Efficacy of varying the NMEP concentrations in the NMGly-NMEP self-etching primer on the resin-tooth bonding

It is well understood that the application of a self-etching primer enhances the bonding at the resin-teeth interface. In this study, we designed a self-etching primer consisting of N-methacryloyl glycine (NMGly) and N-methacryloyl-2-aminoethyl phosphonic acid (NMEP). The demineralization effects on the hydroxyapatite or dentin by the carboxylic acid in the NMGly and by the phosphonic acid in the NMEP and their effects on the bond strength of the resin to the tooth were examined. The application of the NMGly-NMEP solution to the enamel resulted in an increase in the bond strength when additional amounts of NMEP were added to the NMGly aqueous solution. This increase was due to the phosphonic acid in the NMEP demineralizing the enamel. Conversely, the addition of the NMEP to the NMGly solution resulted in a decrease in the bond strength to the dentin. The optimal concentration of the NMEP in the NMGly-NMEP solution resulted in bond strengths of over 20 MPa for both the enamel and dentin.     

Effects of a ferric chloride primer on collagen-depleted dentin bonding between tri-n-butylborane initiated self-curing resin and dentin

This study was designed to evaluate the micro-tensile bond strength between a carboxylic resin and dentin, when the dentin surface was modified with an experimental dentin primer. The three primers tested were ED primer II (ED), 0.3% ferric chloride aqueous solution (FE), and ED containing 0.3% ferric chloride (ED/FE). Three commercial dentin conditioners [40% phosphoric acid, 10% NaOCl, and 10% citric acid with 3% ferric chloride (10-3)] were also used. The coronal surfaces of extracted human molars were ground flat to dentin. The dentin surfaces were treated with phosphoric acid, NaOCl, or with one of the primers. The 10-3 was used without phosphoric acid or NaOCl as a control. A composite material rod was bonded to the dentin surface with 4-META/MMA-TBB resin. After 24-h immersion in 37 degrees C distilled water, 0.9 mm x 0.9 mm composite-dentin beams cut from the bonded specimens were stressed to failure in tension at 0.6 mm/min. The bond strengths were also evaluated after 5000 thermocycles. The bond strength of the group ED/FE was significantly higher than those of the 10-3, ED, and FE. After 5000 thermocycling, 10-3, ED and FE showed significant decrease in bond strength, although no significant decrease was seen for ED/FE. It was concluded that dentin surface treatment with phosphoric acid, NaOCl, and the ED/FE primer improved the bonding (p < 0.05) between 4-META/MMA-TBB resin and dentin, with or without thermocycling, while the bond strengths in the control group fell 34% following 5000 thermocycles.     

Microperoxidase primer promotes adhesion of butylborane-polymerized resin to dentin

The purpose of this study was to investigate the effect of dentin primers containing microperoxidase (MP-11) with 2-hydroxyethyl methacrylate (HEMA) on the bond strength between a tri-n-butylborane-initiated self-polymerizing resin and dentin. Bovine dentin surfaces were etched with 10 wt % phosphoric acid, primed, and then bonded with stainless steel rods. Tensile bond strength after 24 h of storage in water was significantly influenced by both MP-11 and HEMA. Groups with no MP-11 showed the lowest values. Without HEMA, the bond strengths of groups using 0.01, 0.1, and 1.0 micromol/g MP-11 were statistically identical, and also greater than that of the no MP-11 control. In the presence of HEMA, the bond strength was significantly enhanced with an increasing concentration of MP-11. The highest bond strength of 29.0 MPa was obtained with aqueous HEMA primer, containing 1.0 micromol/g MP-11. Microscopic observation showed the formation of a hybrid layer at the bonded interface. Polymerization of the resin was significantly accelerated with the MP-11 primer. In conclusion, MP-11 has a potential for adhesive bonding promoter between the resin and the demineralized dentin surface.     

