一步法自酸蚀粘接剂与吸水性相关因素的研究进展

一步法自酸蚀粘接剂临床使用日益广泛,但其在光固化后仍然有一定的吸水性,发生这一现象的原因可能与许多因素有关,如组成成分(HEMA、溶剂、疏水树脂成分和酸蚀树脂单体等),同时也受到口腔微环境的影响.本文就一步法自酸蚀粘接吸水性相关因素的研究进展进行综述.     

三种纤维桩树脂粘接材料的吸水性和溶解性比较

目的 比较3种纤维桩树脂粘接材料的吸水性和溶解性,为临床应用提供实验依据.方法 选取Paracore Automix、DMG Luxacore和可乐丽菲露DC core 3种双重固化树脂粘接剂,每种材料各制备5个试件,浸泡于蒸馏水中28d,通过测量浸泡前后的重量变化,计算材料的吸水值与溶解值.结果 ParaCore、Luxacore和DC core 3种粘接材料的吸水值分别为（20.13±0.97）μg/mm3、（17.67±1.46）μ g/mm3和（18.29±2.77）μ g/mm3,溶解值分别为（4.81±3.13）μ g/mm3、（3.32±0.74）μg/mm3和（2.57±1.08）μg/mm3,ParaCore的吸水值和溶解值最大,与其他两种材料的吸水值与溶解值之间的差异均有统计学意义（P＜0.05）,DC core的吸水值和溶解值相对较低.结论 三种纤维桩树脂粘接材料中DC core具有较好的稳定性;ParaCore的吸水值和溶解值最大,其远期力学性能较差,使用寿命缩短.     

自酸蚀粘接剂混合后延迟应用对粘接强度的影响

目的:评价"二瓶装、一步法"自酸蚀粘接剂混合后延迟应用对粘接强度的影响.方法:去除磨牙面釉质,等分暴露的牙本质面,其中一个半面用即刻混合的"二瓶装、一步法" 自酸蚀粘接剂(Adper Prompt、Xeno Ⅲ)进行粘接,另一个半面用混合后放置一段时间(0.5、1、2、3、4、5、6 h) 的自酸蚀粘接剂进行粘接.然后制备用于粘接强度测定及粘接界面观察用的条状试样并进行测定.结果:Adper Prompt混合后5 h以内应用,粘接强度无明显变化;Xeno Ⅲ混合后3 h以内应用,粘接强度无明显变化.结论:"二瓶装、一步法"自酸蚀粘接剂混合后的可使用时间是有限的,不同粘接剂的可使用时间是不同的.     

6种复合树脂在水中浸泡的重量改变

关于复合树脂的吸水性和溶解性的研究大部分采用在蒸馏水中浸泡7d并反复干燥脱水的方法来计算吸水值和溶解值。然而,树脂在口腔内并不存在反复彻底干燥的过程,且吸水与溶解同时发生。为了更接近临床实际,我们将研究6种树脂在水中持续浸泡的重量改变。     

评价新型粘接剂在不同粘接模式下的牙本质粘接性能

目的评价1种新型单瓶型多模式粘接剂在不同粘接模式下与牙本质的粘接强度和粘接耐久性。方法制作3组牙本质/复合树脂粘接试件,其中每组牙本质在粘接前接受不同的表面调节。包括不处理(空白对照),Singlebond Universal粘接剂自酸蚀模式下调节牙本质,Singlebond Universal粘接剂在酸蚀冲洗模式下调节牙本质。测量各组粘接试件水储24 h和180 d的微拉伸粘接强度值并进行统计分析。以扫描电子显微镜观察各组试件的粘接界面。结果不论老化前还是老化后,3组间的粘接强度均存在显著性差异,其中空白组的粘接强度值最低,另两组间则无显著性差异。人工老化使空白组的粘接强度值显著下降,而对另两组则并无显著影响。结论 Singlebond Universal粘接剂在自酸蚀粘接模式和酸蚀冲洗粘接模式下均能够形成与牙本质良好的粘接。     

