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。     

Clinical performance of a self-etch adhesive in Class V restorations made with and without acid etching

OBJECTIVES: To evaluate the clinical performance of a self-etching adhesive in Class V carious lesions with and without acid etching procedures. METHODS: A total of 183 Class V carious cavities with incisal margins in enamel and gingival margins in cementum were selected and restored with Futurabond NR self-etch adhesive and resin composite Grandio. Restorations were made using three different techniques; after etching of the enamel, after etching the whole cavity for 20s and without acid etching (control). The restorations were evaluated at baseline, 1 and 2 years using USPHS criteria. RESULTS: No loss of restorations was recorded after 1 and 2 years for all the three restorative techniques. There was no significant difference between the baseline and 2-year results for any of the tested technique. However, restorations made after acid etching showed less marginal discoloration at the enamel margins. CONCLUSION: The clinical performance of Futurabond NR self-etch adhesive was excellent after 2 years. Acid etching of the enamel margin or the whole cavity did not improve the overall quality of the restorations, but displayed less marginal discoloration.     

Response of human pulps capped with a self-etching adhesive system.

OBJECTIVE: The aim of this study was to evaluate the human pulp response following direct pulp capping with a current self-etching bonding agent and calcium hydroxide (CH). METHODS: Thirty-three sound human premolars had their pulp tissue mechanically exposed. Sterile distilled water was used to control the hemorrhage and exudation from the pulp exposure site. The pulps were capped with Clearfil Liner Bond 2 (CLB-2) or CH and the cavities were filled with a resin composite (Z-100) according to the manufacturer's instructions. After 5, 30 and 120-300 days, the teeth were extracted and processed for microscopic examination. RESULTS: At short-term, CLB-2 elicited a mild to moderate inflammatory pulp response with dilated and congested blood vessels adjacent to pulp exposure site. With time, macrophages and giant cells engulfing globules and particulates of resinous material displaced into the pulp space were observed. This chronic inflammatory pulp response triggered by fragments of bonding agent displaced into the pulp space did not allow pulp repair interfering with the dentin bridging. On the other hand, pulps capped with CH exhibited an initial organization of elongated pulp cells underneath the coagulation necrosis. Pulp repair and complete dentin bridge formation was observed at long-term evaluation. SIGNIFICANCE: The present study demonstrated that CH remains the pulp capping agent of choice for mechanically exposed human pulps. CLB-2 did not allow complete connective tissue repair adjacent to the pulp exposure site. Consequently, this bonding agent cannot be recommended for pulp therapy of sound human teeth.     

Microtensile bond strength of a filled vs unfilled adhesive to dentin using self-etch and total-etch technique

OBJECTIVE: The purpose of this study was to evaluate the effect of a filled adhesive (One-Step Plus; Bisco) versus an unfilled adhesive (One-Step; Bisco) on the microtensile bond strength (muTBS) to dentin using total-etch (Uni-etch; Bisco) and self-etch (Tyrian SPE; Bisco) techniques. METHODS: Twenty extracted human third molars were ground flat to expose occlusal dentin. After the dentin surfaces were polished with 600-grit SiC paper, the teeth were randomly assigned to four groups according to the bonding agent and technique being used. Dentin surfaces were bonded with One-Step Plus+total-etch; One-Step Plus+self-etch; One-Step+total-etch and One-Step+self-etch. Composite buildups were performed with Clearfil AP-X (Kuraray Medical). Following storage in distilled water at 37 degrees C for 24 h, the bonded specimens were serially sectioned into 0.7 mm-thick slabs and then trimmed to hour-glass shapes with a 1 mm2 cross-sectional area (n=20). Microtensile bond strengths were determined using the EZ-test (Shimadzu) at a cross-head speed of 1 mm/min. Data were analyzed using two-way ANOVA and Tukey's post hoc test. RESULTS: There were no significant differences in the muTBS between One-Step Plus and One-Step adhesives when they were used with the total-etch and self-etch techniques (p>0.05). However with the total-etch technique both adhesives yielded significantly higher bond strength values than the self-etch technique (p<0.001). CONCLUSION: The filled adhesive One-Step Plus did not show any beneficial effect than the unfilled adhesive One-Step on the muTBS to dentin with total-etch and self-etch techniques. Irrespective from the adhesive type, self-etch technique revealed lower bond strengths than the total-etch technique.     

