臺灣博碩士論文加值系統

研究目的:
本研究在探討不同矽烷偶合劑與黏著劑的混合比例，對於不同酸蝕劑酸蝕的陶瓷表面上進行複合樹脂修復的鍵結強度之影響。
材料與方法：
本研究採用陶瓷（VINTAGE MP，A2B Body）、兩種黏著劑（Single Bond Universal與G-Premio BOND）、一種矽烷偶合劑（Ceramic primer II）、9.5%氫氟酸、32%磷酸進行各種測試。
方法A：分別使用9.5%氫氟酸酸蝕、32%磷酸酸蝕或研磨三種方式處理陶瓷表面，再使用已有矽烷偶合劑添加之黏著劑或是矽烷偶合劑（S）與黏著劑（A）分兩步驟個別塗抹之方式進行表面處理後，以複合樹脂填補。經24小時後，進行微拉力測試測量鍵結強度。
方法B：將陶瓷經過氫氟酸處理後，分別塗抹不同比例矽烷偶合劑與黏著劑混合調製的表面處理劑，共有九種不同比例組別與一組控制組。各組別的S與A混合比例分別如下：(1)S5A1組為S:A=5:1、(2)S4A1組為S:A=4:1、(3)S3A1組為S:A=3:1、(4)S2A1組為S:A=2:1、(5)S1A1組為S:A=1:1、(6)S1A2組為S:A=1:2、(7)S1A3組為S:A=1:3、(8)S1A4組為S:A=1:4、(9)S1A5組為S:A=1:5、(10)S-A組先塗抹矽烷偶合劑再塗抹黏著劑，亦為控制組。這十個組別進行微拉力測試，測量不同矽烷偶合劑與黏著劑混合比例所產生的鍵結強度與破壞模式。
方法A及B中所有組合皆以掃描式電子顯微鏡進行結合界面的觀察。
結果：
結果A：表面處理使用氫氟酸酸蝕組別呈現最高的鍵結強度，比磷酸酸蝕組別與600號砂紙研磨組別呈現顯著意義（p < 0.05）。但是在塗抹不同黏著劑而言，並沒有顯著意義（p = 0.268）。
結果B：在氫氟酸酸蝕表面塗抹不同矽烷偶合劑與黏著劑混合比組別所獲的微拉力強度，S1A1組的微拉力測試值最大，且有優於S-A組的傾向。其中以S4A1、S3A1、S2A1、S1A1、S1A2組與S-A組相似且沒有顯示統計意義（p > 0.05），而S5A1、S1A3、S1A4、S1A5則與S-A組相較顯示有統計差異的較低數值（p < 0.05）。
結論：
在氫氟酸酸蝕陶瓷表面塗抹矽烷偶合劑與黏著劑為1:1混合比之混合型黏著劑可獲得最佳微拉力強度，可比擬傳統處理方式。

Purpose:
This study was to investigate the effect of the different proportion of silane coupling agent mixed with adhesive on the microtensile bond strength between composite resins and different acid-etch treated ceramics.
Materials and Methods:
One kind of porcelain (VINTAGE MP，A2B Body), two kinds of adhesives (Single Bond Universal and G-Premio BOND), one kind of silane coupling agent (Ceramic primer II), 9.5%hydrofluoric acid and 32% phosphoric acid were supplied for this study.
Method A: The surface of the ceramic block was treated with 9.5% hydrofluoric acid, 32% phosphoric acid or surface grinding and applied with Single Bond Universal or the combination of Ceramic primer II and G-Premio BOND. The microtensile bond strength (μTBS) and failure mode were also measured after 24-hour water immersion.
Method B: The hydrofluoric acid-etched ceramics were applied with 9 kinds of different silane coupling agent (S) /adhesive (A) ratio mixed adhesive as experimental groups and one control group. The mix ratio of each group was as followed: S:A=5:1 in S5A1 group, S:A=4:1 in S4A1 group, S:A=3:1 in S3A1 group, S:A=2:1 in S2A1 group, S:A=1:1 in S1A1 group, S:A=1:2 in S1A2 group, S:A=1:3 in S1A3 group, S:A=1:4 in S1A4 group, and S:A=1:5 in S1A5 group. S-A group as control group was applied with silane coupling agent and then conventional adhesive. The μTBS and failure mode were also measured after 24-hour water immersion.
The bonding interface of each group were also observed by scanning electronic microscope.
Result:
Result A: Hydrofluoric acid etched group showed the highest μTBS in the three groups despite of the use of adhesives and revealed significant difference with phosphoric acid etched and 600-grid sandpaper grinding groups (p < 0.05). No significance was found between phosphoric acid etched and 600-grid sandpaper grinding groups.
Result B: In all different silane coupling agent/adhesive ratio groups, S1A1 group showed the greatest μTBS and showed a higher tendency compared with the control group. There was no statistically significant difference among S4A1, S3A1, S2A1, S1A1, S1A2 and S-A groups (p > 0.05), while a significant difference was shown when S5A1, S1A3, S1A4, S1A5 groups compared with S-A group.