Improvement of the bond strength of 4-META/MMA-TBB resin to collagen-depleted dentin

It has been reported that the tensile bond strength between the 4-META/MMA-TBB resin and dentin pretreated with 10% citric/3% ferric chloride solution decreased after immersion in water for 2 years. The current study investigated the effect of an experimental dentin conditioner on the bonding of 4-META/MMA-TBB resin to dentin after thermocycling. The experimental conditioner was an aqueous solution of 10% ascorbic acid and 5% ferric chloride (Exp). Human teeth were prepared to expose flat dentin surfaces. These were treated sequentially with 40% phosphoric acid, 10% sodium hypochlorite, and the experimental conditioner. A commercially available dentin conditioner, an aqueous solution of 10% citric/3% ferric chloride (10-3) was used for a control group. Stainless steel rods were bonded to the pretreated dentin surfaces with the use of the 4-META/MMA-TBB resin. Tensile bond strengths were determined after 0, 5,000, 10,000, 20,000 themocycles. All data were analyzed by ANOVA, and differences among groups were analyzed by Duncan's new multiple range test (n = 10, p < 0.05). The experimental group showed no significant decrease in bond strength through 20,000 thermocycles, while the control group exhibited significant decrease after 10,000 thermocycles. Mean bond strength of the experimental groups were significantly higher than those of the control group at both 10,000 and 20,000 thermocycles. A hybrid layer could not be identified in SEM micrographs of the experimental groups. 10-3-conditioned specimen SEMs displayed crack formation between the adhesive resin and a hybrid layer. The experimental dentin pretreatment improved the bond strength of a 4-META/MMA-TBB resin to human dentin compared to 10-3 treatment after thermocycling.     

Etching kinetics of a self-etching primer

Self-etching primers are thought to offer significant advantages over total-etch adhesive systems. The hypothesis tested in this study was that there was no difference in etching characteristics between a self-etching primer and a phosphoric acid solution at the same pH. Etching was assessed using atomic force microscopy (AFM) evaluation of site-specific changes in the height of the peritubular and intertubular dentin as a function of exposure time. Human dentin disks (n = 6/group), prepared with an acid-resistant glass reference layer, were etched with a self-etching primer and with 0.0134 M phosphoric acid (both pH approximately egual to 1.94). Depth changes relative to the reference layer were measured with the AFM after each etching interval, at 15 different locations, each in the peritubular and intertubular dentin. The total demineralization depth was measured in a scanning electron microscope. Peritubular dentin etching rate was linear while it could be measured (up to 15 s) and was greater for the self-etching primer (p < 0.0001). Intertubular dentin displayed a similar demineralization pattern with both acids, ultimately reaching a plateau in the majority of specimens. The self-etching primer attained a plateau after less recession than phosphoric acid (p < 0.0001). Dentin demineralization appears to be affected by other factors in addition to the pH of the etchant solutions.     

Development of self-etching primer comprised of methacrylamide, N-methacryloyl glycine

In order to develop a more effective self-etching primer, it is helpful to understand how a functional monomer conditions the surface of the teeth.

In this study, the reactivity by the carboxylic acid in the N-methacryloyl glycine (NMGly) on the calcium phosphate in hydroxyapatite or dentin was studied. The efficacy of the NMGly as a functional monomer for a self-etching primer was then examined.

Applying NMGly to both the enamel and dentin resulted in an increase in the bond strength of resin, since the carboxylic acid in the NMGly decalcified the calcium phosphate in the hydroxyapatite and dentin. The bond strength to dentin achieved was higher than with the enamel. This difference was most likely due to different enamel and dentin adhesion mechanisms.     

草酸铁溶液处理牙本质后黏结界面的超微形态

背景：基于流体动力学说,选择良好的生物材料封闭暴露的牙本质小管口是国际上对治疗牙齿敏感研究的热点。草酸铁溶液可以在牙本质小管内形成结晶样结构。 目的：观察草酸铁溶液结合全酸蚀黏结系统处理牙本质后黏结界面的形态学变化。 方法：选择无龋人离体智齿12颗,去除牙冠牙釉质,暴露牙本质。随机均分为实验组和对照组, 32%磷酸酸蚀剂酸蚀牙本质黏结面,实验组用5.3%草酸铁溶液处理表面1 min后充分冲洗10 s,两组表面再充填树脂。平行牙长轴方向片切制备扫描电镜试样,在扫描电镜(SEM)下观察黏结界面的微观形态。 结果与结论：实验组草酸铁产生的结晶样结构几乎堵塞全部牙本质小管开口,树脂层伸出无数短小树脂突嵌于硬化的牙本质小孔内。对照组局部区域混合层与其下方未脱矿的牙本质间有明显的裂隙出现,树脂突较粗,但长短不均匀,可见树脂突的断裂。提示,5.3%草酸铁溶液能够在牙本质小管内形成结晶,使牙本质小管口封闭良好。对照组可见树脂突的断裂,牙本质小管暴露,封闭不严密。说明5.3%草酸铁溶液结合全酸蚀黏结系统治疗牙本质龋能够提高其临床治愈率。     

