臺灣博碩士論文加值系統

牙齒填補複合材料，是一種常見使用於治療(Treat)受損牙齒(Tooth)的材料，達到保護剩於齒質(Dentine)，並提供一定程度之力學性質。而本研究主要以聚乳酸(Poly Lactic Acid, PLA)與低熔點聚乳酸(Low melting point Poly Lactic Acid, LMPLA)來補強牙齒填補複合材料抗壓的力學性質。將氧化鋅粉末(Zinc-oxide powder)和丁香油酚溶劑(Eugenol solvent)以3:1的比例混合，並添加不同比例之LMPLA/PLA的纖維(Fiber)或棉網(Non-woven)，並對其進行滲漏性(Leakage)、最大抗壓強度(Compressive strength)、溶解性(Solubility)、固化時間(Setting time)等測試與評估。另外研究中草藥葉下珠(Phyllanthus urinaria Linnea)萃取黃酮類(Flavonoids)化合物之最佳萃取條件，以紫外光分光光度法(UV-spectrophotometry)測定萃取液(Extract)之吸光度(Absorbance, Abs)，並以紙錠擴散法(disc diffusion)測試葉下珠的抑菌(Bacteriostatic)效果。

Dental filling composite material is used a common material for the treatment of damaged teeth. This study uses Intermediate Restorative Material (IRM®) as matrix and polylactic acid (PLA) and low melting point polylactic acid (LMPLA) fiber as reinforcing material to make the IRM®/LMPLA/PLA composite filling material. According to a previous study of this laboratory, the zinc-oxide powder and eugenol solvent are mixed with a ratio of 3:1, and then added with different wt% of LMPLA/PLA fiber or non-woven. The setting time, compressive strength, solubility and leakage of resulting composite filling materials are evaluated.

目錄
第一章 前言 .................................................................................................. 1
1.1 研究背景 ................................................................................................ 1
1.1.1 牙齒 ..................................................................................................... 2
1.1.2 齲齒 ..................................................................................................... 8
1.1.3 根管治療 ............................................................................................ 10
1.1.4 補牙 .................................................................................................... 11
永久性填補材料 .......................................................................................... 12
暫時性填補材料 .......................................................................................... 16
1.1.5 聚乳酸纖維 ........................................................................................ 17
1.1.6 葉下珠(Phyllanthus urinaria Linnea) ........................................... 19
1.2 文獻回顧 .................................................................,............................. 21
1.3 國內外專利 ........................................................................................... 31
1.4 研究動機 ............................................................................................... 34
1.5 研究目的 ............................................................................................... 34
1.6 專有名詞解釋 ....................................................................................... 35
第二章 原理 ................................................................................................. 36
2.1 氧化鋅及丁香油酚混合原理 ............................................................... 36
2.2 複合材料補強原理 ............................................................................... 38
2.3 不織布成網原理 ................................................................................... 38
第三章 實驗 ................................................................................................. 40
3.1 實驗流程 ............................................................................................... 40
3.1.1 實驗流程1 ......................................................................................... 40
3.1.1.2 實驗流程1說明 .............................................................................. 41
3.1.2 實驗流程2 ......................................................................................... 42
3.1.2.2 實驗流程2說明 .............................................................................. 43
3.1.3 實驗流程3 ......................................................................................... 44
3.1.3.2 實驗流程3說明 .............................................................................. 45
3.1.4 實驗流程4 ......................................................................................... 46
3.1.4.2 實驗流程4說明 .............................................................................. 47
3.1.5 實驗流程5 ......................................................................................... 48
3.1.5.2 實驗流程5說明 .............................................................................. 49
3.2 實驗材料 ............................................................................................... 50
3.3 實驗設備 ............................................................................................... 50
3.4 實驗參數設計 ....................................................................................... 51
3.5 物化性測試 ........................................................................................... 52
第四章 結果與討論 ..................................................................................... 56
4.1 SEM圖觀察 ........................................................................................... 56
4.2 固化測試 ............................................................................................... 65
4.3 抗壓測試 ............................................................................................... 66
4.4 分光光度計 ........................................................................................... 69
4.4 抑菌測試 ............................................................................................... 72
4.5 IRM®/LMPLA/PLA纖維牙齒填補複合材料 ....................................... 74
4.5.1 固化時間評估 .................................................................................... 74
4.5.2 溶解性測試 ........................................................................................ 75
4.5.3 抗壓測試 ............................................................................................ 76
4.5.4 滲漏性測試 ........................................................................................ 77
4.6 IRM®/LMPLA/PLA棉網牙齒填補複合材料 ....................................... 81
4.6.1 固化時間評估 .................................................................................... 81
4.6.2 抗壓測試 ............................................................................................ 82
第五章 結論 ................................................................................................. 84
第六章 建議 ................................................................................................. 87
參考文獻 ...................................................................................................... 89

參考文獻
[1] Petersen PE. The World Oral Health Report. Geneva, Switzerland: WHO, 2003.