自酸蚀粘接剂Adper Easy One的临床研究

目的评价一步法自酸蚀粘接剂Adper Easy One一年复诊期内的临床效果。方法临床选择有2颗恒磨牙面洞的患者27例,按随机数表选择其中一颗牙使用Adper Easy one自酸蚀粘接剂(自酸蚀组),另一颗牙使用Scotchbond酸蚀剂及Adper Single Bond2粘接剂(全酸蚀组),两颗牙均充填Filtek Z350树脂。术后即刻、1周、半年及1年复诊评价术后敏感,并按USPHS/Ryge标准评估充填体情况。结果自酸蚀组1例发生术后敏感,全酸蚀组2例发生术后敏感,两组差异无统计学意义(P>0.05)。全酸蚀组1例充填体边缘不完整,自酸蚀组所有病例充填体边缘完整,两组差异无统计学意义(P>0.05)。所有充填体颜色匹配、解剖学形态、表面质地均在1年复诊期内保持良好,未发生洞缘变色及继发龋。结论一步法自酸蚀粘接剂1年复诊期内术后敏感发生率低,临床效果保持良好。     

自酸蚀与全酸蚀粘接剂对牙釉质和牙本质的剪切粘接强度比较

目的 比较自酸蚀与伞酸蚀粘接剂对牙釉质和牙本质剪切粘接强度,以期为临床提供参考.方法 选择因牙周病拔除的上颌中切牙20颗,使用两种自酸蚀粘接剂[A(ClearfilTM Protect Bond)、B(AdporTM PromptTM)]和两种全酸蚀粘接剂[C(SwissTEC SL Bond)、D(Single Bond)]按照厂家推荐步骤对牙釉质和牙本质进行粘接,并测试牙釉质和牙本质粘接样本的剪切粘接强度.结果 4种粘接剂对牙釉质和牙本质粘接强度分别为:粘接剂A(25.33±2.84)、(26.07±5.56)MPa;粘接剂B(17.08±5.13)、(17.93±4.70)MPa;粘接剂C(33.14±6.05)、(41.92±6.25)MPa;粘接剂D(22.51±6.25)、(21.45±7.34)MPa.粘接剂C对牙釉质和牙本质剪切粘接强度显著高于其他3种粘接剂(P<0.05);粘接剂B的剪切粘接强度显著低于其他3种粘接剂(P<0.05).结论 本研究所选用的自酸蚀两步法粘接剂的剪切粘接强度与部分伞酸蚀粘接剂相当,高于自酸蚀一步法粘接剂.     

不同酸蚀方法对非龋性硬化牙本质黏结强度的影响

目的:测试不同酸蚀方法处理非龋性硬化性牙本质对黏结强度的影响,为临床工作提供参考.方法:牙颈部具有典型楔状缺损的前磨牙共30颗,随机分为2大组,分别应用全酸蚀黏结系统AdperTM Single Bond2 (ASB2)与自酸蚀黏结系统AdperTM Easy one(AEO),每大组各分为3个亚组(ASB21、ASB22、ASB23、AEO1、AEO2、AEO3),每亚组5颗牙.其中,ASB21组:磷酸处理15s后ASB2处理15s,ASB22组:磷酸处理30 s后ASB2处理15s,ASB23组:磷酸处理15s后ASB2处理30 s;AEO11组:AEO1处理20 s;AEO2组:AEO处理40 s;AEO3组:磷酸处理15s后AEO处理20s.进行树脂充填后,室温下放入蒸馏水中24 h后取出,制作成黏结面积为1 mm2的哑铃型试件,微力材料试验机测量各试件的微拉伸黏结强度.采用SPSS17.0软件包对数据进行单因素方差分析,多重比较采用SNK-q检验.结果:各组微拉伸黏结强度依次为AEO3组＞ASB22组＞ASB23组＞ASB21组＞AEO2组＞AEO1组,AEO3组的黏结强度最高,AEO1组最低,差异显著(P＜0.05);ASB22组黏结强度低于AEO3组高于其他组,差异显著(P＜0.05).结论:使用全酸蚀黏结系统.加倍延长磷酸处理时间,黏结强度增加.使用自酸蚀黏结系统,联合磷酸处理或延长自酸蚀黏结剂处理时间,均会使黏结强度增加.其中,磷酸处理硬化性牙本质15s联合自酸蚀黏结剂处理20s获得的黏结强度最高.无论使用全酸蚀系统或自酸蚀系统,磷酸处理硬化性牙本质15s联合自酸蚀黏结剂处理20 s获得的强度最好,单独使用自酸蚀黏结系统黏结强度最差.     