Effect of acid etching on dentin wettability and roughness: self-etching primers versus phosphoric acid

OBJECTIVE: To compare the effect of self-etching primers and phosphoric acid on the wettability and roughness of smear layer-covered and smear layer-free dentin. MATERIALS AND METHOD: Three self-etching primers (Clearfil SE Bond, AdheSE, and Xeno III) and 10% (w/w) phosphoric acid (H(3)PO(4)) solution were evaluated. The substrates were midcoronal dentin with and without smear layer. For each liquid, pH, density, and surface tension were determined. Water wettability of dentin and roughness were measured before and after each etching. Wettability of self-etching primers and phosphoric acid was measured on untreated dentin. RESULTS: Water wettability increased after acid conditioning similarly for all the liquids used. On smear layer-covered surfaces, self-etching primers achieved a comparable wetting but with greater contact angles than phosphoric acid. However, on smear layer-free surfaces, the increasing sequence of contact angle was Clearfil SE < AdheSE < Xeno III < Phosphoric acid. The treatment with phosphoric acid (lowest pH) produced the highest roughness increase on both dentin substrates. The roughening effect of the self-etching adhesives was more evident for AdheSE and Xeno III. CONCLUSIONS: Self-etching primers and phosphoric acid promote similar water wettability increase. However, self-etching primers provided lower dentin roughness increase than pretreatment with phosphoric acid. The presence of smear layer did not affect the results of self-etching and phosphoric acid treatments.     

Hybrid layer seals the cementum/4-META/MMA-TBB resin interface

Although 4-META/MMA-TBB resin has adhesive properties to dentin, and has been clinically used for the bonding treatment of vertically fractured roots and apicoectomy, there has not been any investigation on the adhesion of 4-META/MMA-TBB resin to cementum. The purpose of this in vitro study was to evaluate the bonding and the sealing ability of 4-META/MMA-TBB resin to cementum. Bovine root cementum and dentin surfaces were treated with a citric acid and ferric chloride solution, and the 4-META/MMA-TBB resin was applied on the treated surfaces before testing. The microtensile bond strength and the leakage levels obtained for the cementum were almost equal to those for the dentin. In SEM and TEM observations, a hybrid layer approximately 2-3 microm in thickness was observed at the interface between the resin and the cementum. It is concluded that 4-META/MMA-TBB resin adhered to cementum via a hybrid layer on cementum, as previously reported for dentin.     

Zirconia nanoparticles prepared by laser vaporization as fillers for dental adhesives

Zirconia nanoparticles prepared by laser vaporization were incorporated into the primer or into the adhesive of a commercial adhesive system in order to evaluate its effect on bond strength to dentin. Zirconia nanoparticles (20–50 nm) were prepared using a particular laser vaporization technique and incorporated into the primer (P) or into the adhesive (A) of the Adper Scotchbond Multi-Purpose (SBMP) system at 5, 10, 15 and 20 wt.% by means of mechanical mixing (stirring) and ultrasonication. Control (unfilled) and experimental groups (filled) were applied, according to the manufacturer’s instructions, onto flat mid-coronal human dentin. Composite crowns were built up, stored in distilled water for 24 h at 37 °C and cut into 0.65 ± 0.05 mm² beams following a non-trimming microtensile technique. Specimens were fractured in tension using a universal testing machine (Zwick) and examined by scanning electron microscopy for fractographic analysis. Microtensile bond strength (μTBS) data were analyzed using a two-way ANOVA and modified LSD test at α = 0.05. Analysis of the nanofiller distribution and ultramorphological characterization of the interface were performed by transmission electron microscopy (TEM). Zirconia nanoparticle incorporation into the primer or into the adhesive of SBMP significantly increased μTBS to dentin. Filler concentration only affected μTBS significantly in the P group. Statistically significant differences between groups P and A occurred only at 20 wt.% filler content, with a significantly higher μTBS in group P. TEM micrographs revealed nanoparticle deposition on top of a hybrid layer when incorporated into the primer, whereas they remained dispersed through the adhesive layer in group A. Zirconia nanoparticles incorporation into SBMP increased bond strength to dentin by reinforcing the interface adhesive layer. Nanofiller incorporation into the primer solution showed a tendency of increasing bond strength with increasing concentration. At high concentrations (20 wt.%) nanofiller incorporation was more efficient in increasing bond strength if incorporated in the primer solution. Adding nanofillers to the primer and to the adhesive solutions resulted in different particle distributions at the interface.     