Influence of different smear layers on bond durability of self-etch adhesives

Objective

The purpose of this study was to determine the influence of different smear layers on enamel and dentin bond durability of various types of self-etch adhesives.

Dentin regional bond strength of self-etch and total-etch adhesive systems

OBJECTIVES: To evaluate the microtensile bond strength (MTBS) of self-etch (with or without H(3)PO(4)-etching) and total-etch bonding systems bonded to different regions of dentin. METHODS: Long flat dentin cavity preparations extending from top-crown to root-apex within the same tooth were performed and bonded: using two-step (Clearfil SE Bond/SEB, Resulcin Aqua Prime/RES) and one-step (Etch & Prime 3.0/EP, One-Up Bond F/OUB, Prompt L-Pop/PLP, Solist/SOL and Futurabond/FUT) self-etch adhesives; these same adhesives were also applied following H(3)PO(4)-etching of dentin and finally two more groups were bonded with total-etch adhesives (Single Bond/SB and Prime & Bond NT/PBNT). Build-ups of resin composite were constructed incrementally to ensure sufficient bulk for the MTBS test and the different regions of dentin were identified by painting with different colours on the top of the resin composite. Specimens were sliced into beams and tested in tension. ANOVA and multiple comparisons tests were used (p<0.05). RESULTS: Regardless of the tested dentin region, SEB attained the highest MTBS to smear layer-covered surfaces (i.e., coronal dentin: 42.7MPa), while H(3)PO(4)-etching of dentin hampered bonds (i.e., coronal dentin: 27.7MPa). When bonding with PBNT, SB, RES, EP, PLP, SOL and FUT, MTBS was similar for different dentin regions. H(3)PO(4)-etching of dentin did not alter the attained MTBS. SIGNIFICANCE: SEB yielded the highest MTBS to all regions of dentin. When bonding to parallel-cut dentin, previous H(3)PO(4)-etching of dentin did not increase MTBS and differences in bond strength among dentin regions were absent.     

Short-term dentin bridging of mechanically-exposed pulps capped with adhesive resin systems

Dentin bridging of 150 mechanically exposed monkey pulps to two adhesive resins [BondWell LC (BW); Clearfil Liner Bond II (LB)] and a calcium hydroxide cement [Dycal (DY)] were histopathologically evaluated at 3, 7, 14, 30, and 60 days after operation (n = 10). The dentin bridge structure was three-dimensionally reconstructed from serial sections using a computer-aided reconstruction system. At three and seven days, in all pulps, no necrotic tissue and slight inflammatory cell infiltration was observed just below the exposure site. At 14 days, spindle-shaped fibroblast cells could be detected at the wound surface. All dentin chips showed reparative dentin deposition along the periphery of the wound surface. From this stage, the formation of secondary dentin from the pulpal wall at the periphery of the exposed area was recognized in all pulps. At 30 days, initial signs of dentin bridging were observed at the wound surface with a well-organized layer of odontoblastoid cells. The exposed area became occluded with a dentin bridge as the observation period increased. Group DY showed significantly higher incidence of dentin bridging than other groups at 30 days (p < 0.05). However, no significant difference of dentin bridge formation was found between Group DY and Groups BW and LB at 60 days. Bacterial penetration along the cavity walls and pulp tissue could not be detected in all groups. Histopathological observations and three-dimensional image analysis suggested that dentin bridge formation may occur following three patterns: (1) formed from the periphery of the residual dentin chip at the wound surface within 14 days, (2) formed within 14 days from the periphery of the cavity floor and with formation of reparative dentin by stimulation during the cavity preparation, and (3) formed from the wound surface within 30 days after exposure.     

