Department of Operative Dentistry and Periodontology, University of Ulm, Germany.
J Adhes Dent. 2012 Feb;14(1):39-46. doi: 10.3290/j.jad.a21541.
To determine the effect of the polymerization mode of simplified bonding systems and the corresponding core buildup resin composite on the bond strength to dentin.
Composite core buildups were bonded to flat prepared dentin surfaces of 320 human molars using a two-step etch-and-rinse (Excite, ER) and a two-step self-etching (AdheSE, SE) bonding system. Bonding systems were used both with and without their respective self-curing activators (Excite DSC, ER+SC; AdheSE DC, SE+SC). Six curing protocols for the dual-curing composite (MultiCore Flow) were examined: self-curing for 5 min (a); irradiation with light from each aspect for 10 s (b), 20 s (c), and 40 s (d); and irradiation with light from the occlusal aspect only for 60 s (e) and 120 s (f). Shear bond strengths were measured immediately after curing. Additional measurements were performed after water storage of the specimens for 24 h at 37°C. These specimens had been cured according the curing protocols given in the manufacturer's instructions (groups a and d). Failure modes were analyzed using scanning electron microscopy.
Immediate bond strengths were significantly different among the bonding systems (p < 0.001): SE > ER > ER+SC > SE+SC. Immediate bond strengths of ER and SE were significantly lower when the composite was self-cured (p < 0.05). The use of SC activators reduced the bond strength and promoted adhesive failures to dentin. A severe incompatibility problem was observed between the composite and SE+SC.
Dentin bonding of dual-curing composite core buildups in combination with simplified bonding systems is still unsatisfactory, even when SC activators are employed. For adequate bonding to dentin, polymerization of the dual-curing composite should always be light initiated.
确定简化粘接系统的聚合模式及其相应的核构建树脂复合材料对牙本质粘结强度的影响。
使用两步酸蚀-冲洗（Excite，ER）和两步自酸蚀（AdheSE，SE）粘接系统，将复合核构建物粘结到 320 个人类磨牙的平面预备牙本质表面。粘接系统分别与各自的自固化激活剂（Excite DSC，ER+SC；AdheSE DC，SE+SC）一起使用或不使用。检查了双固化复合材料（MultiCore Flow）的六种固化方案：自固化 5 分钟（a）；从每个方向照射光 10 秒（b）、20 秒（c）和 40 秒（d）；仅从咬合面照射光 60 秒（e）和 120 秒（f）。固化后立即测量剪切粘结强度。将试件在 37°C 下储存 24 小时后进行额外测量。这些试件根据制造商说明中的固化方案进行了固化（组 a 和 d）。使用扫描电子显微镜分析失效模式。
粘接系统之间的即时粘结强度有显著差异（p < 0.001）：SE > ER > ER+SC > SE+SC。当复合材料自固化时，ER 和 SE 的即时粘结强度显著降低（p < 0.05）。使用 SC 激活剂会降低粘结强度并促进对牙本质的粘接力失效。在复合材料和 SE+SC 之间观察到严重的不相容问题。
即使使用 SC 激活剂，简化粘接系统联合双固化复合核构建物的牙本质粘结仍然不理想。为了获得对牙本质的充分粘结，双固化复合材料的聚合始终应由光引发。
