Ferrari M, Cagidiaco M C, Kugel G, Davidson C L
Research Center for Dentistry, Livorno, Italy.
Am J Dent. 1999 Oct;12(5):243-9.
To evaluate the effectiveness of a one-bottle adhesive system as a desensitizing treatment, with or without a prior phosphoric acid-etch step.
Two different clinical procedures using a one-bottle adhesive bonding system were tested for its efficacy on desensitizing exposed roots. Thirty subjects with a history of dentin hypersensitivity were selected and 60 exposed sensitive teeth were divided into two groups (n = 30). In Group 1 samples, Scotchbond 1 bonding system (Single Bond in USA) was applied without a prior acid-etching, while in those of Group 2, the exposed sensitive roots were acid-etched with 35% phosphoric acid for 15 seconds, prior to application of bonding agents. The sensitivity was evaluated at 0, 1, 2, 4 weeks and 3 months using cold air blast stimuli, and recorded using a visual-analogue scale. The scores were analyzed as non-parametric data by means of the Mann-Whitney and Sign tests. Five samples from each group were randomly selected in order to make scanning electron microscope observations of the sensitive dentin surfaces at baseline and at each recall using the replica technique.
At baseline, after both desensitizing procedures all the patients reported distinct reductions in dentin sensitivity. At 1- and 2-week recalls, 20 teeth of Group 1 and 17 teeth in Group 2 exhibited a return of sensitivity, and in five teeth in each group, the sensitivity score was between 5-8. During the first recall (1-2 weeks), the sensitive teeth were retreated and showed an immediate reduction of sensitivity. At the 1-month recall, eight teeth in Group 1 and four teeth in Group 2 showed a return of some sensitivity, and in six teeth in Group 1 and in three teeth in Group 2, old amalgam restorations were replaced and this procedure almost completely resolved the sensitivity. At the 3-month recall, only five teeth from each group showed residual mild sensitivity (score 1-2). For both Groups 1 and 2 there was a statistically significant (P < 0.0005) reduction in sensitivity levels between the baseline pain scores and immediately after treatment, and between the first recall pre-treatment pain scores and the last recall pain scores. Overall, the two methods of treatment demonstrated a general decrease in sensitivity in both groups over the 3-month study period, adequately solving the clinical and patients' perception of the discomfort of sensitivity. The SEM observations of the replicas showed a progressive loss of the adhesive resin from the treated surfaces. This fact was more evident in the non-etched samples (Group 2) than in those in Group 1. The results of this study showed that exposed root dentin sealed with Scotchbond 1, with or without prior acid-etching, did not show spontaneous sensitivity after 3 months.
评估单瓶粘结系统作为脱敏治疗方法的有效性，无论是否进行磷酸酸蚀预处理。
测试了两种使用单瓶粘结系统的不同临床程序对暴露牙根脱敏的效果。选取30名有牙本质过敏史的受试者，60颗暴露的敏感牙被分为两组（每组n = 30）。在第1组样本中，应用Scotchbond 1粘结系统（美国的Single Bond）时未进行酸蚀预处理，而在第2组样本中，在应用粘结剂之前，先用35%的磷酸对暴露的敏感牙根进行15秒的酸蚀处理。使用冷空气吹拂刺激在0、1、2、4周和3个月时评估敏感性，并使用视觉模拟量表进行记录。通过Mann-Whitney和Sign检验将分数作为非参数数据进行分析。每组随机选取5个样本，以便在基线和每次复诊时使用复型技术对敏感牙本质表面进行扫描电子显微镜观察。
在基线时，两种脱敏程序后所有患者均报告牙本质敏感性明显降低。在1周和2周复诊时，第1组的20颗牙和第2组的17颗牙敏感性恢复，每组各有5颗牙的敏感性评分为5 - 8。在首次复诊（1 - 2周）时，对敏感牙进行了再次治疗，敏感性立即降低。在1个月复诊时，第1组的8颗牙和第2组的4颗牙出现了一定程度的敏感性恢复，第1组的6颗牙和第2组的3颗牙更换了旧的银汞合金修复体，该操作几乎完全消除了敏感性。在3个月复诊时，每组仅5颗牙表现出残留的轻度敏感性（评分为1 - 2）。对于第1组和第2组，基线疼痛评分与治疗后即刻之间以及首次复诊治疗前疼痛评分与最后一次复诊疼痛评分之间的敏感性水平均有统计学显著降低（P < 0.0005）。总体而言，在3个月的研究期间，两种治疗方法在两组中均显示出敏感性普遍降低，充分解决了临床问题以及患者对敏感性不适的感受。复型的扫描电子显微镜观察显示，处理过的表面上粘结树脂逐渐流失。这一现象在未酸蚀的样本（第2组）中比在第1组中更为明显。本研究结果表明，用Scotchbond 1封闭暴露的牙根牙本质，无论是否进行酸蚀预处理，3个月后均未出现自发敏感性。
