van Dijken Jan W V, Pallesen Ulla
Department of Odontology, Umeå University, Umeå, Sweden.
Dent Mater. 2008 Jul;24(7):915-22. doi: 10.1016/j.dental.2007.11.008. Epub 2007 Dec 21.
The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems.
A total of 270 Class V restorations of four etch-and-rinse, one self-etch adhesive system and a resin-modified glass ionomer cement were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline, 6, 12, 18, and 24 months and then every year during a 13-year follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations.
During the 13 years, 215 restorations could be evaluated. The cumulative loss rate at 13 years was 53.0%, with significant different failures rates for the different systems varying between 35.6 and 86.8%. Four systems fulfilled the ADA 18-month full acceptance retention criteria. Two systems showed at 18 months and earlier high debonding rates. The annual failure rates for the etch-and-rinse systems were Optibond 3.1%, Permagen 13.0%, Scotchbond MP 4.8%, Syntac classic 2.8%; for the self-etch system P&S 4.4%; and the resin-modified glass ionomer cement Vitremer 2.7%.
It can be concluded that all systems showed a continuous degradation of the bond with a wide variation, which was independent of the adhesion strategy. Three bonding systems showed a cumulative failure rate after 13 years between 36 and 41% with the best retention for the resin-modified glass ionomer cement and a four-step etch-and-rinse system.
本研究旨在评估七种粘结系统对牙本质的临床长期粘结保留情况。
在无龋性颈部病变且未故意累及釉质的情况下，放置了总共270个Ⅴ类修复体，其中包括四种酸蚀冲洗粘结系统、一种自酸蚀粘结系统和一种树脂改性玻璃离子水门汀。在基线、6个月、12个月、18个月和24个月时对修复体进行评估，然后在13年的随访期间每年评估一次。通过修复体脱落的百分比来确定牙本质粘结效率。
在13年期间，可对215个修复体进行评估。13年时的累积脱落率为53.0%，不同系统的失败率差异显著，在35.6%至86.8%之间。四种系统符合ADA 18个月完全接受保留标准。两种系统在18个月及更早时显示出高脱粘率。酸蚀冲洗系统的年失败率分别为：Optibond 3.1%、Permagen 13.0%、Scotchbond MP 4.8%、Syntac classic 2.8%；自酸蚀系统P&S为4.4%；树脂改性玻璃离子水门汀Vitremer为2.7%。
可以得出结论，所有系统的粘结都呈现出持续降解，且差异很大，这与粘结策略无关。三种粘结系统在13年后的累积失败率在36%至41%之间，树脂改性玻璃离子水门汀和四步酸蚀冲洗系统的保留情况最佳。