两种正畸粘接剂托槽生存率的比较研究

目的：比较自酸蚀粘接剂和全酸蚀粘接剂粘接托槽的临床效果。方法：选择42名固定正畸患者,采用自身对照研究,分别使用一步法自酸蚀粘接剂和两步法全酸蚀粘接剂粘接726个托槽,计算12个月内托槽的脱落率,卡方检验比较4种因素（粘接剂、牙弓、牙位和性别）对托槽脱落率的影响;Kaplan-Meier法绘制托槽生存率曲线,log-rank检验分析上述4种因素对托槽生存率的影响,同时评价牙釉质表面的剩余粘接剂指数。结果：两种粘接剂的托槽脱落率无统计学差异;生存分析表明粘接剂类型和牙弓位置对托槽生存率的影响无统计学差异,但前磨牙托槽的生存率比切牙和尖牙低,女性患者的托槽生存率高于男性;自酸蚀粘接剂的剩余粘接剂指数与全酸蚀粘接剂无统计学差异。结论：自酸蚀粘接剂与两步法全酸蚀粘接剂都具有较高的托槽生存率,均能满足正畸临床粘接的要求。     

一步法自酸蚀粘接剂微拉伸粘接强度的研究

目的评价一步法白酸蚀粘接剂的牙本质微拉伸粘接强度，观察并分析样本断裂类型。方法选择新拔除的人无龋下颌第三磨牙12颗，分别用3种一步法、1种两步法的白酸蚀粘接剂进行牙本质粘接。用微拉伸测力仪测试粘接强度，并用体视显微镜和扫描电镜观察样本断裂类型。结果3种一步法白酸蚀粘接剂的微拉伸强度分别为：材料A（Adper Prompt）（23．36±2．55）MPa；材料B（Clearfil S^3 Bond）（30．46±3．82）MPa；材料C（Xenon Ⅲ）（34．59±3．46）MPa；1种两步法自酸蚀粘接剂材料D（Clearfil SE Bond）的微拉伸粘接强度为（45．06±5．29）MPa。材料D微拉伸粘接强度最高，与其他3组相比，差异具有统计学意义（P〈0．01）。样本断裂均发生于粘接界面，未观察到复合树脂或牙本质内聚破坏。结论一步法白酸蚀粘接剂的牙本质粘接强度低于两步法白酸蚀粘接剂，但多数仍可满足临床对树脂粘接强度的要求。     

Long-term evaluation of water sorption and ultimate tensile strength of HEMA-containing/-free one-step self-etch adhesives

Objective

The objective of this study was to evaluate the water sorption (Wsp) and ultimate tensile strength (UTS) of HEMA-containing/free one-step self-etch adhesives after long-term water-storage.

Methods

Three HEMA-containing one-step self-etch adhesives (Bond Force (BF), Clearfil S³ Bond (S3) and OptiBond All-In-One (OP)), and one HEMA-free one-step self-etch adhesive, G Bond (GB) was used. After the solvents of each adhesive were evaporated, polymerised adhesive disks and dumbbell-shaped specimens of thirty-two each were prepared and divided into four groups of 14-, 90-, 180- and 360-day water-storage. After immersion in water for the designated storage periods, the disks were subjected to measurement of Wsp, and the dumbbell-shaped specimens were subjected to measurement of UTS. The data of Wsp and UTS were statistically analysed using a two-way ANOVA and Bonferroni test.

Results

Wsp of BF, S3 and OP increased over time, whereas for GB, there were no significant differences in Wsp among all the storage periods. Wsp of GB was lower than those of BF, S3 and OP in each period. The UTS of BF, S3 and OP decreased over time, whereas for GB, there were no significant differences in UTS among all storage periods. The highest UTS was initially seen in BF > GB = S3 = OP, and after 360-day water-storage, seen in BF = GB > OP = S3.

