3种酸蚀方法处理硬化牙本质表面的超微形态研究

目的采用3种不同的酸蚀方法处理牙颈部非龋性缺损中的硬化牙本质,比较其表面超微形态的变化。方法选择15颗因牙周病拔除具有典型牙颈部非龋性缺损的天然前磨牙作为实验组,同时选用15颗拔除的冠根完好的前磨牙,人工机械预备牙颈部楔状缺损作为对照组。实验组和对照组各随机分成3组,分别采用15%磷酸处理30s、35%磷酸处理15s、自酸蚀处理剂AdperPromptL-Pop处理15s。扫描电镜观察表面形态的变化。结果硬化牙本质的大部分牙本质小管内可见柱状的矿化结晶体。3种酸蚀处理均不能去除牙本质小管内的硬化结晶体。结论硬化牙本质的表面结构与正常牙本质存在差异,其牙本质小管内堵塞的矿化结晶体可能对黏接产生影响。自酸蚀处理剂AdperPromptL-Pop的酸蚀脱矿能力低于15%和35%的磷酸。     

牙颈部非龋性硬化牙本质粘接的超微形态研究

目的观察牙颈部非龋性硬化牙本质经自酸蚀牙本质粘接剂处理后，树脂一牙本质界面的超微结构。方法选择有典型牙颈部非龋性缺损且因牙周病拔除的上颌前磨牙，使用两步法的自酸蚀粘接剂Contax粘接处理。扫描电镜观察硬化牙本质表面超微形态以及树脂一牙本质界面的混合层和树脂突的微观表现。结果硬化牙本质的牙本质小管大部分被柱状的矿化结晶体堵塞。粘接界面也可见到清晰的混合层和树脂突，但树脂突较短。结论硬化牙本质的粘接与正常牙本质存在差异，牙本质小管内的矿化结晶可能影响粘接效果。自酸蚀粘接剂对硬化牙本质具有一定的粘接能力。     

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.     

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。     

自酸蚀粘结剂与全酸蚀粘结剂修复牙本质缺损的术后敏感性比较

目的比较自酸蚀粘结剂和全酸蚀粘结剂修复牙本质缺损术后敏感情况,评价自酸蚀粘结剂对减轻术后敏感的效果。方法选择99例患者(257颗患牙)随机分成两组,实验组(135颗患牙)使用3M Adper Easy One自酸蚀粘结剂,对照组(122颗患牙)使用3M Adper Single Bond2全酸蚀粘结剂,两组都用3M-Z350纳米复合树脂充填。临床观察时间为术后1 d、1周、3个月。结果术后1d、1周,实验组敏感发生率和敏感度明显低于对照组(P<0.05),术后3个月两者无明显差异(P>0.05)。结论自酸蚀粘结剂比全酸蚀粘结剂能在术后短期内有效降低牙齿敏感性。     

脉冲Nd:YAG激光对非龋性硬化牙本质自酸蚀黏结强度的影响

目的:采用微拉伸黏结强度实验,比较脉冲Nd:YAG激光作用于硬化牙本质对复合树脂-硬化牙本质之间自酸蚀黏结强度的影响。方法:选择10颗硬化牙本质视觉分级均为3级以上的面磨损后牙,将磨损面硬化牙本质分为面积近似相等的两部分(约12mm2),随机分为实验组和对照组。实验组以1W、10Hz脉冲Nd:YAG激光作用于硬化牙本质表面,联合自酸蚀黏结剂Adper Prompt L-Pop处理和Z350复合树脂充填;对照组直接使用自酸蚀黏结剂Adper Prompt L-Pop处理硬化牙本质表面,并用Z350复合树脂充填。24h后制作微拉伸试件,测试微拉伸黏结强度,在体视显微镜下观察断裂模式并分类。采用SPSS13.0软件包对试件微拉伸黏结强度值做配对t检验。结果:实验组和对照组的微拉伸黏结强度分别为(18.94±6.81)MPa和(15.76±5.61)MPa。实验组复合树脂与硬化牙本质黏结强度高于对照组,差别有统计学意义(P0.05)。体视显微镜下观察,断裂多发生在黏结树脂-牙本质界面。结论:脉冲Nd:YAG激光处理硬化牙本质,能够提高复合树脂与硬化牙本质之间的自酸蚀黏结强度。     

