通用型粘接剂对双固化树脂水门汀牙本质粘接强度的影响

目的：研究一步法和两步法通用型粘接剂与不同双固化树脂水门汀匹配使用时，光固化模式对牙本质粘接强度的影响。方法： 选用一步法通用型粘接剂Single Bond Universal（SBU）和两步法通用型粘接剂OptiBond Versa（VSA）作为研究对象，以一步法自酸蚀粘接剂OptiBond All in One（AIO）和两步法自酸蚀粘接剂Clearfil SE Bond（SEB）作为对照，同时选择RelyX Ultimate（RLX）和Nexus 3 Universal（NX3）作为不同的双固化树脂水门汀。收集新鲜无龋磨牙80颗，切除冠部釉质，暴露牙本质平面。根据粘接剂种类、粘接剂是否进行光固化和水门汀种类的不同组合分为16组，每组随机5颗。按照说明使用各组粘接剂，光固化（10 s）或者不进行光固化后，在粘接剂上方放置树脂水门汀厚度为1 mm，光照20 s（650 mW/cm2），然后在水门汀上方分层填压复合树脂并固化（厚度5 mm）。水中储存24 h后，使用慢速切片机制备横截面积1 mm×1 mm的条形树脂-水门汀-牙本质样本，测定微拉伸粘接强度。结果： SBU光固化后与RLX和NX3联合使用，粘接强度［(35.45±7.04) MPa和(26.84±10.39) MPa］显著高于未光固化组［(17.93±8.93) MPa和(10.07±5.89) MPa, P<0.001］。SBU在相同光固化模式下，与RLX匹配使用的粘接强度显著高于与NX3匹配使用的粘接强度(P<0.05)。与对照AIO相比，SBU光固化后与RLX匹配使用时的粘接强度高于AIO组［(35.45±7.04) MPa vs. (24.86±8.42) MPa, P<0.05］，而未光固化下SBU的粘接强度低于AIO组［(17.93±8.93) MPa vs. (22.28±7.57) MPa, P<0.05］。两步法通用型粘接剂VSA与对照粘接剂SEB在不同的光照模式及联合使用不同的水门汀各组之间的粘接强度（25.98~32.24 MPa）差异没有统计学意义（P>0.05）。结论： 一步法通用型粘接剂的固化模式以及双固化水门汀的种类对于水门汀与牙本质的粘接强度均有一定的程度的影响。对于两步法通用型粘接系统，固化模式以及水门汀的种类对于水门汀与牙本质的粘接强度无显著影响。

Curing mode of universal adhesives affects the bond strength of resin cements to dentin

Objective:To determine the effects of curing mode of one-step and two-step universal adhesives on the micro-tensile bond strength (μTBS) of different dual-cure resin cements to dentin.Methods:One-step universal adhesive Single Bond Universal (SBU),and two-step universal adhesive OptiBond Versa (VSA) were chosen as the subjects,one-step self-etching adhesive OptiBond All in One (AIO) and two-step self-etching adhesive Clearfil SE Bond (SEB) were control groups,and two dualcure resin cements RelyX Ultimate (RLX) and Nexus 3 Universal (NX3) were used in this study.In this study,80 extracted human molars were selected and the dentin surface was exposed using diamond saw.The teeth were divided into 16 groups according to the adhesives (AIO,SBU,SEB,VSA),cure modes of adhesives (light cure,non-light cure) and resin cements (RLX,NX3).The adhesives were applied on the dentin surface following the instruction and whether light cured or not,then the resin cements were applied on the adhesives with 1 mm thickness and light cured (650 mW/cm2) for 20 s.A resin was built up (5 mm) on the cements and light cured layer by layer.After water storage for 24 h,the specimens were cut into resin-cement-dentin strips with a cross sectional area of 1 mm ± 1 mm and the μTBS was measured.Results:Regarding one-step universal adhesive (SBU) light cured,the μTBS with RLX (35.45 ±7.04) MPa] or NX3 (26.84 ±10.39) MPa] were higher than SBU non-light cured with RLX (17.93 ± 8.93) MPa)] or NX3 (10.07 ± 5.89) MPa,P ＜ 0.001].Compared with AIO,light-cured SBU combined with RLX presented higher μTBS than AIO group (35.45 ± 7.04) MPa vs.(24.86 ±8.42) MPa,P＜0.05].When SBU was not lighted,the μTBS was lower than AIO (17.93 ± 8.93) MPa vs.(22.28 ± 7.57) MPa,P ＜ 0.05].For two-step universal adhesive (VSA) and control adhesive (SEB),curing mode did not affect the μTBS when used with either RLX or NX3 (25.98-32.24 MPa,P ＞ 0.05).Conclusion:Curing mode of one-step universal adhesive may affect the μTBS between dual-cure resin cements and dentin,while for two-step universal adhesive,the curing mode and the type of resin cements did not influence the μTBS.