Costa Carlos Alberto de Souza, Giro Elisa Maria Aparecida, do Nascimento Alexandre Batista Lopes, Teixeira Hilcia Mezzalira, Hebling Josimeri
Department of Physiology and Pathology, Araraquara School of Dentistry, University of São Paulo State-UNESP, Rua Humaita, 1680 Centro, CEP: 14.801-903 CP: 331, SP, Araraquara, Brazil
Dent Mater. 2003 Dec;19(8):739-46. doi: 10.1016/s0109-5641(03)00021-6.
To evaluate the response of the pulpo-dentin complex following application of a resin-modified glass-ionomer cement or an adhesive system in deep cavities performed in human teeth.
Deep class V cavities were prepared on the buccal surface of 26 premolars. In Group 1 the cavity walls (dentin) and enamel were conditioned with 32% phosphoric acid and the dentin adhesive system One Step (Bisco, Inc., Itasca, IL, USA) was applied. In Groups 2 and 3, before total etching and application of bonding agent, the cavity floor was lined with the resin-modified glass-ionomer cement-Vitrebond (3M ESPE Dental Products Division, St. Paul, MN, USA) or the calcium hydroxide cement-Dycal (control group, Dentsply, Mildford, DE, USA), respectively. The cavities were restored using light-cured Z-100 composite resin (3M ESPE). The teeth were extracted between 5 and 30 days and prepared for microscopic assessment. Serial sections were stained with H/E, Masson's trichrome and Brown and Brenn techniques.
In Group 1, the inflammatory response was more evident than in Groups 2 and 3. Diffusion of dental material components across dentinal tubules was observed only in Group 1, in which the intensity of the pulp response increased as the remaining dentin thickness decreased. Bacteria were evidenced in the lateral walls of two samples (Group 2) which exhibited no inflammatory response or tissue disorganization.
Based on the experimental conditions, it was concluded total acid etching followed by application of One Step bonding agent cannot be recommended as adequate procedures. In this clinical condition the cavity walls should be lined with a biocompatible dental material, such as Vitrebond or Dycal.
评估在人类牙齿制备的深龋洞中应用树脂改性玻璃离子水门汀或粘结系统后牙髓-牙本质复合体的反应。
在26颗前磨牙的颊面制备深V类洞。第1组，洞壁（牙本质）和釉质用32%磷酸处理，然后应用牙本质粘结系统单步粘结剂（美国伊利诺伊州伊塔斯卡市必思科公司）。在第2组和第3组中，在全酸蚀和应用粘结剂之前，洞底分别用树脂改性玻璃离子水门汀-Vitrebond（美国明尼苏达州圣保罗市3M ESPE牙科产品部）或氢氧化钙水门汀-Dycal（对照组，美国特拉华州米尔福德登士柏公司）衬层。用光固化Z-100复合树脂（3M ESPE）修复洞。在5至30天之间拔除牙齿并制备用于显微镜评估。连续切片用苏木精/伊红、马松三色染色法和布朗-布伦染色法染色。
第1组的炎症反应比第2组和第3组更明显。仅在第1组观察到牙科材料成分通过牙本质小管扩散，其中牙髓反应强度随着剩余牙本质厚度的减小而增加。在两个样本（第2组）的侧壁中发现细菌，这些样本没有炎症反应或组织紊乱。
基于实验条件，得出结论：全酸蚀后应用单步粘结剂不能作为适当的操作方法推荐。在这种临床情况下，洞壁应用生物相容性牙科材料衬层，如Vitrebond或Dycal。