Conclusions

For the HEMA-containing adhesives, Wsp increased and UTS decreased over time. On the other hand, for the HEMA-free adhesive, Wsp and UTS did not significantly change even after 360-day water-storage.     

Influence of water-storage time on the sorption and solubility behavior of current adhesives and primer/adhesive mixtures

This study evaluated the effects of water-storage on the water sorption and solubility behavior of five commercially available dental adhesive systems and two primer/adhesive mixtures. The adhesives comprised three different approaches to bonding to hard tooth tissues: a one-step self-etching adhesive (One-up Bond F), two two-step self-etching primers (Clearfil SE Bond and Clearfil Protect Bond) and two etch-and-rinse systems: a water/ethanol-based (Single Bond) and an acetone-based filled adhesive (Prime&Bond NT). The bonding agents and primers of the two-step self-etching systems were mixed in a 1:1 volume ratio. Water sorption and solubility values were determined after 1, 7, 30, 90 and 180 days. The results showed that, except for SB, all adhesives presented increased water sorption with increased storage time. The one-step self-etching adhesive and self-etching primer/adhesive mixtures presented the highest water sorption and solubility values. Equilibrium in the water sorption values was observed for all adhesives after 90 days of water-storage. However, solubility values continued to increase for some materials until 180 days. The sorption and solubility behavior of the materials tested seem to be related to hydrophilicity of the adhesive resin solution and might influence the long-term performance of resin-based composite restorations.     

Smear layer-deproteinizing improves bonding of one-step self-etch adhesives to dentin

Objectives

Smear layer deproteinizing was proved to reduce the organic phase of smear layer covered on dentin surface. It was shown to eliminate hybridized smear layer and nanoleakage expression in resin–dentin bonding interface of two-step self-etch adhesive. This study aimed to investigate those effects on various one-step self-etch adhesives.

Bonding effectiveness of a new 'multi-mode' adhesive to enamel and dentine

ObjectivesSelf-etch adhesives are well adopted in general practice, obviously primarily thanks to their ease of use and fast application time. Nevertheless, phosphoric acid is still often recommended to beforehand etch enamel following a so-called ‘selective’ enamel-etch technique, this in particular when most cavity margins end in enamel. The purpose of this study was to test if a new one-step adhesive can be applied in a multi-mode manner, this following different, either ‘full’ or ‘selective’, self-etch and etch-and-rinse approaches. Specific research hypotheses tested were that prior phosphoric-acid etching did not affect the bonding effectiveness of the one-step adhesive to enamel and dentine, and that the bonding effectiveness to dentine was also not affected when the adhesive was applied either following a ‘dry-bonding’ or ‘wet-bonding’ etch-and-rinse technique.MethodsThe micro-tensile bond strength (μTBS) of the one-step self-etch adhesive G-Bond Plus (GC, Tokyo, Japan; 1-SEA) was measured when it was bonded to bur-cut enamel following either a ‘self-etch’ or an ‘etch-and-rinse’ adhesive protocol, and to bur-cut dentine when applied following either a ‘self-etch’, a ‘dry-bonding’ or a ‘wet-bonding’ etch-and-rinse adhesive protocol. Bond-strength testing was corroborated by ultra-structural analysis of the interfacial interaction at enamel and dentine using transmission electron microscopy (TEM).ResultsPrior phosphoric-acid etching significantly increased the bonding effectiveness of the 1-SEA to enamel. A clearly enhanced micro-retentive surface was revealed by TEM. To dentine, no statistically significant difference in bonding effectiveness was recorded when the 1-SEA was either applied following a self-etch or both etch-and-rinse approaches. The ‘dry-bonding’ etch-and-rinse protocol was significantly more effective than its ‘wet-bonding’ version. TEM however revealed indications of low-quality hybridisation following both etch-and-rinse approaches, in particular in the form of a porous and poorly resin-infiltrated collagen mesh.ConclusionsWhile phosphoric-acid etching definitely improved bonding of the one-step self-etch adhesive to enamel, one should be more careful with additional phosphoric-acid etching of dentine. Although the bond strength was not reduced, the resultant adhesive interface appeared ultra-structurally more vulnerable to biodegradation.     

