牙本质黏接剂对复合树脂与湿润和干燥釉质间剪切黏结强度的影响

Section of Operative Dentistry, Department of Restorative Dentistry, Southern Illinois University-School of Dental Medicine, Alton, IL 62002, USA.

Oper Dent. 2000 Jan-Feb;25(1):51-8.

The etched enamel-composite resin bond is the most reliable bond known to us. Moisture and dentin primers are the two most important variables that can interfere with this bond. This study investigated the effect of dentin primer on bond strengths of composite resin to moist and dry enamel. One hundred freshly extracted molar teeth were used for shear bond strength testing. The teeth were mounted in phenolic rings with an approximal enamel surface exposed. The exposed enamel surface on each tooth was flattened using 320- 400- and 600-grit silicon carbide papers and etched using 34-38% phosphoric acid gel. The teeth were then divided into 10 groups (n = 10). Four groups were assigned to each of the two dentin bonding systems, Scotchbond Multi-Purpose and OptiBond FL. Two groups were assigned to the single-bottle bonding agent (Single Bond). Each bonding system was tested on moist and dry enamel. OptiBond FL and Scotchbond MP were tested with and without the use of primer. All samples were thermocycled and tested in shear. Fracture analysis was performed using a binocular microscope. For scanning electron microscopy, approximal samples of enamel (1 mm thick) were flattened, etched, and bonded with and without primer on moist and dry enamel. A 1 mm-thick layer of Z100 was bonded to the specimens, which were then immersed in 10% HCl for 24 hours to dissolve the enamel. The specimens were viewed under a scanning electron microscope. Results indicated that the use of primer on dry enamel did not significantly affect (P > 0.05) shear bond strengths for the two bonding systems, Scotchbond MP (primed 24.10 +/- 4.83 MPa, unprimed 29.57 +/- 7.49 MPa) and OptiBond FL (primed 26.82 +/- 4.44, unprimed 25.66 +/- 2.95). However, the use of primer was found to be essential on moist enamel to obtain acceptable bond strengths with both Scotchbond MP (primed 25.61 +/- 10.29 MPa, unprimed 3.26 +/- 0.95 MPa) and OptiBond FL (primed 30.28 +/- 3.49 MPa, unprimed 8.37 +/- 3.31 MPa). Moisture on enamel did not significantly affect (P > 0.05) bond strengths for the single-bottle bonding agent, Single Bond (moist enamel 31.34 +/- 9.03 MPa, dry enamel 27.93 +/- 5.41 MPa). Fracture analysis revealed that most fractures were adhesive or mixed, with a greater percentage being cohesive for the groups with dry enamel or with primer on moist enamel. Scanning electron micrographs corroborated the shear bond strength data. The specimens without primer on moist enamel showed very poor penetration of adhesive and composite resin into the etched enamel microporosities.

蚀刻釉质 - 复合树脂粘结是我们所知最可靠的粘结方式。水分和牙本质底漆是干扰这种粘结的两个最重要变量。本研究调查了牙本质底漆对复合树脂与湿润和干燥釉质粘结强度的影响。使用100颗新鲜拔除的磨牙进行剪切粘结强度测试。将牙齿安装在酚醛环中，使近中釉质表面暴露。用320目、400目和600目碳化硅砂纸将每颗牙齿暴露的釉质表面磨平，并用34 - 38%磷酸凝胶蚀刻。然后将牙齿分为10组（每组n = 10）。两种牙本质粘结系统，即Scotchbond多功能粘结剂和OptiBond FL，各有四组。单瓶装粘结剂（Single Bond）有两组。每个粘结系统在湿润和干燥釉质上进行测试。OptiBond FL和Scotchbond MP在使用和不使用底漆的情况下进行测试。所有样本进行热循环并测试剪切力。使用双目显微镜进行断裂分析。对于扫描电子显微镜，将近中釉质样本（1毫米厚）磨平、蚀刻，并在湿润和干燥釉质上使用和不使用底漆进行粘结。将一层1毫米厚的Z100粘结到样本上，然后将样本浸入10%盐酸中24小时以溶解釉质。在扫描电子显微镜下观察样本。结果表明，对于两种粘结系统Scotchbond MP（使用底漆为24.10±4.83 MPa，未使用底漆为29.57±7.49 MPa）和OptiBond FL（使用底漆为26.82±4.44，未使用底漆为25.66±2.95），在干燥釉质上使用底漆对剪切粘结强度没有显著影响（P>0.05）。然而，发现在湿润釉质上使用底漆对于Scotchbond MP（使用底漆为25.61±10.29 MPa，未使用底漆为3.26±0.95 MPa）和OptiBond FL（使用底漆为30.28±3.49 MPa，未使用底漆为8.37±3.31 MPa）获得可接受的粘结强度至关重要。釉质上的水分对单瓶装粘结剂Single Bond的粘结强度没有显著影响（P>0.05）（湿润釉质为31.34±9.03 MPa，干燥釉质为27.93±5.41 MPa）。断裂分析表明，大多数断裂为粘结性或混合性，对于干燥釉质组或湿润釉质上使用底漆的组，内聚性断裂的百分比更高。扫描电子显微照片证实了剪切粘结强度数据。湿润釉质上未使用底漆的样本显示粘结剂和复合树脂向蚀刻釉质微孔的渗透非常差。