硬化牙本质粘接界面的激光扫描共聚焦显微镜观察

目的使用激光扫描共聚焦显微镜（CLSM）观察牙颈部硬化牙本质在全酸蚀和自酸蚀粘接系统形成粘接界面的超微结构。方法选用12颗因牙周病拔除的具有典型楔状缺损的上颌前磨牙为实验组；12颗新鲜拔除的无龋人上颌前磨牙为对照组，制备人造楔状缺损。使用Single Bond （SB，全酸蚀单瓶系统）、Clearfil SE Bond（CB，自酸蚀底胶系统）、Xeno Ⅲ（XB，自酸蚀一步粘接系统）粘接系统处理牙面，以罗丹明B异硫氰酸盐为荧光素，使用CLSM观察粘接界面的混合层与树脂突的微观结构。结果双因素方差分析表明粘接剂种类、牙本质类型对粘接界面树脂突长度、混合层厚度有显著影响（P<0.05）。无论是正常牙本质还是硬化牙本质，全酸蚀粘接剂（SB）产生的树脂突长度、混合层厚度均大于自酸蚀粘接剂（CB、XB），并且其差异具有统计学意义（P<0.05）；而CB和XB间树脂突长度、混合层厚度相差不多，二者间无统计学意义。结论硬化牙本质相对于正常牙本质形成的混合层较薄或者没有，树脂突短、少。全酸蚀粘接系统与自酸蚀粘接系统作用同类型的牙本质上，自酸蚀比全酸蚀形成的混合层薄，树脂突短。

Observation on bonding interface of sclerotic dentin with confocal laser scanning microscope

OBJECTIVE: To observe the bonding interface of sclerotic dentin after treated with total-etching system and self-etching system by confocal laser scanning microscope (CLSM). METHODS: A total of 12 maxillary bicuspids with non-caries, natural cervical sclerotic lesions were divided into three groups. The sclerotic dentin was bonded with Single Bond (SB, total-etching adhesive), Clearfil SE Bond (CB, two-step self-etching) and Xeno III (XB, one-step self-etching) according to the manufacturer's instruction. Artificially prepared wedge-shaped lesions made in sound maxillary bicuspids and bonded with same adhesive were used as control. The primer component was labeled with Rhodamine B Isothiocyanate. Hybrid layer and resin tag of dentin bonding interface were observed by CLSM. RESULTS: Two-way ANVOA revealed significant influence of both the type of dentin and the bonding adhesive systems tested on resin tag and hybrid layer (P<0.05). Resin tag and hybrid layer in total-etching adhesive (SB) were longer and thicker than in self-etching adhesive (CB, XB) whatever in normal dentin or sclerotic dentin, while the resin tag and hybrid layer thickness were similar in two kind self-etching adhesive (P<0.05). CONCLUSION: The resin rags were fewer and shorter and the hybrid layers were thinner in sclerotic dentin than in normal dentin. When bonding the same type dentin substrate, the resin rags were shorter and the hybrid layer thinner in used self-etching adhesive than total-etching.