Paranhos Maria Paula Gandolfi, Spohr Ana Maria, Marcondes Maurem, Oshima Hugo Mitsuo Silva, Mota Eduardo Gonçalves, Burnett Luis Henrique
School of Dentistry, Pontifical Catholic University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
Quintessence Int. 2009 Feb;40(2):145-53.
To evaluate the microtensile bond strength of 2 adhesive systems (Adper Single Bond Plus [3M ESPE] and Clearfil SE Bond [Kuraray]) to carious or normal dentin, with or without previous treatment with Nd:YAG laser or Nd:YAG laser associated with fluoride.
Dentin surfaces of 60 human third molars were exposed. Teeth were divided into 12 groups; groups 1 to 6 were submitted to pH cycling for artificial caries, and groups 7 to 12 remained with normal dentin. Dentin surfaces received 3 treatments: laser Nd:YAG irradiation (60 mJ, 15 Hz, and 0.9 W) for 1 minute; laser Nd:YAG irradiation associated with fluoride in gel; and no treatment (controls). In experimental groups, adhesive systems were applied in accordance with the manufacturers' instructions, and a composite resin block (Filtek Z250, 3M ESPE) was made incrementally for the microtensile bond strength test. The teeth were sectioned serially in both x and y directions, and sticks were submitted to microtensile bond strength testing in a universal testing machine.
According to ANOVA and Tukey (P < .05), the highest mean bond strengths were obtained in groups of normal dentin treated with Clearfil SE Bond (40.65 MPa) and Single Bond (34.2 MPa). The presence of carious dentin significantly decreased the mean bond strengths of the 2 adhesive systems whether or not they were previously laser irradiated. Nevertheless, Clearfil SE Bond presented the best microtensile bond strength on an irradiated surface. Moreover, laser irradiation associated with fluoride also decreased the bond strength values of the 2 adhesive systems.
After excavating a cavity with caries-affected dentin, the use of Nd:YAG laser followed by a self-etching adhesive system is the best clinical choice when considering bond strength, compared with the total etching- based system and laser.
评估两种粘结系统(Adper Single Bond Plus [3M ESPE]和Clearfil SE Bond [可乐丽])在有龋或正常牙本质上,有无预先用钕钇铝石榴石(Nd:YAG)激光或Nd:YAG激光联合氟化物处理时的微拉伸粘结强度。
暴露60颗人第三磨牙的牙本质表面。牙齿分为12组;第1至6组进行人工龋的pH循环,第7至12组保留正常牙本质。牙本质表面接受3种处理:Nd:YAG激光照射(60 mJ、15 Hz和0.9 W)1分钟;Nd:YAG激光照射联合凝胶氟化物;不处理(对照组)。在实验组中,按照制造商的说明应用粘结系统,并逐层制作复合树脂块(Filtek Z250,3M ESPE)用于微拉伸粘结强度测试。牙齿在x和y方向上连续切片,小棒在万能试验机上进行微拉伸粘结强度测试。
根据方差分析和Tukey检验(P < 0.05),用Clearfil SE Bond(40.65 MPa)和Single Bond(34.2 MPa)处理的正常牙本质组获得了最高的平均粘结强度。龋坏牙本质的存在显著降低了两种粘结系统的平均粘结强度,无论它们之前是否接受激光照射。然而,Clearfil SE Bond在照射表面呈现出最佳的微拉伸粘结强度。此外,激光照射联合氟化物也降低了两种粘结系统的粘结强度值。
在去除有龋坏的牙本质洞后,与基于全酸蚀的系统和激光相比,考虑粘结强度时,先使用Nd:YAG激光再使用自酸蚀粘结系统是最佳的临床选择。