Perdigão Jorge, Geraldeli Saulo, Hodges James S
Department of Restorative Sciences, University of Minnesota, Minneapolis 55455, USA.
J Am Dent Assoc. 2003 Dec;134(12):1621-9. doi: 10.14219/jada.archive.2003.0109.
Self-etching adhesives are believed to prevent postoperative sensitivity when used under posterior resin-based composite restorations. The authors tested a twofold hypothesis: a self-etch, or SE, adhesive would result in less postoperative sensitivity than a total-etch, or TE, adhesive; an SE adhesive would result in poorer enamel marginal integrity than a TE adhesive.
Patients were selected on the basis of requiring Class I and II restorations in molars and premolars. The authors placed 30 restorations with the SE material (Clearfil SE Bond, Kuraray America, New York) and 36 restorations with Prime & Bond NT (Dentsply Caulk, Milford, Del.), which uses 34 percent phosphoric acid to etch enamel and dentin simultaneously. Preparations were of standard design, with all margins in enamel without beveling. Upon rubber dam isolation, the authors conditioned the enamel and dentin walls with the self-etching primer (for Clearfil SE Bond) or etched with the proprietary 34 percent phosphoric acid (for Prime & Bond NT), followed by application of the corresponding dentin adhesive. Teeth were restored with the proprietary hybrid resin-based composite indicated for posterior restorations: Clearfil AP-X for Clearfil SE Bond or Esthet-X Micro Matrix Restorative for Prime & Bond NT. The restored teeth were evaluated preoperatively and at two weeks, eight weeks and six months postoperatively for sensitivity to cold (ice), air and masticatory forces, as well as for marginal discoloration.
Analysis of variance revealed no statistically significant differences in postoperative sensitivity between the SE and TE materials at any recall time. Marginal discoloration was rated as "absent" for all restorations at six months. Only one tooth displayed sensitivity to occlusal forces at six months.
The SE adhesive did not differ from the TE adhesive in regard to sensitivity and marginal discoloration.
Postoperative sensitivity may depend on the restorative technique rather than on the type of dentin adhesive used.
自酸蚀粘结剂被认为在用于后牙树脂基复合修复体时可预防术后敏感。作者检验了一个双重假设：自酸蚀（SE）粘结剂导致的术后敏感低于全酸蚀（TE）粘结剂；SE粘结剂导致的釉质边缘完整性比TE粘结剂差。
根据需要对磨牙和前磨牙进行Ⅰ类和Ⅱ类修复来选择患者。作者用SE材料（可乐丽美国公司，纽约，Clearfil SE Bond）放置了30个修复体，并用Prime & Bond NT（登士柏卡克公司，特拉华州米尔福德）放置了36个修复体，Prime & Bond NT使用34%的磷酸同时酸蚀釉质和牙本质。预备体采用标准设计，所有边缘位于釉质内且无斜面。在橡皮障隔离后，作者用自酸蚀底漆（用于Clearfil SE Bond）处理釉质和牙本质壁，或用专利性的34%磷酸（用于Prime & Bond NT）酸蚀，随后应用相应的牙本质粘结剂。用专用于后牙修复的混合树脂基复合材料修复牙齿：用于Clearfil SE Bond的Clearfil AP-X或用于Prime & Bond NT的Esthet-X Micro Matrix Restorative。对修复后的牙齿在术前以及术后两周、八周和六个月进行评估，检查对冷（冰）、空气和咀嚼力的敏感性以及边缘变色情况。
方差分析显示，在任何回访时间，SE和TE材料之间术后敏感性均无统计学显著差异。六个月时所有修复体的边缘变色均评定为“无”。六个月时只有一颗牙齿对咬合力敏感。
SE粘结剂在敏感性和边缘变色方面与TE粘结剂无差异。
术后敏感可能取决于修复技术而非所用牙本质粘结剂的类型。