Extension of a one-step self-etch adhesive into a multi-step adhesive.

One-step self-etch adhesives are undoubtedly the most user-friendly adhesives, but have been associated with lower bonding effectiveness as compared to two-step and three-step adhesives. Conversion of a one-step self-etch system into a two-step self-etch adhesive by adding a bonding step, or into a three-step etch&rinse adhesive by adding a beforehand etching step and a bonding step might be tempting in order to improve bond strength. OBJECTIVES: The objective of this study was to investigate whether adding application steps influences the bond strength of a one-step self-etch adhesive. METHODS: In this study, the bonding effectiveness of two experimental one-step self-etch adhesives and three different commercial adhesives to enamel and dentin was determined using a micro-tensile bond-strength protocol. This procedure was repeated for the experimental adhesives transformed into two-step self-etch and three-step etch&rinse adhesives. In addition, their interaction with tooth tissue was investigated using TEM and Feg-SEM. RESULTS: Transforming a one-step into a two-step self-etch adhesive did improve the bond strength to enamel and dentin, though not significantly. By adding a preceding etching step, the bond strength to enamel was significantly improved, but that to dentin was decreased considerably. The latter must be attributed to hampered resin infiltration of the one-step self-etch adhesive within the relatively deeply exposed collagen fibril network. SIGNIFICANCE: Additional application of a hydrophobic bonding agent slightly improved bonding effectiveness. Adding a preceding etching step is beneficial for enamel but should be avoided for dentin as this will decrease bond strengths, and may even jeopardize the bonding durability.     

An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions

Objective. In this intra-individual comparison (an 18-months' randomized, controlled prospective study), we evaluated the clinical performance of one self-etch and one “etch & rinse” adhesive in non-carious cervical lesions. Methods. Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated. Seventy-eight restorations were placed; 39 with etch & rinse (Single-Bond) and 39 with self-etch (Adper Prompt). Both adhesives were combined with the microfilled resin composite Filtek-A110. The restorations were evaluated at baseline, 6, 12, and 18 months according to slightly modified USPHS criteria. Statistical differences between the adhesives was tested with McNemar's test and clinical degradation over time for each material with the Fisher exact test (α=0.05). Results. Thirty pairs were evaluated at 12 and 18 months. Two self-etch restorations were lost after 18 months. Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months (p<0.05). Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration (p<0.05). Conclusions. Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions. The self-etch adhesive showed a faster progressive marginal degradation.     

The effect of five different universal adhesives on the clinical success of class I restorations: 24-month clinical follow-up

Objectives

The aim of this study was to evaluate the 24-month clinical performance of universal adhesives on the restoration success of Class I carious lesions.

Materials and methods

Five different universal adhesives (Gluma Bond Universal (GU), Clearfil Universal (CU), Prime&Bond Elect Universal (PU), All bond Universal (AU), and Single Bond Universal (SU)) were used in the self-etch and etch-and-rinse modes in 42 patients. The study was conducted with 10 groups, with 20 restorations in each group. The restorations were evaluated at baseline and during a 24-month recall using World Dental Federation (FDI) and the US Public Health Service (USPHS) criteria. The changes in the parameters were analyzed using the chi-square test.

Results

At the end of 24 months, there was no loss of restoration in any group. According to the USPHS, there was no difference in the baseline and 24-month clinical behavior of the restorations (P ˃ 0.05). However, according to the FDI, when adhesives were used in the self-etch mode, three adhesives (GU, SU, PU) showed marginal incompatibility, and one adhesive showed (GU) marginal discoloration between baseline and the 24-month follow-up evaluation (P < 0.05). There was no significant difference after 24 months between etch-and-rinse and self-etch groups according to the results based on both the USPHS and FDI criteria (P ˃ 0.05).

Conclusions

The 24-month clinical performance of the evaluated universal adhesives depends on the adhesive strategy.

Clinical relevance

This study helps clinicians to decide in which mode (etch-and-rinse or self-etch) universal adhesives can be safely used.

     

Self-etch adhesives for the bonding of orthodontic brackets: faster, stronger, safer?