Bond strength of a mild self-etch adhesive with and without prior acid-etching

SUMMARY: The self-etch approach provides dentists with a generation of user-friendly and less technique-sensitive adhesives. Nevertheless, some concern has been raised regarding their bonding effectiveness to enamel, in particular when so-called 'mild' self-etch adhesives are employed. OBJECTIVES: The purpose of this study was to test the hypothesis that the two-step self-etch adhesive Clearfil SE Bond (C-SE; Kuraray, Osaka, Japan) bonds equally effective to enamel/dentin either with or without prior etching with phosphoric acid. METHODS: Bur-cut enamel/dentin surfaces prepared from human molars were partially split in two halves by cutting a shallow groove. One half was first etched with 40% phosphoric acid (K-etchant), while protecting the other half by holding a razor blade in the groove. Next, C-SE was applied strictly following the manufacturer's instructions, after which the surface was built up using Z100 (3M Espe). After 24-h water storage, micro-specimens were prepared with the interface circularly constricted using a Micro-Specimen Former, prior to micro-tensile bond strength (MPa) measurement. In addition, interfaces of C-SE with enamel/dentin prepared with and without beforehand acid etching were examined by Feg-SEM and TEM. RESULTS: Beforehand etching significantly increased the bonding effectiveness of C-SE to enamel. A clearly more micro-retentive surface was revealed by TEM and Feg-SEM when enamel was etched. Phosphoric-acid etching prior to C-SE application on dentin significantly decreased the muTBS to dentin. TEM provided indications of a low-quality hybrid layer after beforehand phosphoric-acid etching. CONCLUSION: Using C-SE, additional etching with phosphoric acid to improve bonding effectiveness should be limited to enamel.     

Four-year clinical evaluation of Class II nano-hybrid resin composite restorations bonded with a one-step self-etch and a two-step etch-and-rinse adhesive

Objective

The objective of this prospective clinical trial was to evaluate the 4-year clinical performance of an ormocer-based nano-hybrid resin composite (Ceram X; Dentsply/DeTrey) in Class II restorations placed with a one-step self-etch (Xeno III; Dentsply/DeTrey) and two-step etch-and-rinse adhesive (Ivoclar Vivadent).

Methods

Seventy-eight participants received at random at least two, as similar as possible, Class II restorations of the nano-hybrid resin composite bonded with either a single step self-etch adhesive or a control 2-step etch-and-rinse adhesive. The 165 restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 4 years.

Results

162 restorations were evaluated at 4 years. Postoperative sensitivity was observed in 6 patients (3 Xeno III, 3 Exite) between 1 and 3 weeks. Eleven failed restorations (6.8%) were observed during the follow up. Seven in the one-step self-etch adhesive group (7.7%) and four in the 2-step etch-and-rinse group (5.6%). This resulted in non-significant different annual failure rates of 1.9% and 1.4%, respectively. Fracture of restoration was the main reason for failure.

Conclusion

The ormocer-based nano-hybrid resin composite showed a good clinical performance in Class II cavities during the 4 year evaluation. No significant difference was seen in overall clinical effectiveness between the two adhesives.     

2%氯己定对牙本质自酸蚀粘接强度影响的初步研究

目的采用微拉伸方法检测基质金属蛋白酶抑制剂（2％氯己定）是否影响牙本质自酸蚀粘接的粘接强度。方法将8颗新鲜拔除的人下颌第三磨牙去除冠部釉质,暴露中层牙本质,随机分成两组,对照组用Clearfil SE Bond粘接剂粘接,实验组粘接前用2％氯己定处理粘接面牙本质,硬组织切片机切成1mm×1mm×8mm的微拉伸试件40个,测试两组即刻和水储存6个月时的微拉伸强度,并对断裂样本进行电镜观察。结果对照组和实验组的即刻微拉伸强度分别为40．56±2．78Mpa、41．20±2．66Mpa,两组即刻粘接强度无统计学差异（P〉0．05）;6个月时微拉伸强度实验组高于对照组（P〈0．05）。结论2％氯己定对牙本质自酸蚀粘接的即刻粘接强度没有影响;经过6个月储存后,能够减缓粘接强度的下降。     

