脱矿牙本质与四种粘接剂的粘接强度测试及粘接界面观察

目的比较脱矿牙本质与4种全酸蚀或自酸蚀粘接剂的粘接强度及粘接界面超微结构的差异,以期对临床治疗有所指导。方法选择20颗面龋坏的离体磨牙,在龋显示剂的指示下去除牙本质龋的感染层,保留脱矿牙本质。平齐龋洞洞底平面,去除冠向牙体组织,作为粘接面。选择临床常用的2种全酸蚀粘接剂:材料A(All Bond2)、材料B(Prime&BondNT)和2种自酸蚀粘接剂:材料C(ClearfilSEBond)、材料D(XenoⅢ),分别按说明书要求粘接。用慢速锯将样本牙切为粘接面积约0.9mm×0.9mm的长方体试件。体视显微镜下将试件分为正常牙本质组和脱矿牙本质组,用微拉伸测试仪检测粘接强度。扫描电镜观察各组试件粘接界面的超微形态。结果方差分析提示牙本质类型和粘接剂对微拉伸粘接强度的影响均有统计学意义(P<0.05)。对正常牙本质,不同粘接剂的微拉伸粘接强度差异无统计学意义(P>0.05);对于脱矿牙本质,材料D的微拉伸粘接强度较其他粘接剂明显降低(P<0.05)。扫描电镜下观察脱矿牙本质的混合层多孔稀疏,树脂突短少,无侧枝形成。结论对脱矿牙本质,本项实验中全酸蚀粘接剂的粘接强度优于自酸蚀粘接剂。

Microtensile bond strength and morphological evaluations of total-etch and self-etch adhesives to caries-affected dentin

OBJECTIVE: To evaluate the microtensile bond strength and bond interface of total-etch or self-etch adhesives to normal dentin and caries-affected dentin. METHODS: A total of 20 molars with occlusal caries lesion were used. The caries-affected dentin was obtained by removing the caries-infected dentin under the guidance of the caries detector. Beyond the level of caries-affected dentin all the enamel and partial dentin were removed. The adhesive systems, two total-etch adhesives (All-Bond 2, Prime&Bond NT) and two self-etch adhesives (Clearfil SE Bond, Xeno III) were applied respectively under the instructions of manufacturers. A block of composite resin was build up superficially. All the teeth were sectioned to obtain bar-shaped specimens with bonded surface area about 0.9 mm x 0.9 mm. The specimens were divided into normal dentin group and caries-affected dentin group via stereomicroscope. The bond strength was tested in a microtensile tester with a crosshead speed of 1 mm/min. The mean values of bond strength were compared using two-way ANOVA. The bonding interface between the dentin and adhesives was qualitatively evaluated under the observation of scanning electron microscope (SEM). RESULTS: Two-way ANOVA revealed a significant influence of both the type of dentin and the adhesive systems tested on microtensile bond strength values. All the adhesives attained higher strength in normal dentin. In normal dentin, there was no significant difference between total-etch and self-etch adhesives. In caries-affected dentin, bond strength of Xeno III was significantly lower than the others. For SEM, the hybrid layer in caries-affected dentin was thicker but more porous than that in normal dentin. Compared with normal dentin, there was fewer resin tag exhibited in caries-affected dentin and no lateral branches were observed. CONCLUSIONS: The total-etch adhesive had higher bond strength than self-etch adhesive systems in caries-affected dentin.