The pKa effects of the carboxylic acid in N-methacryloyl-omega-amino acid on the demineralization and bond strengths to the teeth

It is understood that the application of a self-etching primer to the tooth enhances the bonding of the resin to the tooth. In this study, we designed a self-etching primer consisting of a series of three N-methacryloyl-omega-amino acids (NMomegaA) with different methylene chain lengths. The demineralization aspect of the teeth components by the carboxylic acid in the NMomegaA and its effects on the bond strength of the resin to the tooth were examined. The amount of decalcification of the hydroxyapatite or dentin by the carboxylic acid in the NMomegaA was strongly dependent on the carboxylic acid's pKa value in the NMomegaA. However, the bond strength's mean values for both the enamel and dentin were not influenced by the degree of demineralization by the carboxylic acid in the NMomegaA. The greater mean value of the dentin's bond strength than with the enamel's was due to differences in the adhesion mechanism types, since the NMomegaA not only exhibited an etching efficacy but also a priming efficacy to the collagen that had been exposed by the NMomegaA conditioning.     

Effect of addition of chitosan to self-etching primer: antibacterial activity and push-out bond strength to radicular dentin

The purpose of this study was to evaluate the antibacterial activity of a modified self-etching primer incorporating chitosan and whether this modification affected the bond strength to radicular dentin.A modified self-etching primer was prepared by adding chitosan solutions at 0.03%,0.06%,0.12% and 0.25%(W/W) to RealSeal selfetching primer.RealSeal primer without chitosan was used as the control.The antibacterial activity of the modified self-etching primer was evaluated using the direct contact test against Enterococcus faecalis.The bonding ability of the RealSeal system to radicular dentin was evaluated using the push-out bond strength test.The modes of failure were examined under a stereomicroscope.Data were analyzed using analysis of variance(ANOVA) and Tukey's test,with a P-value 0.05 indicating statistical significance.The results showed that the antibacterial properties of the freshly prepared and aged modified self-etching primer incorporating chitosan exhibited potent antibacterial effect against Enterococcus faecalis compared with the unmodified primer.The RealSeal system with the aged modified self-etching primer incorporating chitosan showed no significant differences in the bond strength as compared with the control(P = 0.99).The findings suggest that modified self-etching primer incorporating chitosan is a promising antibacterial primer which does not adversely affect the bond strength of the RealSeal system to radicular dentin.     

Resin penetration through submicrometer hiatus structures: a SEM and CLSM study

The purpose of this study was to confirm the existence of submicrometer hiatus structures and to examine the degree of resin penetration through these formations. Dentin disks 2.0 mm in thickness were sectioned from 48 human molars with the use of a microtome saw. Three different fifth-generation (total-etch, combined primer/resin) dentin adhesive systems were used to bond a light-cured, resin-based composite to the dentin disks (n = 16 each group). Bonded disks from the three groups were then sectioned. Half of each group was examined with the use of a scanning electron microscope (SEM) (n = 8), and the other half with the use of a confocal laser scanning microscope (CLSM) (n = 8). The frequency of submicrometer hiatus formation was recorded and documented with associated imaging techniques. Resin penetration within submicrometer hiati were observed in 41.7% (10/24) of SEM specimens and 83.3% (20/24) of CLSM specimens. The location and size of these structures were found to be quite uniform. Submicrometer hiati approximated 200 microm in each of the three dentin bonding systems examined. Resin penetration through submicrometer hiati does not appear to be an artifact of desiccation. These structures were clearly identified within the hybrid layer of each dentin adhesive system used in this study.     