人深层牙本质粘结时牙髓反应的短期评价

目的 :评价两种不同体系的牙本质粘结系统直接用在人深层牙本质上时牙髓 -牙本质复合体在短期内的反应。方法 :局麻下在 2 4颗因正畸治疗需要而计划拔除的前磨牙的颊面颈部预备深Ⅴ类洞 ,随机分为两组 ,一组牙齿的窝洞各壁直接应用全酸蚀牙本质粘结系统Prime&BondNT ,光固化复合树脂充填 (PB组 ) ;另一组的窝洞内则直接使用自酸蚀牙本质粘结系统XenoⅢ (Xeno组 )。以上所有的牙齿在术后 7～ 2 0d之间拔除 ,常规组织病理切片预备 ,HE、Masson’strichrome、BrownandBrenn染色 ,显微镜下盲法评价其牙髓 -牙本质复合体的反应。结果 :PB组中有大量粘结树脂成分沿着牙本质小管扩散 ,同时牙髓出现较为明显的炎症反应和组织结构紊乱。相比之下 ,Xeno组牙髓的不良反应较小。结论 :在深窝洞中直接使用全酸蚀牙本质粘结系统Prime&BondNT是不恰当的 ,此时使用自酸蚀牙本质粘结系统XenoⅢ较为安全。     

Microleakage of self-etch primer/adhesives in endodontically treated teeth

BACKGROUND: The authors evaluated the coronal marginal leakage of endodontically treated teeth bonded with four self-etching adhesives and one total-etch adhesive system. MATERIALS AND METHODS: The investigators prepared Class II cavities in 60 extracted human premolars. They performed conventional endodontic therapy using a resin-based sealer and gutta-percha points. They randomly assigned each tooth to a group receiving one of the following adhesives: Adper Prompt L-Pop (3M ESPE, Seefeld, Germany), Clearfil SE Bond (Kuraray, Osaka, Japan), FL Bond (Shofu, Kyoto, Japan), Single Bond (3M ESPE) or Xeno III (Dentsply De Trey, Konstanz, Germany). They restored all teeth with resin-based composite material (Z250, 3M ESPE). Specimens underwent thermocycling and dye penetration and were sectioned longitudinally. The authors photographed the sections under a stereomicroscope. They transferred the images to an IBM-compatible personal computer for quantitative assessment of dye penetration using image analysis software. They analyzed data by means of Kruskal-Wallis and Mann-Whitney U tests (P = .05) and evaluated two specimens from each group under scanning electron microscopy. RESULTS: None of the tested self-etch adhesives completely eliminated microleakage. Dye leakage was restricted to the coronal cavity walls; it did not migrate toward the pulp chamber or toward the root canal. Single Bond and Clearfil SE Bond showed significantly lower dye penetration values at occlusal and gingival margins. CONCLUSIONS: The coronal sealing performance of the tested self-etch adhesive systems in endodontically treated teeth was material-dependent. The use of Clearfil SE Bond in such teeth can help achieve a marginal seal comparable to that achieved with Single Bond.     

牙颈部非龋性硬化牙本质经自酸蚀粘结剂处理后的超微形态

目的:观察牙颈部非龋性硬化牙本质经一步法自酸蚀粘结剂处理后树脂—牙本质界面的超微结构变化。方法:实验组选择因牙周病拔除的有典型牙颈部非龋性缺损的前磨牙,使用一步法自酸蚀粘结剂AdperPrompt L-Pop处理硬化牙本质表面,并用树脂修复缺损。对照组为正畸拔除的正常前磨牙,人工机械制备牙颈部楔形缺损。扫描电镜观察自酸蚀处理后硬化牙本质表面的超微形态以及树脂—牙本质界面的微观表现。结果:牙颈部非龋性硬化牙本质表面的牙本质小管大部分被柱状的矿化结晶体堵塞。自酸蚀粘结剂AdperPrompt L-Pop酸蚀不能去除小管内的矿化结晶。硬化牙本质与树脂的粘结界面可见到树脂突,但与正常牙本质比较,树脂突的数量较少、长度较短。结论:硬化牙本质的粘结特性与正常牙本质存在差异。树脂突的数量及长度不足可能影响硬化牙本质的粘结。     

Early responses of human pulp to direct capping with resin adhesive systems and calcium hydroxide

Objective

Early responses of human pulp to Prime&Bond/phosphoric acid, Clearfil SE Bond, Clearfil S3 Bond and Dycal were investigated ex vivo.

