Carisolv去龋对龋损内层牙本质粘接修复的影响

目的：评价Carisolv化学机械去龋对龋损内层牙本质与复合树脂之间粘接强度的影响。方法：12个牙合面中龋离体恒磨牙,随机等分为2组,分别用Carisolv化学机械法和牙钻机械法去龋,去龋后用复合树脂充填,低速切片机将牙齿切割成0.9mm×0.9mm×8mm的条形试件,微拉伸测试仪检测粘接强度,扫描电镜观察断裂模式。结果：Carisolv化学机械去龋和牙钻机械去龋后龋损内层牙本质与复合树脂之间的粘接强度分别为：22.98±4.17MPa,20.01±3.97Mpa,差异具有显著性意义（P〈0.05）;试件断裂以混合破坏为主。结论：Carisolv化学机械去龋可增加复合树脂与龋损内层牙本质的粘接强度。     

龋影响牙本质粘接强度的研究进展

对于大多数粘接剂而言,龋影响牙本质的粘接强度均低于正常牙本质的粘接强度。本文回顾近几年有关龋影响牙本质粘接强度的文献,着重介绍不同去龋方法、表面处理和粘接剂对龋影响牙本质粘接强度的影响。     

不同性质的牙本质对牙本质粘接强度的影响

牙本质由于其复杂的组织结构和组成成分使得它比釉质粘接更复杂,本文主要针对不同性质的牙本质这一因素对牙本质粘接强度的影响作一综述。     

冷热循环对牙本质粘结系统与牙釉质粘结强度的影响

目的评价冷热循环对牙本质粘结系统与牙釉质粘结强度的影响。方法选取人离体下颌第三磨牙20颗,使用600目砂纸打磨颊面釉质,分别使用全酸蚀粘结系统AdperTM Single Bond2（SB2）、两步法自酸蚀粘结系统Clearfil SE Bond（CSE）、一步法自酸蚀粘结系统ClearfilS3Bond（CS3）和iBondGI（IB）进行粘结。实验组冷热循环3000次后测定微拉伸粘结强度,对照组不做冷热循环处理直接测试。结果实验组冷热循环后,各粘结系统粘结强度均有所下降,但与对照组相比,仅IB有显著性差异（P〈0.05）。对照组中SB2和CSE的粘结强度相近,明显高于CS3和IB。结论不同牙本质粘结系统与牙釉质的粘结强度存在差异。冷热循环3000次可导致一步法自酸蚀粘结系统IB与牙釉质粘结强度显著性下降。     

3 种粘结剂对龋损内层牙本质粘结强度的研究

目的比较3 种粘结剂对正常和龋损内层牙本质的粘结强度.方法18 颗近中牙合面中龋人离体磨牙, 在龋检液监控下用慢速球钻去龋,在远中牙合面健康牙本质上制备相同深度窝洞作为对照组.按完全随机化的方法分成3 组,用3 种粘结剂粘接(Prime&Bond NT、Adper Prompt 、Contax)粘结,然后复合树脂(Chrisma A2)充填.制备用于测试微抗拉粘结强度的条状试件,在拉力试验机上测定粘结强度,扫描电镜观察断裂模式.结果3 种粘结剂对龋损内层牙本质和正常牙本质的粘结强度分别为Prime&Bond NT (16.26±4.73) MPa,(20.36±10.18) MPa;Adper Prompt (20.19±4.04) MPa,(23.01±7.34) MPa; Contax (27.73±8.82) MPa,(26.32±8.26) MPa,试件断裂以混合破坏为主.结论3 种粘结剂龋损内层牙本质的粘结强度与正常牙本质无显著差异.     

CarisolvTM去龋对牙本质黏结强度的影响

目的评价化学机械去龋系统CarisolvTM对龋病内层牙本质黏结强度的影响.方法40个中龋人离体磨牙, 随机分成2组,分别用慢速手机球钻和CarisolvTM去龋,然后用黏结剂Prime&Bond NT或Contax黏结,复合树脂(Chrisma A2)充填.制备测试微拉伸黏结强度的龋病内层牙本质条状试件,在万能材料实验机上测定黏结强度.结果CarisolvTM去龋,用两种黏结剂黏结后牙本质的黏结强度为,Prime&Bond NT22.86(±3.42)MPa;Contax28.15(±5.39)MPa.慢速手机球钻去龋,两种黏结剂黏结后的牙本质黏结强度为,(Prime&Bond NT22.23(±4.26)MPa;Contax26.68(±6.41)MPa .结论CarisolvTM去龋对牙本质黏结强度无显著影响.     