Conclusion:
The application of adhesive by mixture ratio of silane coupling agent/adhesive in 1:1 could gain the desirable μTBS and comparable to conventional group (control).

目錄
中文摘要--------------------------------------2
英文摘要--------------------------------------4
目錄------------------------------------------7
壹、緒論--------------------------------------8
貳、文獻回顧----------------------------------13
參、研究目的----------------------------------20
肆、材料與方法 A------------------------------22
伍、結果 A------------------------------------29
陸、材料與方法 B------------------------------31
柒、結果 B------------------------------------35
捌、討論--------------------------------------38
玖、結論--------------------------------------51
拾、參考文獻----------------------------------52
拾壹、附表------------------------------------56
拾貳、附圖------------------------------------73

1.Gracis S, Thompson VP, Ferencz JL, Silva NR, Bonfante EA: A new classification system for all-ceramic and ceramic-like restorative materials. Int J Prosthodont 2015, 28(3):227-235.
2.Queiroz JR, Souza RO, Nogueira Junior L, Jr., Ozcan M, Bottino MA: Influence of acid-etching and ceramic primers on the repair of a glass ceramic. Gen Dent 2012, 60(2):e79-85.
3.Ozcan M, Niedermeier W: Clinical study on the reasons for and location of failures of metal-ceramic restorations and survival of repairs. Int J Prosthodont 2002, 15(3):299-302.
4.Ozcan M, Vallittu PK: Effect of surface conditioning methods on the bond strength of luting cement to ceramics. Dent Mater 2003, 19(8):725-731.
5.Oh WS, Shen C: Effect of surface topography on the bond strength of a composite to three different types of ceramic. J Prosthet Dent 2003, 90(3):241-246.
6.Kalavacharla VK, Lawson NC, Ramp LC, Burgess JO: Influence of Etching Protocol and Silane Treatment with a Universal Adhesive on Lithium Disilicate Bond Strength. Oper Dent 2015, 40(4):372-378.
7.Yoshihara K, Nagaoka N, Sonoda A, Maruo Y, Makita Y, Okihara T, Irie M, Yoshida Y, Van Meerbeek B: Effectiveness and stability of silane coupling agent incorporated in ''universal'' adhesives. Dent Mater 2016, 32(10):1218-1225.
8.Lacy AM, LaLuz J, Watanabe LG, Dellinges M: Effect of porcelain surface treatment on the bond to composite. J Prosthet Dent 1988, 60(3):288-291.
9.Guruprasada, Rivankar N, Dhiman RK, Viswambaran M: Evaluation of the effect of surface preparation using phosphoric acid and luting cement on the flexural strength of porcelain laminate veneering material. Med J Armed Forces India 2015, 71(Suppl 2):S299-305.
10.Latta MA, Barkmeier WW: Approaches for intraoral repair of ceramic restorations. Compend Contin Educ Dent 2000, 21(8):635-639, 642-634; quiz 646.
11.Chen JH, Matsumura H, Atsuta M: Effect of etchant, etching period, and silane priming on bond strength to porcelain of composite resin. Oper Dent 1998, 23(5):250-257.
12.Ramakrishnaiah R, Alkheraif AA, Divakar DD, Matinlinna JP, Vallittu PK: The Effect of Hydrofluoric Acid Etching Duration on the Surface Micromorphology, Roughness, and Wettability of Dental Ceramics. Int J Mol Sci 2016, 17(6).
13.Foxton RM, Nakajima M, Tagami J, Miura H: Effect of acidic pretreatment combined with a silane coupling agent on bonding durability to silicon oxide ceramic. J Biomed Mater Res B Appl Biomater 2005, 73(1):97-103.
14.Prochnow C, Pereira GKR, Venturini AB, Scherer MM, Rippe MP, Bottino MC, Kleverlaan CJ, Valandro LF: How does hydrofluoric acid etching affect the cyclic load-to-failure of lithium disilicate restorations? J Mech Behav Biomed Mater 2018, 87:306-311.
15.Blatz MB, Sadan A, Kern M: Resin-ceramic bonding: a review of the literature. J Prosthet Dent 2003, 89(3):268-274.
16.Kato H, Matsumura H, Atsuta M: Effect of etching and sandblasting on bond strength to sintered porcelain of unfilled resin. J Oral Rehabil 2000, 27(2):103-110.
17.Kato H, Matsumura H, Ide T, Atsuta M: Improved bonding of adhesive resin to sintered porcelain with the combination of acid etching and a two-liquid silane conditioner. J Oral Rehabil 2001, 28(1):102-108.
18.Bergoli CD, de Carvalho RF, Luz JN, Luz MS, Meincke DK, Saavedra Gde S: Ceramic Repair Without Hydrofluoric Acid. J Adhes Dent 2016, 18(4):283-287.
19.Santos GC, Jr., Santos MJ, Rizkalla AS: Adhesive cementation of etchable ceramic esthetic restorations. J Can Dent Assoc 2009, 75(5):379-384.
20.Antonucci JM, Dickens SH, Fowler BO, Xu HH, McDonough WG: Chemistry of Silanes: Interfaces in Dental Polymers and Composites. J Res Natl Inst Stand Technol 2005, 110(5):541-558.
