通用型粘接剂对牙体组织粘接效果影响因素的研究进展

近年来,通用型粘接剂因其操作简单、适用范围广等优点而被广泛运用于口腔治疗中。在实际临床操作中,酸蚀模式、涂布方法、粘接前预处理等因素可能影响其对牙体组织的粘接性能。本文归纳和分析可能影响通用型粘接剂粘接性能的因素,并以此为基础阐述如何进一步改善通用型粘接剂的粘接效果,以期为临床工作提供参考。现阶段研究表明,对于牙釉质粘接,通用型粘接剂的全酸蚀模式可取得更好的粘接效果;而对于牙本质粘接,全酸蚀和自酸蚀的粘接效果相近。延长粘接剂的涂布时间、双层涂布粘接剂、粘接前用水或乙醇润湿可提升粘接强度。0.2%氯己定和金属纳米粒子可有效抑制基质金属蛋白酶(matrix metallo?proteinases,MMPs)的激活,提高长期粘接效果。通用型粘接剂具有良好的稳定性和抗唾液污染能力,但抗血液污染能力不佳。酸蚀模式、涂布方法、粘接前预处理等因素均可影响粘接效果,临床操作中医师应注意以上因素。目前,通用型粘接剂仍存在对牙釉质自酸蚀粘接强度不佳、对龋病周围脱矿的牙体组织粘接能力下降等问题,仍有待进一步研究改进。

Research progress on the factors influencing the bonding effect of universal adhesives on tooth tissues

Universal adhesives have been widely used in dentistry due to their easy application process and wide range of applications.In the literature,the etching modes of universal adhesives,coating methods of universal adhe?sives,pretreatment of adhesive,and other factors were reported to have an impact on the bonding performance of univer?sal adhesives.This review focused on the factors affecting the bonding performance of universal adhesives and aimed to provide evidence?based recommendations for clinical practice.Current research suggests that the etch?and?rinse mode can achieve a better adhesive strength of enamel and that the etch?and?rinse mode and the self?etch mode exhibit a simi?lar adhesive performance in bonding dentin.The bond strength would be improved by prolonging the application time,applying a double layer of adhesives,and wetting enamel and dentin with water or ethanol before adhesive procedures.Chlorohexidine(0.2%)and metal nanoparticles can inhibit matrix metalloproteinases(MMPs)and improve the long?term bond strength of dentin.Finally,universal adhesives have excellent stability and saliva pollution resistance,although they lack blood pollution resistance.In the clinic,dentists should pay attention to the etching modes of universal adhesives,coating methods of universal adhesives,pretreatment of adhesive,and other factors that may affect the effect strength.universal adhesives will be improved in bonding strength of enamel in self?etch mode and bonding perfor?mance in demineralized dentals around caries.