自酸蚀粘结剂治疗牙本质过敏症的临床疗效观察

目的：对比观察3M Adper Prompt自酸蚀粘结剂和75%氟化钠甘油糊剂治疗牙本质过敏症的临床疗效.方法：颈部牙本质过敏症患者110例,共122颗牙,随机分为治疗组55例62颗牙,用3M Adper Prompt自酸蚀粘结剂脱敏治疗,对照组55例60颗牙,用75%氟化钠甘油糊剂脱敏治疗,在统一标准下进行即刻和1个月、3个月后的疗效对照分析.结果：两组之间即刻疗效无显著性差异,而1个月、3个月后的疗效具有显著性差异,3M Adper Prompt自酸蚀粘结剂脱敏效果明显优于氟化钠甘油糊剂的脱敏效果.结论：3M Adper Prompt自酸蚀粘结剂对牙本质过敏症具有较好的临床治疗效果.     

自酸蚀树脂水门汀ResiCem牙本质粘结强度的评价

目的 评价自酸蚀树脂水门汀ResiCem的牙本质粘结强度并探讨酸蚀对其粘结强度的影响。方法 选择离体无龋第三恒磨牙15颗。沿垂直于牙体长轴方向将磨牙冠中1/3处切开,将牙本质面分别用自酸蚀树脂水门汀Panavia F和Resi-Cem原位对位粘结。其中ResiCem组牙本质面分别用磷酸酸蚀0、5、10、15 s。用低速切片机把样本切割成约1 mm×1 mm×8mm条块后进行微拉伸测试,并通过扫描电镜观察粘结界面。结果 ResiCem的牙本质微拉伸粘结强度[(16.9±5.3)MPa]与Panavia F[(17.0±5.2)MPa]间差异无统计学意义(P>0.05)。磷酸酸蚀显著地降低ResiCem与牙本质间的粘结强度(P<0.05),并随着酸蚀时间的延长而降低。结论 ResiCem的牙本质微拉伸粘结强度与Panavia F相当,但酸蚀会降低ResiCem的牙本质粘结强度。     

不同酸蚀时间对空气喷砂去龋后牙本质界面影响

目的：探讨不同酸蚀时间对空气喷砂去龋后牙本质界面组织学变化。方法：空气喷砂机对龋坏牙本质制洞后，对牙本质界面进行不同时间酸蚀，扫描电镜下观察牙本质界面的组织学变化。结果：牙本质酸蚀30s后界面呈珊瑚状相互交联，有大量牙本质小管开口，小管内无栓塞。结论：喷砂制洞后对龋损牙本质界面酸蚀30s较为适宜。     

自酸蚀粘结系统的研究进展

自酸蚀粘结系统是一种将酸性功能成分和偶联剂混合，牙齿表面脱矿与偶联作用同时发生，省略了独立的酸蚀步骤的牙科粘结材料，它的研究应用是牙科粘结技术研究发展的新趋势，本文对自酸蚀粘结系统的原理、主要分类、相关成分和作用以及该系统的特点进行综述。     

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。     

Er,Cr:YSGG激光照射后硬化牙本质表面超微结构观察

目的 通过比较Er,Cr:YSGG激光照射、磷酸酸蚀等方法处理后硬化牙本质表面的超微结构特点,寻找适合硬化牙本质粘接的表面处理方法.方法 选择16颗有硬化牙本质的离体牙,使用随机数字表随机分为4组,每组4颗,分别进行磷酸酸蚀(A组)、激光照射(B组)、磷酸酸蚀+激光照射(C组)、激光照射+磷酸酸蚀(D组)处理,扫描电镜观察硬化牙本质表而的超微结构.结果 A组硬化牙本质表而可见大部分牙本质小管被硬化柱堵塞;B组硬化牙本质表面为均匀一致的蜂窝状改变;C组硬化牙本质表面形态特点与B组类似;D组硬化牙本质表面形态类似于A组,无激光照射后形成的蜂窝状改变.结论 Er,Cr:YSGG激光照射硬化牙本质后增加了表面粗糙度,形成的粗糙面可能有利于粘接.     

Rationale behind the design and comparative evaluation of an all-in-one self-etch model adhesive

Objective

To investigate and compare bonding and dentin sealing efficacy of a marketed all-in-one and an experimental model adhesive with minimum effective amounts of acidic monomer and water.

