Moosavi Horieh, Moghaddas Mohammad Javad, Ghoddusi Jamileh, Rajabi Omid
Department of Restorative Dentistry of the School of Dentistry, Dental Material Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
J Contemp Dent Pract. 2010 Dec 1;11(6):E033-40.
The aim of this study was to compare the neutralizing effect of antioxidant agents on the microleakage of dental restorations in nonvital teeth after bleaching with carbamide peroxide. Also assessed was the correlation of the microleakage data between an electrochemical and a staining technique.
Following root canal therapy, 40 sound and similar human maxillary central incisors were randomly divided into four groups of 10 specimens each (n=10). The groups were subjected to one of four treatments: Group 1, bleaching with 10 percent carbamide peroxide for periods of eight hours per day for one week without an antioxidant agent; Group 2, bleaching with 10 percent carbamide peroxide plus 10 percent sodium ascorbate gel; Group 3, bleaching with 10 percent carbamide peroxide plus 10 percent sodium ascorbate gel combined with a surfactant; and Group 4, no bleaching treatment (control group). In all groups, the access cavities were restored using the Single Bond Plus Adhesive system and Z100 resin-based composite. After 1,000 thermal cycles, the teeth were dried and three layers of nail varnish were applied over the entire surface area to within 1.0 mm of the restoration. A PVC-covered copper wire, with 3.0 mm of exposed bare wire, was inserted apically 5.0 mm into the canal, which was obturated with gutta-percha and sealed with sticky wax and varnish at the apex. Leakage was continuously monitored for 40 days using a conductimetric method. The teeth were immersed in 0.5 percent basic fuchsine for 24 hours, followed by sectioning for microscopic examination at 16x magnification. The data were analyzed using ANOVA and the Newman-Keuls multiple comparison, Kruskal-Wallis, Mann-Whitney, and Spearman's rho tests (p<0.05).
Based on the electrochemical results, cavities subjected to 10 percent sodium ascorbate gel combined with a surfactant displayed the least amount of microleakage while teeth that were bleached but not treated with an antioxidant exhibited significantly greater microleakage (p=0.007). These findings also were corroborated by the results of the staining experiments that showed a strong correlation between the electrochemical and staining findings (p=0.006) for the groups.
After nonvital bleaching and the application of the antioxidant 10 percent sodium ascorbate, the addition of the surfactant 0.2 percent Tween 80 to the conventional antioxidant formulation significantly reduced microleakage.
The addition of a surfactant to the antioxidant formulation significantly reduced microleakage when it was applied after bleaching.
本研究旨在比较抗氧化剂对过氧脲素漂白后无髓牙修复体微渗漏的中和作用。同时评估电化学技术和染色技术所得微渗漏数据之间的相关性。
根管治疗后，40颗健康且相似的人上颌中切牙随机分为四组，每组10个样本（n = 10）。四组分别接受以下四种处理之一：第1组，每天用10%过氧脲素漂白8小时，持续一周，不使用抗氧化剂；第2组，用10%过氧脲素加10%抗坏血酸钠凝胶漂白；第3组，用10%过氧脲素加10%抗坏血酸钠凝胶并联合一种表面活性剂漂白；第4组，不进行漂白处理（对照组）。所有组均使用Single Bond Plus粘结系统和Z100树脂基复合材料修复髓腔。经过1000次热循环后，将牙齿干燥，并在修复体周围1.0 mm范围内的整个表面涂抹三层指甲油。将一根PVC包覆的铜线，露出3.0 mm的裸线，从根尖插入根管5.0 mm，根管内用牙胶尖充填，根尖处用粘蜡和清漆密封。使用电导法连续监测渗漏40天。将牙齿浸入0.5%碱性品红中24小时，然后切片，在16倍放大倍数下进行显微镜检查。使用方差分析、Newman-Keuls多重比较、Kruskal-Wallis检验、Mann-Whitney检验和Spearman秩相关检验（p < 0.05）对数据进行分析。
基于电化学结果，使用10%抗坏血酸钠凝胶并联合一种表面活性剂处理的髓腔微渗漏量最少，而仅经过漂白但未用抗氧化剂处理的牙齿微渗漏明显更多（p = 0.007）。染色实验结果也证实了这些发现，显示各实验组的电化学结果和染色结果之间存在强相关性（p = 0.006）。
无髓牙漂白并应用10%抗坏血酸钠抗氧化剂后，在传统抗氧化剂配方中添加0.2%吐温80表面活性剂可显著降低微渗漏。
漂白后应用抗氧化剂配方时添加表面活性剂可显著降低微渗漏。
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