Mueller Jan, Meyer-Lueckel Hendrik, Paris Sebastian, Hopfenmuller Werner, Kielbassa Andrej M
Department of Operative Dentistry and Periodontology, School of Dental Medicine, Campus Benjamin Franklin, Charité-Universitätsmedizin, Berlin, Germany.
Oper Dent. 2006 May-Jun;31(3):338-45. doi: 10.2341/05-39.
This study compared the progression of sealed initial enamel lesions penetrated with a fissure sealant (Helioseal, Vivadent) or various adhesives (Heliobond, Excite, Vivadent; Resulcin, Merz; Solobond M, Voco; Prompt L-Pop, 3M-ESPE) after exposure to a demineralizing solution, in vitro. From 27 bovine teeth, 54 enamel specimens were prepared and covered with nail varnish (control), thus obtaining three windows for treatment. After demineralization (pH 5.0; 14 days), two of the windows (A, B) were etched with phosphoric acid (20%; 5 seconds); whereas, the third area served as the control (C). The specimens were divided randomly into six groups (n=9), and the material was applied (90 seconds) either once (A) or twice (B). Light-curing followed each application. Half of the area of each specimen window was then covered with nail varnish, and the samples were again stored in the demineralizing solution (pH 5.0; 14 days). The specimens were cut perpendicular to the surface, and both enamel slabs were studied after infiltration using a fluorescent, low viscous resin (VIRIN) and confocal microscopy (CLSM). Lesion depths were calculated (ImageJ) from the surface to that point in the lesion where the grey values clearly changed to a darker grey. After demineralization, mean lesion depths (SD) (14 days) were measured at 105 (21) microm. The second demineralization led to a mean progression of the lesion depths of 52 (31)%. Adper Prompt L-Pop and Solobond M could not significantly prevent lesion progression after a single application (p > 0.05; t-test); however, the second application of Solobond M significantly decreased lesion progression (p < 0.05; t-test). Helioseal, Heliobond, Resulcin Monobond and Excite showed significantly better inhibition of the demineralization compared to the other materials (p < 0.05; Bonferroni). It can be concluded that the penetration of adhesives into initial lesions inhibited a further demineralization in vitro.
本研究在体外比较了用窝沟封闭剂（Helioseal，Vivadent）或各种粘结剂（Heliobond，Excite，Vivadent；Resulcin，Merz；Solobond M，Voco；Prompt L-Pop，3M-ESPE）渗透封闭的初期釉质龋损在暴露于脱矿溶液后的进展情况。从27颗牛牙制备了54个釉质标本，并用指甲油覆盖（对照组），从而获得三个用于治疗的窗口。脱矿（pH 5.0；14天）后，其中两个窗口（A、B）用磷酸（20%；5秒）蚀刻；而第三个区域作为对照（C）。标本被随机分为六组（n = 9），材料单次（A）或两次（B）应用（90秒）。每次应用后进行光固化。然后将每个标本窗口面积的一半用指甲油覆盖，样本再次储存在脱矿溶液（pH 5.0；14天）中。标本垂直于表面切割，使用荧光低粘度树脂（VIRIN）和共聚焦显微镜（CLSM）对两块釉质薄片进行浸润后研究。从表面到病变中灰度值明显变为深灰色的点计算病变深度（ImageJ）。脱矿后，14天的平均病变深度（标准差）测量为105（21）微米。第二次脱矿导致病变深度平均进展52（31）%。Adper Prompt L-Pop和Solobond M单次应用后不能显著阻止病变进展（p>0.05；t检验）；然而，Solobond M的第二次应用显著降低了病变进展（p<0.05；t检验）。与其他材料相比，Helioseal、Heliobond、Resulcin Monobond和Excite对脱矿的抑制作用明显更好（p<0.05；Bonferroni检验）。可以得出结论，粘结剂渗透到初期病变中在体外抑制了进一步的脱矿。
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