[2] Petersen PE. The burden of oral disease: challenges to improving oral health in 21st century. Bull World Health Organ 2005; 83(1): 3.
[3] Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, et al. The global burden of oral disease and risks to oral health Bull World Health Organ. 2005; 83(9): 661-669.
[4] 蕭思郁、黃純德、劉秀月、許淑春、謝蕙如、戴怡佳、洪雅欣、陳弘森，探討台灣北部地區0-6歲兒童齲齒狀況及其相關因素，中華牙醫學雜誌第26卷第2期，P125，2007。
[5] 黃純德、蕭思郁、陳韻婷、劉秀月、林怡如、陳弘森、嚴雅音、周振英，台灣中部地區0-6歲兒童齲齒與口腔清潔行為之城鄉差距，中華牙醫學雜誌第26卷第2期，P200，2007。
[6] 蕭思郁、黃純德、趙聆惠、劉秀月、張綺舫，台灣南部地區0-6歲兒童齲齒狀況之探討，中華牙醫學雜誌第26卷第1期，P52，2007。
[7] 蕭思郁、黃純德、劉秀月、胡文嘉、李信枝、王乃亭、林妤姍，台灣東部地區六歲以下兒童齲齒狀況之探討，中華牙醫學雜誌第26卷第2期，P190，2007。
[8] 劉仁義、李嫈嫈、黃純德、劉秀月、洪雅欣、戴怡佳、蕭思郁、林雯君，台灣山地鄉0-6歲幼兒齲齒狀況，中華牙醫學雜誌第26卷第2期，P209，2007。
[9] 張雀鳳、楊奕馨，學童口腔保健行為與齲齒之探討，Taiwan Journal of Oral Medicine & Health Sciences Vol. 23 No. 2，P120，2007。
[10] 許志原、張彩秀，社區中老年人口腔保健行為、口腔狀態與口腔相關生活品質之探討，Taiwan Journal of Oral Medicine & Health Sciences Vol. 25 No. 1，P52，2009。
[11] 高材、林康平、林峰輝、陳家進，生物醫學工程導論，滄海書局，P300-301，2010。
[12] http://www.dr-tony.com.tw/index/health_sub01-101.htm
[13] 高橋常男、小林繁、副島泰子著，周振英譯，牙齒解剖形態學，合記圖書出版社，P 85-86、P88-90、P92、P94-95、P97-98、P101，2010。
[14] 大田绢代，Nursing Care of Diseases of the tooth & mouth，五南圖書出版公司，1995。
[15] 邱清華、謝天渝、姚振華、王宜斌、陳振漢、黃志勇，口腔疾病與保健，國立空中大學，2003。
[16] 姚振華，牙科公共衛生學，國立編譯館，P114、P202，2001。
[17] 大田絹代著，徐家杰譯，齒、口腔疾病護理，五南，P56-61，2000。
[18] 陳弘森等，國民健康局九十四與九十五年度科技研究發展計畫：台灣地區兒童及青少年口腔狀況調查研究報告，高雄醫學大學口腔醫學院牙醫學研究所，國民健康局，P256、P259，2005-2007。
[19] http://www.bjkq.cn/kouqiang/27959.html
[20] 家和，口腔牙齒及其疾病，正中書局，臺北市，P113，1978。
[21] Gutmann JL, Harrison JW. Surgical endodontics, 1st ed. Boston: Blackwell Scientific Publications, 1991.
[22] 鍾國雄，牙科材料學，合記圖書出版社，P233、P417、P419、P428-429，2007。
[23] Giomer restorations. Dental Abstracts Vol.50, P355, 2005.
