Abstract

BACKGROUND:Resin-modified glass ionomer (RMGI) cements have higher bond strength, especially can release fluoride. But there are fewer reports of the clinical application for the prevention of decalcification.
OBJECTIVE: To test the benefit from using RMGI cement instead of a conventional composite resin in bracket bonding for patients with malocclusion, and observe bracket-failure rates and decalcification on enamel surfaces at pretreatment and at debonding.
DESIGN: Observational and comparative trial.
SETTING: The Second Hospital Affiliated to Hebei Medical University.
PARTICIPANTS: Forty successive patients (358 teeth) with malocclusion admitted to the Department of Orthodontics in the Second Hospital Affiliated to Hebei Medical University, were selected for the study from July to August in 2002. All the patients (21 females and 19 males, mean age 16 years) had normal and complete anterior teeth, good oral hygiene. There were no obvious differences in bilateral teeth. Informed consents were obtained from all the subjects. The experiment was also approved by the ethical committee of the hospital. Experimental materials were RMGI adhesive (Fuji, GC, Japan, Lot 0005111) and composite resin cement (enamel adhesive of Beijing and Tianjin, Tianjin product, Lot 020402). Brackets produced from Hangzhou 3B and 37% phosphoric acid were used.
METHODS: ①Bonding brackets: Subjects selected according to random procedure were divided into two groups, each with 20. GroupⅠ: The left buccal surfaces bonded with light-cure RMGI were etching for 30 seconds with 37% phosphoric acid, rinsed with water; the right buccal surfaces bonded with composite resin cement were etching for 60 seconds with 37% phosphoric acid, rinsed with water and dried; Group Ⅱ: After etching for 30 seconds with 37% phosphoric acid, the right buccal surfaces were rinsed with water and bonded brackets with light-cure RMGI. The left buccal surfaces were bonded brackets with composite resin cement after etching for 60 seconds with 37% phosphoric acid, rinsing with water and drying; Attachment of 0.036-cm NiTi wires with ligature to the brackets was conducted 10 minutes after light-curing. The information about differences in bilateral bonding materials was not told to patients. To ensure an equal bonding materials containing fluoride and minimize the error, all the patients were instructed to use toothpaste containing fluoride, a fluoride mouthwash was not prescribed. The treatment period was 9-26 months (mean 18 months).②Patients were rechecked at intervals of 4 weeks postoperatively. Each bonded tooth was checked for loose or missing brackets, and failures were recorded. A color transparency of anterior teeth area was taken using a standardized photographic technique. The enamel surface conditions were classified at a magnification of ×10. The condition of enamel surface recorded was made according to the scoring system by Geiger before treatment and at debonding.
MAIN OUTCOME MEASURES: ①The number and site of bonding failures.②Enamel surface conditions at before treatment and debonding.
RESULTS: Forty patients were all involved in the result analysis. Eliminating 4 teeth occurring bond failure and 4 teeth of opposite side at anterior teeth, a total of 232 teeth were evaluated.①The number and sit of bonding failures: There was no significant difference between the failure rates of RMGI adhesive and composite resin cement (P > 0.05). Significantly more premolar brackets failed than incisor brackets.②Decalcification of enamel surface: At debonding after treatment, the incidence rates of white spots in the surfaces bonded with the RMGI were significantly lower than that in the composite resin (25.9%, 38.8%, P < 0.05).
CONCLUSION: The use of RMGI for brackets bonding results in a significant reduction in the incidence of white spot at debonding. Reducing etching time may obtain a similar survival rate with the routine etching time.

Department of Orthodontics, the Second Hospital Affiliated to Hebei Medical University, Shijiazhuang 050000, Hebei Province, China

Shan Li-hua★, Master, Chief physi-cian, Department of Orthodontics, the Second Hospital Affiliated to Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
shanlihua@tom.com

Received: 2007-09-20 Accepted: 2007-11-15 (07-50-9-5191/YWY)

Shan LH, Cui ZQ, Shen QH, Gao Q, Qiu ZX.Application of light-cure resin-modified glass ionomer cement in orthodontic prac-tice.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(6): 1149-1152(China)
[www.zglckf.com/zglckf/ejournal/upfiles/ 08-6/6k-1149
(ps).pdf]