Effects of dentine moisture on the permeability of total-etch and one-step self-etch adhesives

Objectives

The aim of this study was to compare the technique sensitivity of a one-bottle total-etch adhesive and a self-etch primer adhesive to the moisture condition of the dentine substrate.

Methods

The methods used were hydraulic conductance, light microscopy and scanning electron microscopy.

Results

When the moisture conditions of the dentine surface are modified with respect to the standard, the bonded interfaces obtained with the one-bottle total-etch Adper Scotch Bond 1 XT (SB) and the all-in-one self-etch Adper Prompt L-Pop (AP) are morphologically highly perturbed. But, although this study also showed a significant (p < 0.01) relationship between increases in permeability of resin-bonded dentine and variations of dentine moisture conditions with SB, a significant relationship was found only for the influence of the over-wet condition with AP.

Conclusion

Within the limitations of this study, the self-etch primer tested gave a greater reduction in dentine permeability than the one-bottle adhesive, while being more tolerant to handling. Although excess water should be avoided with both these systems, air-drying can be an alternative to wet-bonding with the self-etch primers, thus reducing the sensitivity to technique.     

Influence of dentinal regions on bond strengths of different adhesive systems

This in vitro study assessed comparatively the shear bond strengths of three composite resins, 3M Valux Plus (3MVP), Herculite (H), Clearfil AP-X (CAP-X), a polyacid modified composite resin Dyract (D), and a resin modified glass-ionomer materials Vitremer (V), to cervical and buccal dentine regions of extracted human molar teeth. Four different bonding systems, 3M ScotchBond Multipurpose (SB), Clearfil Liner Bond 2 (LB2), Opti Bond (OB), and Prime & Bond 2.1 (PB 2.1) were used with the manufacturer's respective composite and compomer materials. One hundred freshly extracted mandibular molar teeth were selected for this study. Flat buccal dentine surfaces were created on 50 teeth and cylindrical rods of the five materials were bonded to the dentine surfaces. For assessment of cervical bond strengths, the materials were bonded to mesial and distal enamel bordered occlusal dentinal surfaces of the remaining 50 teeth. The five groups of restorative procedures were applied as follows; Group 1: SB + 3MVP, Group 2: LB2 + CAP-X, Group 3: OB + H, Group 4: PB2.1 + D, Group 5: Vitremer primer (VP) VP + V. Each restorative procedure thus had 20 specimens (10 buccal + 10 cervical). After 24 h of water storage (37 degrees C), the specimens were tested on a Universal Testing machine in shear with a cross head speed of 0.5 mm min-1. The bond strength values were calculated in MPa and the results were evaluated statistically using Kruskal-Wallis one-way/anova and Mann-Whitney U-tests. It was found that the bond strengths of SB + 3MVP, LB2 + CAP-X and VP + V to buccal dentine surfaces were significantly stronger (P < 0.05) than those to the occluso-cervical dentine floors. When the bond strengths to the occluso-cervical dentine and buccal dentine surface were compared, there was no significant difference between the materials (P > 0.05). Vitremer was found the least successful adhesive material in terms of shear bond strength on both buccal and occluso-cervical dentine surfaces.     