[24] 林清安，纖維化學，臺灣區絲織工業同業公會，P347、P351，2006。
[25] 張耀南，漫談乳酸聚合物在生物醫學材料的應用與發展，生醫材料專輯，化工技術第4卷第7期，P174，1996。
[26] 李繼煌，聚乳酸之開發與應用綜論，朝陽科技大學應用化學系碩士論文，P22、P24-25，2006。
[27] 顏克中，β-磷酸三鈣/聚乳酸複合支架仿骨雙層結構之製備技術，逢甲大學紡織工程研究所碩士論文，P15，2007。
[28] 李幸祥，臺灣藥草事典4，旺文社，P10-11，2001。
[29] 中華本草編委會，中華本草(四)，上海科學技術出版社，P842-843，2000。
[30] 中央研究院植物標本館http://hast.sinica.edu.tw/
[31] Lewinstein L, Banks-Sills L. Eliase R. Finite element analysis of a new system (IL) for supporting an implant-retained cantilever prosthesis. Int J Oral Maxillofac Implants. Vol. 10, P355-366, 1995.
[32] Loney RW, Kotowicz WE, McDowell GC. Three-dimensional photoelastic stress analysis of the ferrule effect in cast post and cores. J Prosthet Dent Vol. 63, P 506-512,1990.
[33] Standlee JP, Caputo AA. The retentive and stress distribution properties of split threaded endodontic dowels. J Prosthet Dent Vol. 68, P436-442, 1992.
[34] Mattila ML, Rautava P, Aromaa M, Ojanlatva A, Paunio P, Hyssälä L, Helenius H, Sillanpää M. Behavioural and demographic factors duringearly childhood and poor dental health at 10 years of age. Caries Res. Vol. 39, P85-91, 2005.
[35] 楊奕馨、胡素婉、謝天渝、黃純德、周明勇、潘文函，「台灣地區國小學童營養健康狀況調查2001-2002」─甜食和乳製品與齲齒狀況關係之研究，中華牙醫學雜誌第25卷第3期，P169-181，2006。
[36] 陳弘森、黃純德、蕭思郁、嚴雅音、楊奕馨、詹嘉一、邱耀章、蔡宗平、陳俊志、吳青樺、紀乃智、王宏欽、戴怡佳、洪雅欣、林妤珊、王乃亭、劉秀月，台灣地區兒童及青少年口腔狀況調查，國民健康局九十四與九十五年度科技研究發展計畫(DOH94-HP-1310/DOH95-HP-1317)，高雄醫學大學口腔醫學院牙醫學研究所，2005-2007。
[37] Pommel L, Jacquot B, Camps J. Lack of Correlation among Three Methods for Evaluation of Apical Leakage. J Endodon Vol. 27, P347-350, 2001.
[38] Copeland HI, Brauer GM, Sweeney WT, Forziati AF. Setting reaction of zinc oxide and eugenol. J. Res. Natl. Bur. Stand. Vol. 55, P134-138, 1955.
[39] Gerner MM, Zadorozhnyi BA, Ryabina LV, Batovskii VN, Scharchilev VI. Infrared spectra of eugenol and zinc eugenolate. Russ. J. Phys. Chem.(Zhurnal Fizicheskoi Khimii) Vol. 40, P122, 1966.
[40] Wu M-K, Kontakiotis EG, Wesselink PR. Long-term seal provided by some root-end filling materials. J Endodon. Vol. 24, P557-560, 1998.
[41] Dagher FB, Yared GM. Influence of operator proficiency on the sealing ability of the vertical condensation. J Endodon Vol. 21, P335-336, 1995.
[42] Antonopoulos KG, Attin T, Hellwig E. Evaluation of the apical seal of root canal fillings with different methods. J Endodon Vol. 24, P655-658, 1998.
[43] Forte SG, Hauser MJ, Hahn C, Hartwell GR. Microleakage of Super-EBA with and without finishing as determined by the fluid filtration method. J Endodon Vol. 24, P799-801, 1998.
[44] Jacquot BM, Panighi MM, Steinmetz P, G’sell C. Evaluation of temporary restorations' microleakage by means of electrochemical impedance measurements. J Endod. Vol. 22, P586-589, 1996.
[45] Michaïlesco PM, Valcarel J, Grieve AR, Levallois B, Lerner D. Bacterial leakage in endodontics: an improved method for quantification. J Endodon Vol. 22, P535-539, 1996.
[46] Haïkel Y, Wittenmeyer W, Bateman G, Bentaleb A, Allemann C. A new method for the quantitative analysis of endodontic microleakage. J Endodon Vol. 25, P172-178, 1999.