摘要
背景：树脂加强型玻璃离子粘接剂具有良好的粘接强度和持续释放氟的性能，但临床应用预防釉质脱矿的作用有待验证。
目的：对牙齿畸形患者左右侧上颌牙齿采用树脂加强型玻璃离子水门汀粘结剂或复合树脂粘结剂粘结托槽,观察托槽脱落及治疗前后去粘接时牙釉质面的脱矿情况。
设计：观察对比试验。
单位：河北医科大学第二医院。
对象: 选择2002-07/2002-08于河北医科大学第二医院口腔正畸科收治的40 例牙齿畸形患者（358颗） ，女21 例, 男19例,平均16岁,所有患者上前牙正常、完整, 双侧牙齿无明显不同,口腔卫生状况良好。患者均对治疗项目知情同意，实验经过医院伦理委员会许可。实验用粘结材料为RMGI (富士. GC. 日本产，生产批号为0005111) 和复合釉质粘结剂(京津釉质粘结剂,天津生产，生产批号为020402) ,所用托槽为杭州三比燕尾型托槽,所用酸蚀液为37 %磷酸。
方法: ①粘结正畸托槽: 抽签法随机将患者分为2组，每组20例。Ⅰ组:左侧用37 %磷酸酸蚀30 s,水潮湿牙面,用光固化RMGI 粘结托槽;右侧37 %磷酸酸蚀60 s,清洁、干燥,用复合树脂粘结托槽。Ⅱ组:右侧用37 %磷酸酸蚀30 s,水潮湿牙面,光固化RMGI 粘结托槽;左侧37 %磷酸酸蚀60 s, 清洁、干燥,用复合树脂粘结托槽。10 min后0.036 cm镍钛丝结扎,患者均不告知两侧粘结材料存在差异,常规医嘱,指导患者固定矫治器治疗期间饭后使用含氟牙膏刷牙,不用含氟漱口液,以统一含氟材料,减少误差。疗程9~26 个月,平均为18个月。②每4 周后复诊观察患者托槽脱落情况，并记录脱落部位。 统一拍摄条件拍摄前牙区照片,10 倍放大后观察牙面的脱矿情况，并根据Gerger等记数法评价并记录粘接前和去粘接时的釉质面白斑形成情况。
主要观察指标：①托槽脱落情况及脱落部位。② 两种材料粘接托槽治疗前后脱矿情况。
结果：40 例患者均进入托槽脱落结果分析， 4 例患者托槽脱落发生在前牙,则此4 颗牙及对侧同名牙除外,其余232 颗牙齿将进行白斑形成情况评价。①托槽脱落情况及脱落部位：树脂加强型玻璃离子水门汀托槽脱落率与复合树脂相近，差异无统计学意义（P > 0.05），脱落位置主要发生在双尖牙区,其次为中切牙。②脱矿情况： 粘结托槽治疗后, 树脂加强型玻璃离子水门汀托槽发生白斑率低于复合树脂，差异有统计学意义（25.9 %,38.8 %，P < 0.05）。
结论：树脂加强型玻璃离子水门汀可以明显减少正畸治疗后牙齿白斑发生率的增高，减少酸蚀时间仍可达到类似的粘接成功率。
关键词：光固化树脂加强型玻璃离子水门汀; 脱落率; 氟; 脱钙; 牙齿白斑;生物材料

单丽华，崔占琴，沈庆华，高　琪，邱志香
河北医科大学第二医院口腔正畸科， 河北省石家庄市 050000
单丽华★，女，1964年生，河北省石家庄市人，汉族，1987年河北医科大学口腔系毕业，硕士，主任医师，主要从事粘接材料和种植体研究。

中图分类号: R318.08 文献标识码: A 文章编号: 1673-8225(2008)06-01149-04
单丽华，崔占琴，沈庆华，高琪，邱志香.光固化树脂加强型玻璃离子水门汀在正牙学实践中的作用[J].中国组织工程研究与临床康复，2008，12(6):1149-1152
[www.zglckf.com/zglckf/ejournal/upfiles/12-6/6k-1149(ps).pdf]
(Edited by: Zhan DS/Yang Y/Wang L)