21.Souza RO, Castilho AA, Fernandes VV, Bottino MA, Valandro LF: Durability of microtensile bond to nonetched and etched feldspar ceramic: self-adhesive resin cements vs conventional resin. J Adhes Dent 2011, 13(2):155-162.
22.Chen KK, Wang CH, Ting CC, Du JK: Bonding performance of a temporary tooth coating material to enamel. J Adhes Sci Technol 2016, 30(20):2277-2288.
23.Armstrong S, Geraldeli S, Maia R, Raposo LH, Soares CJ, Yamagawa J: Adhesion to tooth structure: a critical review of "micro" bond strength test methods. Dent Mater 2010, 26(2):e50-62.
24.Brentel AS, Ozcan M, Valandro LF, Alarca LG, Amaral R, Bottino MA: Microtensile bond strength of a resin cement to feldpathic ceramic after different etching and silanization regimens in dry and aged conditions. Dent Mater 2007, 23(11):1323-1331.
25.Della Bona A, Anusavice KJ, Shen C: Microtensile strength of composite bonded to hot-pressed ceramics. J Adhes Dent 2000, 2(4):305-313.
26.Holden JE, Goldstein GR, Hittelman EL, Clark EA: Comparison of the marginal fit of pressable ceramic to metal ceramic restorations. J Prosthodont 2009, 18(8):645-648.
27.Ozcan M, Allahbeickaraghi A, Dundar M: Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review. Clin Oral Investig 2012, 16(1):15-23.
28.Valian A, Moravej-Salehi E: Surface treatment of feldspathic porcelain: scanning electron microscopy analysis. J Adv Prosthodont 2014, 6(5):387-394.
29.Filho AM, Vieira LC, Araujo E, Monteiro Junior S: Effect of different ceramic surface treatments on resin microtensile bond strength. J Prosthodont 2004, 13(1):28-35.
30.Eames WB, Rogers LB, Feller PR, Price WR: Bonding agents for repairing porcelain and gold: an evaluation. Oper Dent 1977, 2(3):118-124.
31.Stewart GP, Jain P, Hodges J: Shear bond strength of resin cements to both ceramic and dentin. J Prosthet Dent 2002, 88(3):277-284.
32.Vargas MA, Bergeron C, Diaz-Arnold A: Cementing all-ceramic restorations: recommendations for success. J Am Dent Assoc 2011, 142 Suppl 2:20S-24S.
33.Furuse AY, Scotti CK, Llerena-Icochea A, Bombonatti JFS, Haragushiku GA, Gonzaga CC: Influence of light activation of simplified adhesives on the shear bond strength of resin cements to a leucite-reinforced ceramic. Eur J Dent 2018, 12(1):3-6.
34.de Menezes FC, da Silva SB, Valentino TA, Oliveira MA, Rastelli AN, Concalves Lde S: Evaluation of bond strength and thickness of adhesive layer according to the techniques of applying adhesives in composite resin restorations. Quintessence Int 2013, 44(1):9-15.
35.Ozcan M, Valandro LF, Amaral R, Leite F, Bottino MA: Bond strength durability of a resin composite on a reinforced ceramic using various repair systems. Dent Mater 2009, 25(12):1477-1483.
36.Hisamatsu N, Atsuta M, Matsumura H: Effect of silane primers and unfilled resin bonding agents on repair bond strength of a prosthodontic microfilled composite. J Oral Rehabil 2002, 29(7):644-648.
37.Feitosa VP, Sauro S, Ogliari FA, Stansbury JW, Carpenter GH, Watson TF, Sinhoreti MA, Correr AB: The role of spacer carbon chain in acidic functional monomers on the physicochemical properties of self-etch dental adhesives. J Dent 2014, 42(5):565-574.
38.Van Landuyt KL, Snauwaert J, De Munck J, Peumans M, Yoshida Y, Poitevin A, Coutinho E, Suzuki K, Lambrechts P, Van Meerbeek B: Systematic review of the chemical composition of contemporary dental adhesives. Biomaterials 2007, 28(26):3757-3785.
39.Kalachandra S, Taylor DF, Deporter CD, Grubbs HJ, Mcgrath JE: Polymeric Materials for Composite Matrices in Biological Environments. Polymer 1993, 34(4):778-782.
40.Cura C, Saracoglu A, Cotert HS: Effect of different bonding agents on shear bond strengths of composite-bonded porcelain to enamel. J Prosthet Dent 2003, 89(4):394-399.
41.Romanini-Junior JC, Kumagai RY, Ortega LF, Rodrigues JA, Cassoni A, Hirata R, Reis AF: Adhesive/silane application effects on bond strength durability to a lithium disilicate ceramic. J Esthet Restor Dent 2018.
42.Staxrud F, Dahl JE: Role of bonding agents in the repair of composite resin restorations. Eur J Oral Sci 2011, 119(4):316-322.
43.Della Bona A, Anusavice KJ, Mecholsky JJ, Jr.: Apparent interfacial fracture toughness of resin/ceramic systems. J Dent Res 2006, 85(11):1037-1041.