栓道预处理对自粘接树脂水门汀粘接纤维桩粘接强度的影响

BACKGROUND: The bonding interface of resin cements with dentin is unstables, therefore, improvement on the bonding strength is of great significance. OBJECTIVE: To evaluate the effects of different pretreatments to post space on bonding strength of the self-adhesive resin cement EmbraceCoreTM Resin Cement to fiber posts after phosphoric acid etching or self-etching. METHODS:Twenty-five human mandible canines or premolars with single-rooted canal were selected. After conventional root canal treatment and post space preparation, they were randomly divided into five groups (n=5 per group): group I (control group): 0.9% normal saline irrigation; group II: etching with 35% phosphoric acid for 15 seconds; group III: self-etching with CLEARFILTM SE BOND binder for 20 seconds; group IV: etching with 35% phosphoric acid for 15 seconds and bonding with single bong 2; group V: self-etching with CLEARFILTM SE BOND binder for 20 seconds and bonding with CLEARFILTM SE BOND binder. Fiber posts were edusing self-adhesive resin cement EmbraceCoreTM Resin Cement. The thin-slice push-out test was performed to record the bonding strengths, and the failure modes of fiber posts were observed by stereomicroscope. RESULTS AND CONCLUSION: The bond strength of groups I-V were as follows: (8.66±2.43), (7.05±3.0), (7.37±2.83), (9.88±2.9), and (10.04±2.86) MPa. Groups II, IV and V showed significantly different bond strength from the group I (P < 0.05), but there were no significant differences between groups III and I (P > 0.05). The main failure models in the groups I, II and III were A1 and A2, and less B1 and B2 appeared. The failure modes in the groups IV and V also focused on the A1 and A2, but B1 and B2 increased gradually. These results indicate that neither the pretreatments by phosphoric acid etching nor by self-etching in root canal dentin can improve the bonding strength of EmbraceCoreTM Resin Cement to fiber posts, but the use of binder relative to phosphoric acid etching or self-ctching is helpful.      

Effect of load cycling and in vitro degradation on resin-dentin bonds using a self-etching primer

The objective of this study was to evaluate the effect of in vitro degradation and mechanical loading on microtensile bond strength (MTBS) and microleakage (ML) of a resin composite to dentin using a self-etching primer adhesive [Clearfil SE Bond (SEB)] under two hydration statuses. Twenty-four flat dentin surfaces were divided in groups: 1) blot-dried, 2) air-dried. SEB was applied and resin buildups were performed with Tetric Ceram. Specimens were divided in four subgroups: a) sectioned into beams, b) load cycled, c) beams were immersed in NaOCl for 5 h, d) load cycled and immersed in NaOCl. Beams were tested in tension. For ML testing, 80 Class V cavities were prepared and molars divided in subgroups as described above (in group c and d, specimens were kept in distilled water for 1 year, instead of the 5-h NaOCl immersion). ML was assessed by dye penetration. Analysis of variance and multiple comparisons tests were used for MTBS. For ML, Mann-Whitney U and Wilcoxon matched pairs signed ranked were used (p<0.05). SEB applied to completely dehydrated dentin produced the highest MTBS, at 24-h evaluation. In vitro degradation always decreased MTBS, and fatigue loading only diminished MTBS on dehydrated dentin. Load cycling increased dye penetration on dentin margins. Degradation always increased ML in both enamel and dentin margins.     

Effect of structural change of collagen fibrils on the durability of dentin bonding

This study investigates the effect of structural changes of collagen fibrils on the bonding durability of a total etch luting resin (Super-Bond C&B) and a self-etching luting resin (Panavia F 2.0) to dentin. An atomic force microscope (AFM) was used to observe structural changes of intact dentin collagen fibrils after acidic conditionings of two bonding systems. After 90 d water storage and 15,000 thermal cycles (TC) as artificial aging, micro-tensile bond strength (microTBS) was utilized to evaluate the bonding durability of the two bonding systems to dentin. microTBS after 1 d or 90 d water storage without TC were separately measured in control groups. A cross-banding periodicity of about 67 nm along collagen fibrils was seen on demineralized intertubular dentin surfaces in AFM images. For both luting resins, thermal cycling decreased (p < 0.05) microTBS of 1 d and 90 d, compared to controls. Scanning electron microscope and transmission electron microscopic examinations revealed that the top and bottom of hybrid layer (HL) were weak links in the bonding interface over time. The results suggest that the top of HL contains disorganized collagen fibrils from the smear layer which degrade over time. AFM results indicate that the demineralized intact collagen fibrils beneath the smear layer were not denatured during acidic conditioning. However, these collagen fibrils may be structurally unstable due to poor infiltration by resin or loss of resin protection within the HL over time, reducing the long-term microTBS. This process was accelerated by thermal fatigue cycling.     

