据，仍存在一定争议。 2.1.2 化学腐蚀除了机械处理外，对纤维桩进行化学处理可以将纤维桩表面的基质去除，增加纤维桩表面粗糙度和纤维面积，能够产生更多的摩擦力和结合位点，从而加强纤维桩与树脂的黏结强度[24]。另外，由于化学处理对几乎不影响纤维桩直径，因此不会改变纤维桩的弹性模量[24]。目前常用的化学腐蚀剂为H2O2、氢氟酸(HF)、高锰酸钾及磷酸等。有作者分别应用过氧化氢、乙醇钠、磷酸、氢氟酸对玻璃纤维桩进行表面处理，以蒸馏水处理者为对照组，观察4种桩表面处理对玻璃纤维桩黏结强度的影响，结果显示黏结强度值乙醇钠组>过氧化氢组>氢氟酸组>磷酸组>对照组，提示使用乙醇钠和过氧化氢进行纤维桩表面处理可有效提高玻璃纤维桩与牙本质的黏结强度[25]。虽然氢氟酸能更大程度地去处纤维桩表层的异丁烯酸酯，但电镜显示有些玻璃纤维变细或者被破坏，说明氢氟酸会腐蚀玻璃纤维而破坏纤维桩的完整性[26]，所以近几年的研究方向逐渐关注于H2O2。H2O2能够有效的降解纤维桩表面的环氧树脂基质并暴露其中的纤维，然而其性质却较为温和，纤维桩表面经过H2O2处理后形态较氢氟酸处理后更为完整、规则。Monticelli等[27]对体积分数24%的H2O2处理10 min和体积分数10%的H2O2处理20 min的纤维桩样本进行电镜扫描，观察到两种处理方式产生的石英纤维暴露层厚度均约为50 μm，而纤维桩表面的这一改变除了能够显著增加桩核有效黏结面积外，还能使树脂与桩内纤维的接触面积明显增加，从而增强了微机械固位，使树脂与纤维桩的黏结强度得到提高。 Braga等[23]对比了分别应用低浓度H2O2(10%)、高浓度H2O2(24%)和Al2O3打磨3种处理方式的纤维桩的黏结效果，发现使用高浓度的H2O2较机械处理法可以显著增强纤维桩与树脂之间的黏结强度，并可优化临床操作时间。肖月等[22]的研究得出了相似的结果，他们以体积分数24%的H2O2浸泡玻璃纤维桩10 min，其黏结强度大于喷砂处理组及对照组(P < 0.05)，电镜结果显示纤维桩本身没有被破坏(图2)。Khamverdi等[28]对在水中保存0-9个月的H2O2处理和喷砂打磨的纤维桩进行研究亦得出相似结论。有作者用高锰酸钾、过氧化氢、乙醇钠处理石英纤维桩，结果发现这些酸蚀方法均能增加纤维桩的黏结强度，且高锰酸钾处理的效果最好，石英纤维的结构完整无损，内层的环氧树脂也无裂隙，推测其机制是高锰酸钾酸蚀提高了石英纤维的亲水性[29]。王琳等[20]也用高锰酸钾处理纤维桩，同样得到了相似的结果，高锰酸钾表面处理方法可以提高纤维桩在根管内的黏结强度。以上研究均显示，对纤维桩进行化学处理是比机械处理更为有效的粗糙化方法。"

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