[47] 王宜斌，口腔疾病與保健，空中大學出版社，臺北，P39-41，1999。
[48] Ausiello P, De Gee AJ, Rengo S, Davidson CL. Fracture resistance of endodontically treated premolars adhesively restored. Am J Dent Vol. 10, P237-241, 1997.
[49] Trope M, Maltz DO, Tronstad L. Resistance to fracture of restored endodontically treated teeth. Endod Dent Traumatol Vol. 1, P108-111, 1985.
[50] Combe EC, Douglas WH. The Future of Dental Materials. Dent Update Vol. 25 No. 9, P411-417, 1998.
[51] Setcos JC, Staninec M, Wilson NH. Bonding of Amalgam Restorations: Existing Knowledge and Future Prospects. Oper Dent Vol. 25 No. 2, P121-129, 2000.
[52] Rubin C, Krishnamurthy N, Capilouto E, Yi H. Stress Analysis of the Human Tooth Using a Three-dimensional Finite Element Model. J Dent Res Vol. 62 No. 2, P82-86, 1983.
[53] Deveaux E, Hildelbert P, Neut C, Romond C. Bacterial microleakage of Cavit, IRM, TERM, and Fermit: a 21-day in vitro study. J Endod. Vol. 25, P653-659, 1999.
[54] Ferrari M, Vichi A, Garcia-Godoy F. Clinical evaluation of fiber-reinforced epoxy resin posts and cast post and cores. Am J Dent Vol.13, P15B-18B, 2000.
[55] 陳慈蓉、林唯芳、陳敏慧、許勝豪、何榮銘、林芳禾，化工第50卷第6期，P111，2003。
[56] 林思洸，漫談根管治療，臺大醫網，P17，2003。
[57] 沈領昌，根管治療最新發展，科學發展第394期，2005。
[58] 牙科醫學雜誌(J Dent Sci) Vol. 28, P55-62, 2008.
[59] Uludag B, Ozturk O, Ozturk AN. Microleakage of ceramic inlays luted with different resin cements and dentin adhesives. J Prosthet Dent Vol. 102, P235-241, 2009.
[60] Wälivaara DÅ, Abrahamsson P, Fogelin M, Isaksson S. Super-EBA and IRM as root-end fillings in periapical surgery with ultrasonic preparation: a prospective randomized clinical study of 206 consecutive teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Vol.112 No. 2,P258-263, 2011.
[61] Dabur R, Gupta A, Mandal TK, Singh DD, Bajpai V, Gurav AM, Lavekar GS. ANTIMICROBIAL ACTIVITY OF SOME INDIAN MEDICINAL PLANTS. Afr. J. Traditional, Complementary and Alternative Medicines Vol. 4 No. 3, P313-318, 2007.
[62] Eldeen IM, Seow E-M, Abdullah R, Sulaiman SF. In vitro antibacterial, antioxidant, total phenolic contents and anti-HIV-1 reverse transcriptase activities of extracts of seven Phyllanthus sp. South African Journal of Botany Vol. 77 No. 1, P75-79, 2011.
[63] Anja Klančnik, Saša Piskernik, Barbara Jeršek, Sonja Smole Možina. Evaluation of diffusion and dilution methods to determine the antibacterial activity of plant extracts. J Microbiol Methods Vol. 81 No. 2, 121-126, 2010.
[64] Othman M, Loh HS, Wiart C, Khoo TJ, Lim KH, Ting KN. Optimal methods for evaluating antimicrobial activities from plant extracts. J Microbiol Methods Vol. 84 No. 2, P161-166, 2011.
[65] Norlimg BK, Greener EH. X-ray diffraction studies of the ZnO-eugenol reaction. Paper presented at annual meeting of International Association for Dental Research Abstracts, 46th General Meeting No. 430, San Francisco, P145, 1968.
[66] el-Tahawi HM, Craig RG. Thermal analysis of zinc oxide-eugenol cements during setting. J Dent Res. Vol. 50, P430-435, 1971.
[67] 高資彬、翁秀和，牙科材料學上冊，合計圖書出版社，1977。
[68] 中村正明、武田昭二、大島浩、篠崎照泰、福間正泰、中川正史著，燕敏譯，牙科材料學，合記圖書出版社，臺北市，P157-158，2010。
[69] 許明發、柯澤豪、劉顯光、郭文雄，複合材料入門，中華民國尖端材料科技協會，臺中市，2005。