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牙本质脱敏剂和牙本质黏结剂对牙本质通透性的影响。

Effect of dentin desensitizers and dentin bonding agents on dentin permeability.

作者信息

Jain P, Reinhardt J W, Krell K V

机构信息

Department of Restorative Dentistry, SIU School of Dental Medicine, Alton, IL 62002, USA.

出版信息

Am J Dent. 2000 Feb;13(1):21-7.

Abstract

PURPOSE

To determine the effect of dentin desensitizing agents (oxalates and glutaraldehyde) and dentin bonding agents, with and without resin-based composite (RBC) on dentin permeability and morphology of the dentin surface. The influence of saliva and toothbrushing on these agents was also evaluated.

MATERIALS AND METHODS

Radicular dentin discs +/-1 mm thick were obtained from extracted human teeth. The thickness of the discs was standardized by grinding them with 600 grit silicon carbide powder. Both pulpal and periodontal surfaces of the discs were treated with 6% citric acid for 2 min prior to the baseline measurement of dentin permeability. Permeability was measured for the discs, using a split-chamber apparatus, at four different time points: at baseline, after treatment with each desensitizing modality, after 24 hrs of saliva immersion and after simulated toothbrushing equivalent to 3 weeks of normal brushing. The treatment modalities were: Sensodyne Dentin Desensitizer, Gluma Dentin Desensitizer, All-Bond DS (primers without etching), Etch+Primers (All-Bond 2 system), Etch+Primers+Adhesive and Etch+Primers+Adhesive+RBC (AElite Flo). Radicular dentin discs were prepared separately for scanning electron microscopy (SEM). One group was left untreated as the control group. Discs in the other groups were treated with the modalities listed above. One disc from each group was viewed under the SEM after treatment with the desensitizing modality. The second disc in each group was viewed after 24 hrs of saliva immersion following desensitizing treatment and the third disc after 3 weeks of simulated toothbrushing following desensitizing treatment and saliva immersion.

RESULTS

The greatest reduction in permeability was caused by All-Bond DS followed by Sensodyne Dentin Desensitizer and Etch+Primers+Adhesive+RBC. Gluma Dentin Desensitizer, Etch+Primers, and Etch+Primers+Adhesive did not reduce permeability by a significant amount. Saliva immersion increased permeability significantly only for the Gluma and Etch+Primers+Adhesive groups. There was a trend towards increase in permeability after toothbrushing; however, this increase was not statistically significant for any group (P > 0.05). Thus, placement of primers without etching (All-Bond DS) reduced permeability more than any other treatment modality. These data indicate that etching a sensitive dentin area may be appropriate only if RBC is to be placed in the area. Exposure to saliva and toothbrushing countered the decrease in permeability caused by dedicated desensitizers and dentin bonding agents. The SEM micrographs revealed that in most cases, form corroborated function and the morphology of the dentin surface corresponded to the dentin permeability values.

摘要

目的

确定牙本质脱敏剂(草酸盐和戊二醛)以及牙本质粘结剂在有或没有树脂基复合材料(RBC)的情况下对牙本质渗透性和牙本质表面形态的影响。还评估了唾液和刷牙对这些药剂的影响。

材料与方法

从拔除的人牙中获取厚度约为±1mm的牙根牙本质片。用600目碳化硅粉末研磨使牙本质片的厚度标准化。在对牙本质渗透性进行基线测量之前,将牙本质片的牙髓面和牙周面均用6%柠檬酸处理2分钟。使用分室装置在四个不同时间点测量牙本质片的渗透性:基线时、用每种脱敏方式处理后、唾液浸泡24小时后以及模拟刷牙相当于正常刷牙3周后。处理方式包括:舒适达牙本质脱敏剂、Gluma牙本质脱敏剂、全粘结DS(未酸蚀的底漆)、酸蚀+底漆(全粘结2系统)、酸蚀+底漆+粘结剂以及酸蚀+底漆+粘结剂+RBC(AElite Flo)。分别制备牙根牙本质片用于扫描电子显微镜(SEM)观察。一组不做处理作为对照组。其他组的牙本质片用上述方式处理。用脱敏方式处理后,每组取一片牙本质片在SEM下观察。每组的第二片牙本质片在脱敏处理后唾液浸泡24小时后观察,第三片在脱敏处理和唾液浸泡后模拟刷牙3周后观察。

结果

全粘结DS导致的渗透性降低最大,其次是舒适达牙本质脱敏剂和酸蚀+底漆+粘结剂+RBC。Gluma牙本质脱敏剂、酸蚀+底漆以及酸蚀+底漆+粘结剂并未显著降低渗透性。仅Gluma组和酸蚀+底漆+粘结剂组在唾液浸泡后渗透性显著增加。刷牙后有渗透性增加的趋势;然而,对于任何组而言,这种增加在统计学上均不显著(P>0.05)。因此,未酸蚀底漆(全粘结DS)的应用比其他任何处理方式更能降低渗透性。这些数据表明,仅在要在该区域放置RBC时,对敏感牙本质区域进行酸蚀才可能是合适的。暴露于唾液和刷牙会抵消专用脱敏剂和牙本质粘结剂所导致的渗透性降低。SEM显微照片显示,在大多数情况下,形态与功能相符,牙本质表面形态与牙本质渗透性值相对应。

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