三种粘接剂粘接不同牙本质的微拉伸粘接强度比较

目的采用微拉伸粘接强度实验测定3种牙本质粘接剂粘接楔状缺损处硬化牙本质的粘接强度。方法选择有典型楔状缺损并因牙周病拔除的上颌前磨牙30颗作为实验组，正常上颌前磨牙30颗作为对照组，使用粘接剂A（全酸蚀粘接剂Scotchbond Multi—Purpose）、B（一步法自酸蚀粘接剂Adper Prompt L-Pop）和C（两步法自酸蚀粘接剂Contax）处理硬化牙本质和正常牙本质表面，相应树脂修复。测试两组试件的微拉伸粘接强度。结果粘接剂A、B、C粘接硬化牙本质的微拉伸粘接强度分别为46．805MPa、39．045MPa、29．852MPa。粘接剂A和C与硬化牙本质的微拉伸粘接强度低于正常牙本质，而粘接剂B与之相反，差异有统计学意义（P〈0．05）。结论牙颈部楔状缺损处硬化牙本质由于结构上的特殊性可造成粘接困难。酸性强有利于粘接剂与硬化牙本质的粘接。     

2种自制牙本质粘接剂的微拉伸粘接强度和耐久性能的实验研究

目的 测试自行研制的自酸蚀及全酸蚀粘接剂的微拉伸粘接强度和耐久性能,并与市售的进口同类产品进行对比.方法 选用正畸拔除前磨牙60颗,随机分成4组,每组分循环前、后各2个亚组,各15个试件,分别为自制的自酸蚀粘接剂(44组)和全酸蚀粘接剂(45组),Easy one(EO组)和Single Bond2(SB组).测试各组冷热循环前后的微拉伸粘接强度变化,并进行统计分析,体视显微镜观察断裂模式.结果 冷热循环前,各组微拉伸粘接强度从大到小分别为SB组(35.05±3.01)Mpa＞44组(27.76±1.44)Mpa＞ 45组(27.65±1.67)Mpa＞EO组(26.03±2.15)Mpa,45组和SB组之间及44组和EO组之间微拉伸粘接强度的差异有统计学意义(P＜0.05).冷热循环后,各组从大到小为SB组＞44组＞EO组＞45组,45组和SB组之间及44组和EO组之间微拉伸粘接强度的差异有统计学意义(P＜0.05).同一粘接剂冷热循环前后相比,粘接强度均呈下降趋势(P＜0.05);试件的断裂面类型以混合型断裂为主.结论 自制牙本质粘接剂和市售的进口同类产品相比,自酸蚀粘接剂粘接强度高且耐久性能好,全酸蚀粘接剂则与之相反.冷热循环后各组粘接剂的微拉伸粘接强度均有下降.     

Carisolv去龋对牙本质黏结强度影响的实验研究

目的：研究Carisolv去龋对牙本质黏结强度的影响：方法：选择30颗新鲜拔除的[牙合]面中度龋损的第三磨牙，每个牙的龋洞分成两半，一半用Carisolv去龋，另一半用慢速球钻去龋，而后随机分成3组，分别使用Prime＆Bond NT＋Dyract AP复合体黏结；Uni—Etch（320ml／L磷酸）＋One—Step Plus＋Renew树脂黏结：Prompt—L—Pop＋Z100树脂黏结。测试微抗拉强度（MTBS）：结果：Cafisolv组3种黏结系统MTBS分别为：（17．22±7．95）MPa、（25．40±8．44）MPa、（17．66±8．33）MPa，车针组分别为：（16．01±7．43）MPa、（23.45±7．55）MPa、（16.26±7.97）MPa：2种去龋方法间差异无显著性。结论：Carisolv去龋法对以上3种黏结系统与牙本质的黏结强度无不利影响：     

牙本质的表面状态对黏接剂粘接强度的影响

目的研究3种不同的表面状态对两种牙本质黏接剂的粘接强度的影响。方法选用两种牙本质粘接系统SingleBond(SB)和Prime&BondNT(PB),分别应用于干燥、湿润和过湿的离体的人牙本质表面,用Z-100树脂恢复牙冠至4mm。用低速锯片切牙齿,精细金刚砂车针修成沙漏状的粘接面积约0.8mm2的样本,测试各个样本的微拉伸粘接强度。结果两种黏接剂在湿润状态下的粘接强度均高于干燥组和过湿组(P<0.05),干燥组与过湿组的差异无显著性。在3种表面状态下,SB的粘接强度均高于PB组(P<0.05)。结论在使用全酸蚀单瓶粘接系统时,牙本质表面必须保持适度的湿润。     

The effect of thermocycling and dentine pre-treatment on the durability of the bond between composite resin and dentine