Materials and methods

Composition of model adhesive (NAD) in mass%: UDMA (45), 4-META (20), H₂O (7.5), and acetone (27.5). For characterization of a reasonable NAD application procedure shear bond strengths (SBS, n = 8) were determined on human enamel and dentin. Clearfil S³ Bond (TSB; Kuraray) served as reference. SBSs were evaluated after 10 min, 1 and 7 days, and 1 month, marginal adaptation (n = 8) was assessed in cylindrical butt-joint dentin cavities. Diffusive and convective water fluxes through 1 mm thick adhesive-coated dentin disks (n = 6) were qualitatively and quantitatively analyzed.

Results

SBSs proved that application of NAD in one coat with 20 s agitated dwell time was ≥20 MPa, enamel SBSs (24 h) were 25 MPa, p > 0.05. Dentin SBSs for TSB and NAD were not different (p > 0.05) at the four stages (means: 18.9, 23.5, 25.4, and 23.6 MPa). Five and seven of the eight bonded restorations with TSB and NAD were gap-free (p > 0.05). Dentin disks treated with EDTA from both sides or one side only were highly permeable for liquid, whereas adhesive-coated dentin disks showed no permeability at 0 and 2.5 kPa water pressure.

Conclusions

Within the limitations of this study the model adhesive tested represents a promising basic composition for all-in-one adhesives, eliminating common problems encountered with single step adhesives such as phase separation and permeability.     

Nd:YAG激光联合不同黏结系统对非龋性硬化牙本质黏结强度的影响

目的:通过微拉伸黏结强度实验,检测Nd:YAG激光联合3种不同黏结系统处理的硬化牙本质与复合树脂的黏结强度。方法:选择15颗硬化牙本质视觉分级为3级以上的面磨损牙,将面硬化牙本质分为面积近似相等的两部分,随机分为A(A1、A2)、B(B1、B2)、C(C1、C2)3组,以1W、10Hz Nd:YAG激光处理硬化牙本质表面后,按照随机数字表,使每颗牙分割的两部分进入不同的处理组,A2、C1联合ScotchbondTM处理,Z350复合树脂充填;A1、B1联合Adper Prompt L-Pop处理,Z350复合树脂充填;B2、C2联合Clearfil SE Bond处理,Z350复合树脂充填。置于37℃生理盐水中24h后,制作微拉伸试件,测试黏结强度,在体视显微镜下观察断裂模式并分类。采用SPSS13.0软件包对试件微拉伸黏结强度值做单因素方差分析。结果:Nd:YAG激光联合3种黏结剂处理后的微拉伸黏结强度分别为ScotchbondTM(A2、C1)处理组(22.96±4.93)MPa,Adper Prompt L-Pop(A1、B1)处理组(18.73±4.71)MPa,Clearfil SE Bond(...     

Effect of the application time of phosphoric acid and self-etch adhesive systems to sclerotic dentin

Objectives:

To evaluate the effect of application time on the resin-dentin bond strength (µTBS) and etching pattern of adhesive systems applied on sclerotic dentine.

Material and Methods:

A total of forty-two bovine incisors had their roots removed. The 1-step self-etch GO (SDI), the 2-step self-etch Adper SE Bond (3MESPE) and the 35% phosphoric acid (3MESPE) from the 2-step etch-and-rinse Adper Single Bond 2 (3MESPE) were applied on the bovine incisal surfaces according to the manufacturer''s instructions or duplicating the recommended conditioning time. After adhesive application, thirty teeth were restored with composite resin, stored for 24 h in distilled water at 37º C, and sectioned into resin-dentin bonded sticks (0.8 mm²⁾ and tested according to the µTBS at 0.5 mm/min. The etching pattern of the remaining twelve teeth (n=4 for each material) was examined under scanning electron microscopy. Each tooth was divided into a buccal-to-lingual direction into three thirds, and each third randomly assigned to the groups: control (no treatment), according to the manufacturers'' instructions and duplicating the recommended application time. The µTBS and the relative percentage of the tubule area opening were evaluated by two-way repeated measures ANOVA and Tukey''s tests (α=0.05).

Results:

The duplication of the conditioning time favored only the GO adhesive (p<0.05). Both application methods significantly increased the tubule area opening (p<0.05) compared to the controls.

Conclusions:

The efficacy of duplicating the conditioning time was only effective for the 1-step self-etch adhesive system tested.     

