Tay Franklin R, Pashley David H
Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
J Adhes Dent. 2002 Summer;4(2):91-103.
The current trend in the development of dentin adhesives attempts to simplify bonding steps and make them more user-friendly. However, optimizing speed and efficiency should be accomplished without major tradeoffs in the quality or durability of resin bonds. Although dentin adhesives have improved tremendously over the past decade, postoperative sensitivity, incomplete marginal seal, premature bond degradation, biocompatibility, and compromised bonding to abnormal substrates are still considered potential problems associated with their use. Advances in different scientific disciplines will enrich the pool from which ideas may be drawn in designing future dentin adhesives. It is probably on the molecular level that we will see the greatest expansion of horizons. With the advances in biomimetics, future dentin adhesive monomers may contain domains derived from protein-based, underwater bioadhesives secreted by aquatic animals such as mussels and barnacles, making them less dependent on the surface energy of the bonding substrates as well as less susceptible to hydrolytic degradation. As adhesive joints produced by contemporary adhesives are brittle in nature, future adhesive design may incorporate biomimetic intermediate-strength domains that can undergo stepwise reversible unfolding in response to varying functional stress levels before ultimate catastrophic failure of the adhesive joint occurs. These domains may also re-establish folded configurations on stress relaxation, making the adhesive both strong and tough. Using the concept of controlled release, future adhesives may contain fluorescent biosensors that can detect pH changes around leaking restorations. They may even have the capacity to heal autonomously, in response to microcracks formed by functional stresses within the adhesive joint. The ability to self-diagnose and self-repair will increase the life expectancy of adhesive restorations. Future dentin adhesives may also assume a more instrumental role in therapeutics apart from caries prevention. These features may include the controlled release of noncollagenous proteins to promote remineralization of collagen matrices in sound and caries affected dentin, and growth factors to induce controlled formation of reparative dentin.
目前牙本质黏结剂的发展趋势是试图简化黏结步骤，使其更便于使用。然而，在优化速度和效率的同时，不应在树脂黏结的质量或耐久性方面做出重大权衡。尽管在过去十年中牙本质黏结剂有了巨大的改进，但术后敏感、边缘封闭不完全、黏结过早降解、生物相容性以及与异常底物的黏结受损等问题，仍然被认为是与它们的使用相关的潜在问题。不同科学学科的进展将丰富未来设计牙本质黏结剂时可供借鉴的思路库。很可能在分子层面上，我们将看到最大程度的视野拓展。随着仿生学的进步，未来的牙本质黏结剂单体可能包含源自蛋白质基水下生物黏附剂的结构域，这些生物黏附剂由贻贝和藤壶等水生动物分泌，这将使它们减少对黏结底物表面能的依赖，也更不易受到水解降解的影响。由于当代黏结剂产生的黏结接头本质上是脆性的，未来的黏结剂设计可能会纳入仿生中强度结构域，这些结构域可以在黏结接头最终发生灾难性失效之前，根据不同的功能应力水平进行逐步可逆的展开。这些结构域在应力松弛时也可能重新建立折叠构型，使黏结剂既坚固又坚韧。利用控释概念，未来的黏结剂可能包含荧光生物传感器，能够检测渗漏修复体周围的pH变化。它们甚至可能有自主愈合的能力，以应对黏结接头内功能应力形成的微裂纹。自我诊断和自我修复的能力将延长黏结修复体的使用寿命。未来的牙本质黏结剂除了预防龋齿外，在治疗方面可能还会发挥更重要的作用。这些功能可能包括非胶原蛋白的控释，以促进健康牙本质和龋损牙本质中胶原基质的再矿化，以及生长因子的控释，以诱导修复性牙本质的可控形成。