The effect of NaOCl dentin treatment on nanoleakage formation

The term "nanoleakage" has been introduced to explain a penetration pathway within hybrid layers of the dentin-composite junction in the absence of gap formation. This phenomenon is argued in the literature to be a risk factor for the quality of the dentin bonding. NaOCl is a well-known agent used to remove collagen layers that are exposed after acid etching. The purpose of this study was to determine the influence of an NaOCl treatment of dentin to the formation of nanoleakage. Class V cavities were prepared in 40 human molars with the cervical margins located in dentin. After etching with phosphoric acid, 20 samples were treated with 10% NaOCl for 60 s, and 20 samples were used as control. Composite restorations were placed using two different bonding systems. The specimen were exposed in silver nitrate solution and then in developer. After embedding, the teeth were sectioned, dried, coated with gold, and analyzed by SEM. For all the specimen in the control group, backscatter images indicated a silver penetration within the hybrid layer. There was no penetration of silver detectable in the teeth that were treated with NaOCl. We conclude that the removal of the collagen layer by using NaOCl avoids the formation of nanoleakages with the materials tested.     

Microleakage and interfacial morphology of self-etching adhesives in class V resin composite restorations

The purpose of the study was to evaluate the marginal leakage of three adhesive systems in Class V resin composite restorations. Two adhesive systems containing acidic primers: Clearfil SE Bond (CSEB) and Etch & Prime 3.0 (E&P), were compared with a conventional water-based primer: Scotchbond Multipurpose Plus (SBMP). Class V cavities were made at the cementum-enamel junction of extracted human molars, which were then divided between three groups. One of the adhesive systems was applied to each group following manufacturers' instructions. Composite restorations were placed, light cured for 40 s, and polished. Specimens were then immersed in a solution of 2% basic fuchsin dye for 24 h. Longitudinal sections were obtained and studied with a stereomicroscope for assessment of the microleakage according to the degree of dye penetration (scale of 0-3). Data were analyzed by Kruskal-Wallis one-way ANOVA, Mann-Whitney tests, and the Wilcoxon matched-pairs signed rank test. Two specimens for each group were analyzed by scanning-electron microscopy (SEM). Bonded interfaces of dentin were also examined by transmission-electron microscopy (TEM). On enamel, there were no significant differences between the three groups. On dentin, CSEB showed the lowest dye penetration values among the three adhesive systems. SEM and TEM studies showed hybrid layer and resin tag formations in all groups.     

Hydrolytic stability of methacrylamide in acidic aqueous solution

In order to develop a more effective self-etching primer, with a longer lasting shelf life, we designed a self-etching primer comprised of methacrylamide, N-methacryloyl glycine, NMGly. In this study, the hydrolytic stability of the amide portion in the NMGly was examined. The difference in the hydrolytic stability between the methacrylamide and the methacrylate, 2-hydroxyethyl methacrylate, HEMA was then discussed. The addition of an acid to an aqueous solution allows for the hydrolysis of the ester portion in the methacrylate and for the production of methacrylic acid, MA and ethylene glycol, EG. From our study, the data clearly demonstrated that, if the storage duration of a commercially available self-etching primer is prolonged, then the functional methacrylates constituting the self-etching primer will be altered upon use. However, the hydrolytic stability of the amide portion in the methacrylamide, NMGly, designed as an acidic and/or hydrophilic monomer for the self-etching primer, was greater than the results achieved with the methacrylate, HEMA.     

酸蚀牙面后黏结树脂嵌体修复牙体的抗力性能

背景：树脂嵌体修复牙体缺损在一定程度上可减少修复后牙齿的折裂,但嵌体经不同方法黏结处理后对牙体抗力的影响未见报道。 目的：了解复合树脂经不同方法处理后修复牙体的抗力特性。 方法：将40颗无龋人前磨牙制作近中-牙合面-远中洞型洞,随机分成4组：其中一组备洞后未进行修复作为对照组,其他3组分别以可乐丽菲露光固化复合树脂直接充填,可乐丽菲露光固化复合树脂嵌体直接黏结和酸蚀黏结修复。 结果与结论：①力学模型静态力学加载实验结果：树脂直接充填组、树脂嵌体直接黏结和酸蚀黏结组断裂载荷均高于对照组(P < 0.05),前3组断裂载荷比较组间差异无显著性意义(P > 0.05),树脂嵌体酸蚀黏结组断裂载荷最大。②扫描电镜观察结果：树脂直接充填组断裂位于牙本质层和树脂之间,几乎无树脂残留,有较多孔隙;树脂嵌体直接黏结组大量牙本质基体与树脂间断裂,有较少树脂残留;树脂嵌体酸蚀黏结组牙与树脂之间无气泡、无缝隙、相互嵌合、紧密接触;对照组,树脂直接充填、直接黏结、酸蚀黏结组分别出现10,5,3,1个样本树脂内聚破坏断裂。表明经酸蚀处理复合树脂嵌体可提高牙体力学性能。