Department of Dental Materials, School of Dentistry, University of São Paulo, SP, Brazil.
J Dent Res. 2010 Dec;89(12):1499-504. doi: 10.1177/0022034510385240. Epub 2010 Oct 12.
The long-term effectiveness of chlorhexidine as a matrix metalloproteinase (MMP) inhibitor may be compromised when water is incompletely removed during dentin bonding. This study challenged this anti-bond degradation strategy by testing the null hypothesis that wet-bonding with water or ethanol has no effect on the effectiveness of chlorhexidine in preventing hybrid layer degradation over an 18-month period. Acid-etched dentin was bonded under pulpal pressure simulation with Scotchbond MP and Single Bond 2, with water wet-bonding or with a hydrophobic adhesive with ethanol wet-bonding, with or without pre-treatment with chlorhexidine diacetate (CHD). Resin-dentin beams were prepared for bond strength and TEM evaluation after 24 hrs and after aging in artificial saliva for 9 and 18 mos. Bonds made to ethanol-saturated dentin did not change over time with preservation of hybrid layer integrity. Bonds made to CHD pre-treated acid-etched dentin with commercial adhesives with water wet-bonding were preserved after 9 mos but not after 18 mos, with severe hybrid layer degradation. The results led to rejection of the null hypothesis and highlight the concept of biomimetic water replacement from the collagen intrafibrillar compartments as the ultimate goal in extending the longevity of resin-dentin bonds.
当牙本质粘结过程中水分未完全去除时，洗必泰作为基质金属蛋白酶 (MMP) 抑制剂的长期效果可能会受到影响。本研究通过测试以下假设来挑战这种抗粘结降解策略，即假设在 18 个月的时间内，水或乙醇湿粘结对洗必泰防止混合层降解的有效性没有影响。在牙髓压力模拟下，用 Scotchbond MP 和 Single Bond 2 对酸蚀牙本质进行粘结，分别采用水湿粘结、含乙醇的疏水性粘结剂湿粘结、或先用氯己定二乙酸盐 (CHD) 预处理，然后进行粘结。在 24 小时后以及在人工唾液中老化 9 个月和 18 个月后，制备树脂-牙本质梁以进行粘结强度和 TEM 评估。用乙醇饱和牙本质制作的粘结剂随时间推移而没有变化，混合层完整性得以保留。用商用粘结剂对预处理过的酸蚀牙本质进行 CHD 水湿粘结，在 9 个月后仍得以保留，但在 18 个月后则不行，混合层严重降解。结果否定了原假设，突出了从胶原原纤维腔内仿生水替代的概念，这是延长树脂-牙本质粘结耐久性的最终目标。