Three different adhesive systems; three different bond strength test methods

Abstract

Objective. The aim of this study was to evaluate the efficacy of the microtensile, microshear and shear bond strength test methods to assess the bond strength of two self-etch adhesives and one etch&rinse adhesive on dentin. Materials and methods: Seventy-five extracted human molars were ground to expose their flat dentin surfaces and randomly assigned to one of three groups according to the type of test method (15 for microtensile, 15 for microshear, 45 for shear). Each of these groups was then assigned to three sub-groups according to the bonding systems (Clearfil SE Bond, Kuraray; G Bond, GC; Prime&Bond NT, Dentsply) used. Then, 15 specimens were prepared for each sub-group according to the test method employed (n = 15). After being stored in distilled water at 37°C for 24 h, the specimens were placed in a universal testing machine for three test methods and stressed at a crosshead speed of 0.5 mm/min. Mean bond strengths were analyzed using Kruskall-Wallis and Mann-Whitney U-tests at a significance level of p < 0.05. Results. The microtensile test had the highest bond strength (p = 0.046). Clearfil SE Bond and Prime&Bond NT produced significantly higher values than the G Bond in the microtensile bond test (p < 0.05), whereas no significant differences were found among the adhesives in the microshear bond test (p > 0.05). For the shear test, Clearfil SE Bond showed higher bond strength than Prime&Bond NT and G Bond (p < 0.05). Conclusion: Bond strength to dentin depends on the material and the test method used.     

不同粘结系统配合硅烷偶联剂对纤维桩粘结强度的影响

目的:观察2种不同粘结系统(RelyX Unicem和ParaCore)配合硅烷偶联剂对高强度玻璃纤维预成根管桩(ParaPost Taper Lux)与牙本质粘结强度的影响。方法:将32个新鲜完整人离体下颌中切牙截冠,进行完善的根管预备和充填后,制备5 mm深的桩道(Φ1.25 mm),根据纤维桩的处理方式和粘结系统的选择将32个牙随机分为硅烷偶联剂加ParaCore粘结组;直接ParaCore粘结组(对照组);硅烷偶联剂加RelyXUnicem粘结组;直接RelyX Unicem粘结组(对照组)。使用相应粘结系统粘接纤维桩后,制作拉出试验试件,用万能材料测试仪测试各试件桩脱出最大载荷,记录数值并进行统计学分析。结果:各组粘结强度(MPa)依次为11.4±3.7、12.1±2.7、5.2±1.0、4.9±1.2。此2种粘结系统,无论是实验组(使用硅烷偶联剂)还是对照组,ParaCore的粘结强度明显高于RelyX Unicem,差异均有统计学意义(P<0.05),在相同粘结系统下的实验组与对照组相比无统计学差异(P>0.05)。结论:高强度玻璃纤维预成根管桩(ParaPost Taper Lux)、牙本质的粘结强度和粘结系统有一定相关性,ParaCore粘结系统优于RelyX Unicem粘结系统,而硅烷偶联剂处理对纤维桩与牙本质的粘结强度未见明显影响。     

Conditioning effect on dentin, resin tags and hybrid layer of different acidity self-etch adhesives applied to thick and thin smear layer

OBJECTIVES: to assess the conditioning effect (CE) of self-etch adhesives of different acidity applied to thick and thin smear layer (SL), the corresponding resin tags (RT) and hybrid layer (HL). METHODS: Twenty-seven molars had their occlusal dentin exposed and were sectioned into two halves. Each of them was ground with a 60 or 600-grit SiC paper, respectively for thick and thin SL production. Three self-etch adhesives: a mild (Clearfil SE Bond), an intermediary (Optibond Solo SE and Solo Plus) and a strong (Tyrian Self Priming Etchant+One Step Plus) and an etch-&-rinse system (Scotchbond Multi Purpose Plus) were used. For CE evaluation, the self-etch primers were applied and rinsed off with acetone and alcohol prior to SEM preparation. For RT and HL specimens self-etch adhesives were applied and restored with Z-250. For RT specimens, dentin was removed with HCl (6N) and NaClO (1%) baths. The HL specimens were fixed, dehydrated, dried with HMDS, embedded, polished and slightly demineralized (6N HCl) and deproteinized (1% NaClO). After gold sputtering they were observed by SEM. RESULTS: The thick smear layer was clearly not totally removed by the mild self-etch primer. RT varied in density and shape among the self-etch adhesives. Thicker HL was observed for the strong self-etch and etch-&-rinse adhesives. CONCLUSIONS: The etch-&-rinse adhesive presented the thickest HL and was the only adhesive to produce RT in high density and uniform distribution along the whole dentin surface, independently of the SL thickness.