Hardness,elasticity and ultrastructure of primary tooth dentin bonded with a self-reinforcing one-step self-etch adhesive

Objective

This study evaluated the interfacial quality of sound and caries-affected primary tooth dentin bonded with a self-reinforcing one-step self-etch adhesive.

Methods

Non-carious, sound dentin was prepared with water-cooled high-speed diamond burs. Caries-infected dentin was removed with water-cooled low-speed round steel burs and hand instrument. Dentin was bonded with Bond Force (Tokuyama Dental). A nano-indentation tester was employed for determination of hardness (H) and Young's modulus (Y) of resin–dentin interface. Similar resin–dentin interfaces were examined with a SEM/EDX, and with a TEM using ammoniacal silver nitrate tracer for nanoleakage.

Results

In the comparison of the H and Y values between the interfacial dentin and the underlying mineralized dentin, no significant difference was seen in caries-affected dentin, however, the values of the interfacial dentin were significantly lower in sound dentin. The H value of the interfacial dentin of sound dentin was significantly lower than that of caries-affected dentin with significantly higher Ca content. No significant difference was observed in the Y values of the interfacial dentin of the two substrates. For both sound and caries-affected dentin, TEM revealed silver deposits in the interfacial dentin and adhesive layer, and smear layer remained within the resin–dentin interface. However, Ca and P contents of the adhesive layer at 10 μm above the dentin surface were the same as those present in the interfacial dentin.

Conclusions

Both for sound teeth and caries teeth, Bond Force does not prevent the nanoleakage along the resin–dentin interface.     

Effect of pretreatment with mildly acidic hypochlorous acid on adhesion to caries-affected dentin using a self-etch adhesive

Caries-affected dentin is covered with a thicker and organically enriched smear layer than normal dentin. This may affect the demineralization ability and the infiltration of self-etch adhesives, thus reducing the efficacy of bonding to caries-affected dentin. This study evaluated the adhesion of a two-step self-etching adhesive to normal and caries-affected dentin after pretreatment with mildly acidic hypochlorous acid (HOCl) solutions. We used a microtensile bond strength (μTBS) test to compare the μTBS of Clearfil SE Bond to either caries-affected dentin or to normal dentin, after pretreatment for 5 s with one of three solutions (806 mM NaOCl, or 0.95 or 1.91 mM HOCl). The μTBS of the self-etch adhesive was significantly lower to caries-affected dentin than to normal dentin. Pretreatment with 0.95 mM HOCl improved the μTBS of the self-etch adhesive to caries-affected dentin, but there was no significant difference compared with normal dentin. On the other hand, pretreatment with 806 mM NaOCl or 1.91 mM HOCl did not demonstrate a significant improvement in the μTBS to caries-affected dentin. None of the pretreatments demonstrated a negative effect on adhesion to normal dentin.     

Reinforcement of dentin in self-etch adhesive technology: A new concept

Objective

Characterize the ultramorphology and secondary caries inhibition potential of different dentin adhesive systems in order to find a satisfactory explanation resist to recurrent caries.

Methods

Human premolar dentin was treated with one of the two self-etching adhesive systems, Clearfil SE Bond, Clearfil Protect Bond or an acid-etching adhesive system, Single Bond. The bonded interface was exposed to an artificial demineralizing solution (pH 4.5) for 90 min and then 5% sodium hypochlorite for 20 min. Transmission electron microscopic observation was performed at the adhesive–dentin interface. The width of the reinforced zone was measured and data were analyzed with univariate analysis of variance under general linear model. In order to identify type of crystallites in the reinforced zone selected area electron diffraction was performed.

Results

An acid–base resistant zone (ABRZ) was found adjacent to the hybrid layer in the outer lesion front with only Clearfil SE Bond and Clearfil Protect Bond, while Single Bond was devoid of this protective zone. Crystallite arrangement and the ultramorphology were almost similar in the corresponding regions of Clearfil SE Bond and Clearfil Protect Bond. However, thickness of the ABRZ at the mid portion was 1159(±41.91) nm in Clearfil protect Bond, which was significantly thicker than that of Clearfil SE Bond (F = 514.84, p < 0.001). Selected area electron diffraction confirmed the crystallites in the zone as apatite.

Conclusions

The self-etching adhesive systems created a new reinforced acid resistant dentin under the hybrid layer. Difference in the thickness of the zone expressed a different potential for demineralization inhibition.