臺灣博碩士論文加值系統

樹脂改良玻璃離子體黏著劑（resin-modified glass-ionomer cement，RM-GICs）為玻璃離子體之改良型，發展已有數十年之歷史，至今於牙科臨床補綴上仍有廣泛地應用，RM-GIC其因樹脂的添加有效改良了原本玻璃離子體強度不足的缺點，但伴隨著亦降低了生物相容性；氧化釔安定氧化鋯（Yttrium stabilized Zirconia，YSZ）為具有良好生物相容性與機械強度的陶瓷材料，近年來被廣泛應用於生醫材料上。因此，本研究目的為探討藉由YSZ的添加對RM-GIC於機械強度與生物相容性的影響，期望藉由YSZ的優點讓RM-GIC擁有更良好的表現。
本實驗為添加不同比例之微米級YSZ至RM-GIC材料中，以光聚合製成試片進行機械強度以及生物相容性之評估實驗。以未添加YSZ之RM-GIC為控制組，機械強度為測量壓縮強度以及對徑壓縮強度之表現；生物相容性則將材料浸泡於不同時間點，選用L929老鼠纖維母細胞已浸泡液觀察細胞存活，以及浸泡後才料之表面細胞貼附型態，以及以觀察細胞內環氧化酶二型（COX-2）的表現與細胞外腫瘤壞子因子α（TNFα）的產量來評估材料與細胞發炎反應之相關性。
結果顯示，YSZ不論添加5%、10%或是20%，壓縮強度與對徑壓縮強度皆無統計上顯著性差異。而將細胞培養於添加5%與10% YSZ的RM-GIC 0-3天之浸泡液細胞存活率，相較於控制組有統計上顯著較多（p＜0.05）；從SEM觀察細胞貼附型態，於未浸泡與浸泡3天後之細胞貼附材料表面形態，添加YSZ之組別相較於控制組有較良好的細胞貼附型態；在發炎反應COX-2表現上，0-3天浸泡液培養細胞12小時時，添加10% YSZ之組別相較於控制組統計上有顯著較少的COX-2表現量（p＜0.05），但各組於細胞培養24小時後之TNFα產物則無顯著性差異。因此，本研究可得結論，添加10% YSZ之RM-GIC能在不影響機械強度之同時提高材料之生物相容性。

Resin-modified glass-ionomer cements (RM-GICs) containing a basic ion-leachable glass, a water soluble polymeric acid, organic monomer and an initiator system, was considered not as biocompatible as conventional GICs. This study, therefore, was focused on the effects, especially adverse cellular reactions, of yttria-stabilized zirconia (YSZ) addition on resin-modified GIC. YSZ powder was added into Fuji II LC (GC, Japan) in the ratios of 0%, 5%, 10%, and 20%, respectively, molded into columns (2 mm x 4 mm), and light-cured as instructed. There were no statistically significant differences between groups in their compressive strength and diametric tensile strengths, although the group of 20% YSZ addition showed slight reductions. When incubating L929 cells, a fibroblast cell line, with cured 0-3day RMGIC-YSZ eluates, YSZ addition showed a dose dependent improvement of cell vitality, with a 25% increase in 10% YSZ group compared with the control（p＜0.05）. Better cell attachment was observed under electronic microscope in the YSZ group than the control. The production of COX-2 by L929 cells when incubating with RM-GIC eluates, was curbed by the addition of YSZ, also in a dose-dependent pattern, but there were no statistically significant differences between groups in TNFα production . We concluded that the addition of YSZ is capable of improving biocompatibility of GIC without compromising mechanical strength.

致謝 ....................................................................... I
中文摘要 ................................................................ II
Abstract ................................................................ III
總目錄 .................................................................. IV
表目錄 ................................................................. VII
圖目錄 ................................................................. VIII

第一章 前言 .................................................................. 1
1-1 文獻回顧 ................................................................. 1
1-1-1 玻璃離子體 ......................................................... 1
1-1-2 牙科樹脂之生物相容性 ........................................... 3
1-1-3 氧化鋯 ............................................................... 6
1-2 研究目的 ................................................................. 8
第二章 材料與方法 ........................................................ 9
2-1 材料備製 ................................................................. 9
2-2 機械性質測試 ......................................................... 11
2-2-1 壓縮強度測試 ................................................... 11
2-2-2 對徑壓縮強度測試 ............................................. 11
2-3 材料晶相與表面觀察 ............................................... 12
2-3-1 材料晶相分析 ................................................... 12
2-3-2 材料表面觀察 ................................................... 12
2-4 生物相容性分析 ...................................................... 14
2-4-1 浸泡液配製 ...................................................... 14
2-4-2 pH值測量 ......................................................... 14
2-4-3 細胞培養 ......................................................... 14
2-4-4 細胞貼附 ......................................................... 14
2-4-5 細胞存活率 ...................................................... 15
2-4-6 蛋白質萃取與定量 ............................................. 15
2-4-7 環氧化酶二型（COX-2）表現 .................................. 17
2-4-8腫瘤壞死因子α（TNFα）Cytokine 釋放量 ................. 19
2-5統計分析 ................................................................. 20
第三章 結果 ................................................................. 21
3-1 機械性質 ................................................................ 21
3-1-1 壓縮強度 ......................................................... 21
3-1-2 對徑壓縮強度 ................................................... 22
3-2 材料性質與型態 ...................................................... 24
3-2-1 材料晶相分析 ................................................... 24
3-2-2 材料表面形態 ................................................... 26
3-3 生物相容性 ............................................................. 28
3-3-1 材料浸泡液pH值 ............................................... 28
3-3-2 細胞存活率 ...................................................... 30
3-3-3 細胞貼附觀察 ................................................... 32
3-3-4 環氧化酶二型（COX-2）表現 .................................. 36
3-3-5 腫瘤壞子因子α（TNFα）表現 ................................. 36
第四章 討論 ................................................................. 39
4-1添加YSZ對RM-GIC之機械強度影響 ............................ 39
4-2各組材料對細胞存活率與貼附之影響 .......................... 40
4-3 各組材料於發炎反應之探討 ...................................... 42
第五章 結論 ................................................................. 44
第六章 參考文獻 ........................................................... 45

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