The high bond strength between restorative resin and dentine plays an important role in long-term performance of restorations in the oral environment. A variety of treatment techniques have been described to enhance the bond strength of composite resin to dentine. Unfortunately, few studies have reported available bond durability of adhesive resins to dentine. The purpose of this research was to study the shear bond strength of composite resin to dentine pre-treated with phosphoric acid, self-etching agent or Nd:YAP laser irradiation. The durability of bond strength between resin and dentine stored in the artificial saliva thermocycling between 5 and 55 degrees C was also evaluated. The scanning electron microscope was used to assess the treated-dentine surfaces. The mean value of the shear bond strength in the acid-etching group (18.2 +/- 4.9 MPa) was the highest among the three dentine treatments (self-etching system: 12.6 +/-3.0 MPa, Nd:YAP laser: 13.4 +/- 3.3 MPa) prior to thermocycling. After thermocycling, shear strength values of all treated dentines decreased with increasing number of the cycles. When subjected to 3000 thermocycles, the mean bond strengths of these pre-treated samples to composite resin became 9.1 +/- 1.4, 7.8 +/- 1.8, and 8.1 +/- 1.7 MPa for acid-etching, self-etching and laser-irradiation, respectively, with a significant reduction of 38-50%.     

Effects of luting agent and thermocycling on bond strengths to root canal dentine

AIM: To investigate the effects of luting agent and thermocycling on bond strengths to root canal dentine. METHODOLOGY: Extracted maxillary canines (n =144) were root filled and divided into six groups of 24 teeth each. Fibre posts (FRC Postec) were inserted using six luting agents: Panavia F, Multilink, Variolink II, PermaFlo DC, RelyX Unicem and Clearfil Core. Each root was sliced into six discs (thickness 1 mm) representing the coronal, middle and apical part of the root canal. Push-out tests were performed 24 h after post insertion (n = 12) as well as after thermocycling (5000x; 5-55 degrees C, 30 s) (n = 12). Statistical analysis was conducted using analysis of variance (anova) followed by post-hoc comparisons (Tukey-B). The influence of thermocycling on bond strengths was investigated for each material and region separately using t-tests. RESULTS: The bond strengths were significantly affected by the luting agent (P < 0.001), the root position (P = 0.003) and thermocycling (P < 0.001; three-way anova). RelyX had significantly higher bond strengths compared with all other materials (P < 0.05; Tukey-B). The apical region of the root canal had significantly higher bond strengths compared with the middle and coronal region (P < 0.05; Tukey-B). After thermocycling for RelyX a significant increase in bond strengths was detected for the middle and apical region (P < 0.01; t-test, Bonferroni factor 18). CONCLUSIONS: Bond strengths were affected significantly by luting agent and root position. RelyX had higher bond strengths compared with other materials. The apical region of the canals was characterized by significantly higher bond strengths.     

Micro-tensile bond strengths of bonding agents to pulpal floor dentine

AIM: The purpose of this study was to characterize the dentine surface of the pulpal floor and to determine the micro-tensile bond strengths of two dentine adhesive systems used in conjunction with a resin composite core material to pulpal floor dentine. METHODOLOGY: Thirty-six extracted human molars were cut horizontally with a slow-speed diamond saw to expose the pulp chamber and the pulp tissue was removed. Eight teeth were used to investigate characteristics of untreated and etched dentine surfaces of the pulpal floor using SEM. Twenty-eight teeth were randomly allocated to two groups, each of 14 teeth. In group 1, a 'one-bottle' system (Prime & Bond NT) was used as dentine bonding agent and in group 2, a self-etching-priming system (Clearfil SE Bond) was applied. Pulp chambers of both groups were then filled with resin composite core buildup (FluoroCore) and kept moist in tap water at 37 degrees C for 24 h. Samples were prepared for micro-tensile bond testing by sectioning each tooth vertically in the mid-pulpal floor region and shaped to an hour-glass form of 1 +/- 0.2 mm(2) area at the bonded interface. Micro-tensile bond strengths were determined using a universal testing machine at a crosshead speed of 1 mm min-1. Fractured surfaces were examined by SEM. RESULTS: The intact pulpal floor showed numerous calcospherites with variable tubule density and few accessory canals. Etching the pulpal floor with 34% phosphoric acid gel resulted in an irregular surface with patent dentinal tubules and the dome-shaped calcospherites mostly lost. With self-etching primer, the superficial dentine surface was less demineralized and little peritubular dentine matrix was removed. Mean bond strength for the self-etching-priming (Clearfil SE Bond) specimens was significantly greater than for 'one-bottle' (Prime & Bond NT) specimens (P< 0.05, Student's t-test). The fracture mode of Clearfil SE Bond specimens was mostly partial cohesive failure within dentine, whilst Prime & Bond NT specimens mostly showed partial cohesive failure in bonding resin/composite. CONCLUSIONS: Despite an irregular surface morphology and absence of a smear layer, bonding to pulpal floor dentine was weaker than previously reported for cut coronal dentine. The self-etching-priming system bonded more strongly than the 'one-bottle' system.     

