牙本质表面预处理对牙釉质粘结和氯己定预处理对牙本质粘结的影响。

Department of Stomatology, Zhejiang University, Hangzhou, China.

J Adhes Dent. 2013 Aug;15(4):351-9. doi: 10.3290/j.jad.a29582.

PURPOSE

To evaluate the influence of peripheral enamel bonding, chlorhexidine digluconate (CHX) pretreatment, and storage time on resin-dentin microtensile bond strength (µTBS) of a self-etching adhesive system and selfetching cement.

MATERIALS AND METHODS

Fifty-six noncarious human third molars were coronally sectioned to provide a flat dentin surface; the circumferential enamel was removed from half of these and the other half was left intact. Pretreatment with 0.2% or 2% CHX or none (control) was performed before bonding composite blocks with Panavia F2.0 or RelyX Unicem to dentin. Specimens were stored in 0.5% chloramine for 3 days (control) or 6 months. Bonded specimens were sectioned into 1-mm2 dentin-only beams and a tensile load was applied until failure. The resulting 14 test groups, defined by control group/storage time/cement/CHX application mode/enamel bonding, were analyzed using two-way and three-way ANOVA, as well as Tukey's HSD post-hoc test (α = 0.05). Failure patterns of the specimens were observed and measured using scanning electron microscopy.

RESULTS

The comparison of the control vs experimental subgroups with peripheral enamel bonding and without CHX pretreatment after six months found no significant differences regarding the µTBS between the cements (p > 0.05) but did for the storage time (p <= 0.05). When storing the specimens for six months, the absence of peripheral enamel bonding significantly decreased the µTBS (p <= 0.05). Panavia F2.0 specimens showed significantly higher µTBS values than RelyX Unicem specimens (p <= 0.05). CHX pretreatment, regardless the concentration, showed a significant influence on the µTBS (p <= 0.05). SEM revealed that peripheral enamel bonding reduced failures at the resin/dentin interface.

CONCLUSIONS

The absence of peripheral enamel bonding and a longer storage time decrease the µTBS of twostep self-etching adhesive system and a one-step self-etching cement. CHX pretreatment of the dentinal surfaces seems to improve the durability of the bond to dentin.

目的

评估边缘牙釉质粘结、洗必泰葡萄糖酸（CHX）预处理和储存时间对自酸蚀粘结系统和自酸蚀粘结剂的树脂-牙本质微拉伸粘结强度（µTBS）的影响。

材料与方法

56 颗无龋人第三磨牙被冠状面切割，以提供一个平坦的牙本质表面；其中一半的牙釉质被去除，另一半则保持完整。在使用 Panavia F2.0 或 RelyX Unicem 将复合块粘结到牙本质之前，用 0.2%或 2%的 CHX 或不处理（对照）进行预处理。对照组/储存时间/粘结剂/CHX 应用模式/牙釉质粘结），采用双因素和三因素方差分析，以及 Tukey 的 HSD 事后检验（α=0.05）。使用扫描电子显微镜观察和测量试件的失效模式。

结果

对有边缘牙釉质粘结和无 CHX 预处理的对照组与实验组在 6 个月时的比较发现，两种粘结剂之间的 µTBS 没有显著差异（p＞0.05），但储存时间有显著差异（p≤0.05）。当将试件储存 6 个月时，没有边缘牙釉质粘结显著降低了 µTBS（p≤0.05）。Panavia F2.0 试件的 µTBS 值明显高于 RelyX Unicem 试件（p≤0.05）。CHX 预处理，无论浓度如何，对 µTBS 都有显著影响（p≤0.05）。SEM 显示，边缘牙釉质粘结减少了树脂/牙本质界面的失效。