Objectives

This study aimed to evaluate the performance of accelerating procedures for bonding of orthodontic brackets in vitro by comparing different adhesives (etch-and-rinse, self-etch) and polymerization procedures (curing devices, time). The performance was characterized by three parameters: (1) the bond strength achieved, (2) the incidence of enamel damage, and (3) the extent of residual composite on the tooth.

Materials and methods

Bracket bonding was performed on 500 extracted human teeth after application of either an etch-and-rinse adhesive or a one-step self-etch adhesive. Two different two-component self-etch adhesives (Clearfil SE and Transbond Plus) and two single-component self-etch adhesives (Ideal and iBond) were investigated after using different polymerization procedures (light-emitting diode for 10 or 20 s or plasma arc curing device for 3 or 6 s). The bond strength, incidence of enamel damage, and extent of residual composite on the tooth were measured.

Results

Single-component self-etch adhesives gave the lowest bond strengths. No significant difference in bond strength could be detected between the two-component self-etch adhesives and the etch-and-rinse method. There was a 70.3 % risk for enamel damage at bond strengths above 12 MPa, but only 5 % risk below 12 MPa and no risk below 8.2 MPa. The risk of enamel damage increased by an odds ratio increment of 1.3 for each additional MPa above 8.2 MPa.

Conclusion

Single-component self-etch adhesives showed the lowest bond strengths, caused limited enamel damage, and generally left less residual composite on the tooth.

Clinical relevance

The nature of the adhesive greatly influences the resultant bond strength, the risk of enamel damage, and the extent of residual composite on the teeth.     

Incompatibility of self-etch adhesives with chemical/dual-cured composites: two-step vs one-step systems

This study tested the null hypothesis that there no difference between two-step and one-step self-etch adhesives in their compatibility with these composites. The microtensile bond strengths (microTBS) of two two-step systems (Clearfil SE Bond, Kuraray and Tyrian SPE/One-Step Plus, BISCO) were compared with two one-step systems (Xeno III, Dentsply DeTrey and Brush&Bond, Parkell) for their coupling to a dual-cured composite. Silver tracer penetration of the four adhesives bonded to a light-cured or a chemical-cured composite was examined using TEM. Significant differences in microTBSs between composite curing modes were seen only in the one-step adhesives. For one-step self-etch adhesives bonded to the chemical-cured composite, TEM revealed signs of frank composite uncoupling along the adhesive-composite interface, which may be attributed to the adverse chemical interaction between the acidic adhesive and the composite. In addition, "water trees" that represent channels of increased permeability with the polymerized adhesive layer were also observed in the one-step adhesives. Both features were absent along the resin-dentin interfaces when chemical-cured composites were coupled to the two-step self-etch adhesives.     

Optimization of the concentration of photo-initiator in a one-step self-etch adhesive

ObjectivesThe objective of this study was to determine the optimal concentration of photo-initiator (camphorquinone) in an experimental one-step self-etch adhesive and to investigate the role of the photo-initiator.MethodsSeven experimental one-step adhesives with a varying amount of camphorquinone ranging from 0 to 5.25 wt% were prepared. Their micro-tensile bond strength to enamel and dentin was determined. In addition, the bond strength was also determined when the adhesive was not light-cured prior to the application of the composite. SEM and TEM were used for further evaluation of the resultant interfacial ultrastructure.ResultsThe bond strength to enamel was not influenced by the amount of photo-initiator, whereas the bond strength to dentin dropped significantly when concentrations below 0.35 wt% camphorquinone were used. Besides phase-separation droplets, electron microscopy revealed the presence of many small droplets at the bottom of the adhesive layer when the adhesive contained no or only a low concentration of initiator, or when the adhesive was not light-cured.SignificanceSince polymerization is severely hampered by oxygen inhibition in thin layers, one-step self-etch adhesives depend greatly on the polymerization of the first layer of lining composite to achieve their ultimate mechanical strength. Consequently, the bond strength to enamel is not influenced by the amount of photo-initiator, but on dentin, bond strength is compromised by droplets, probably due to water absorption, and additionally by the negative effect of water on polymerization and by continuing demineralization of unpolymerized acidic monomers. Overall, it was found that minimally 0.7 wt% camphorquinone was needed.