4种粘接剂对非龋性硬化牙本质粘接强度的实验研究

目的：比较4种牙本质粘接剂对牙颈部非龋性硬化牙本质的粘接强度。方法：选择具有典型牙颈部非龋性硬化牙本质的新鲜离体牙32个，随机分为4组，分别用Prime＆Bond NT、Contax、Xeno Ⅲ及Clearfil TRI—S Bond4种粘接剂和复合树脂粘接，24h后制作微拉伸试件，测试微拉伸强度，扫描电镜观察断裂模式并进行分类。结果：4种粘接剂对非龋性硬化牙本质的微拉伸强度分别为：Prime＆Bond NT 38．81＋11．75MPa。Contax 37．82±11．74MPa，Xenom 29．55±10．25MPa，Clearfil TRI—S Bond 38．63±12．17MPa，试件断裂多为混和破坏。结论：4种粘接剂对硬化牙本质粘接强度存在差异，XenoⅢ最低（P〈0．01），其余3种粘接材料两两比较无显著差异（P〉0．05）。     

Effects of additional and extended acid etching on bonding to caries-affected dentine

This study evaluated the effects of additional and extended acid etching on microtensile bond strength ( micro TBS) of two adhesive systems to sound (SD) and caries-affected dentine (CAD). Flat surfaces of CAD surrounded by SD of 36 extracted carious third molars were assigned to four treatments (i): self-etching adhesive system (Clearfil SE Bond) applied to dentine surfaces following manufacturer's instructions (MI); (ii) after additional etching for 15 s (35% phosphoric acid, PA); (iii) total-etch one-bottle adhesive (Single Bond) applied to dentine surfaces following MI; or (iv), after etching for 45 s with PA. Composite 'blocks' were built on bonded surfaces and restored teeth were vertically sectioned to obtain bonded slices of 0.7 mm thick. Slices were trimmed to create hourglass-shaped specimens (cross-sectional area of 1 mm(2)), which were tested under tension in a universal testing machine. Additional CAD and SD samples were prepared for scanning electron microscopy observations. Additional and extended etching significantly increased micro TBS to CAD; however, micro TBS of both adhesives to CAD were significantly lower than to SD. Additional and extended etching can improve bonding to CAD; however, adhesives applied on SD showed the best results for bonding.     

Determination of adhesive bond strength to dentine. A new method

Specimens for the determination of adhesive bond strength to dentine were prepared using suitable surfaces of freshly extracted teeth from 15 patients who were having immediate dentures fitted. As soon as possible after extraction, shallow cavities were cut into the dentine to a depth of 1 mm using a high-speed round bur (diameter 4.2 mm) under water coolant. The cavities were restored using dentine bonding agents and single increments of light activated composite resin. The restored teeth were cut down to approximately 5 mm in diameter and 3 mm thick and were either placed in previously prepared sites in the buccal or occlusal surfaces of their respective dentures or in containers of tap water. Patients were instructed to remove their dentures only for cleaning with a soft nylon brush and toilet soap, while the laboratory specimens were stored at ambient temperature. After one week, the tensile force needed to dislodge each restoration from its cavity was determined using a universal testing machine. Previously reported laboratory methods for bond strength determination have usually employed a flat dentine surface. However, this study more closely resembled the clinical situation in that the smear layer was produced by a rotary cutting instrument, and the effects of polymerization shrinkage when curing the composite resin were simulated. Furthermore, it was easier to confine the bonding agent to the desired dentine surface.     

预酸蚀对非龋性硬化牙本质黏结强度的影响

目的：评价预酸蚀处理提高3种自酸蚀黏结剂对牙颈部非龋性硬化牙本质黏结的有效性。方法：选择牙颈部有典型硬化牙本质的离体牙29个，其中24个随机分3组，每组8个牙，分别应用黏结剂Contax、Clearfil TRI—S Bond及Xeno Ⅲ，剩余5个牙用来观察硬化牙本质表面微观结构。以等分硬化牙本质的方式纵向切开每个牙齿，一半先用350g／L磷酸酸蚀15s，然后应用黏结剂，另一半直接应用黏结剂。在黏结剂上充填复合树脂并固化，24h后片切制作微拉伸黏结试件，测试拉伸黏结强度，并在扫描电镜下观察断裂面。结果：Contax与Clearfil TRI—S Bond2种黏结剂的预酸蚀组的黏结强度明显高于未预酸蚀黏结组（P〈0．01），XenoⅢ预酸蚀组与未预酸蚀黏结组拉伸黏结强度无显著性差异（P〉0．05）。结论：用350g／L的磷酸预酸蚀能够提高一些自酸蚀黏结剂对非龋性硬化牙本质的黏结强度。