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洗必泰和乙醇湿粘结剂辅助应用对与健康牙本质和龋损牙本质粘结耐久性的影响

Adjunctive application of chlorhexidine and ethanol-wet bonding on durability of bonds to sound and caries-affected dentine.

作者信息

Ekambaram Manikandan, Yiu Cynthia Kar Yung, Matinlinna Jukka Pekka, King Nigel Martyn, Tay Franklin Russell

机构信息

Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong SAR, China.

Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong SAR, China.

出版信息

J Dent. 2014 Jun;42(6):709-19. doi: 10.1016/j.jdent.2014.04.001. Epub 2014 Apr 13.

Abstract

OBJECTIVES

To examine the effect of adjunctive application of chlorhexidine (CHX) and ethanol-wet bonding (EWB) on bond durability and nanoleakage of hydrophobic adhesive to sound (SD) and caries-affected dentine (CAD).

METHODS

Dentine surfaces of molars were etched after caries removal and randomly allocated to four groups (n=12). In Groups 1 and 2, dentine surfaces were saturated with either 2 ml of 100% ethanol or 2 ml of ethanol with 2% CHX for 60s. In Groups 3 and 4, dentine surfaces were saturated with either 15 μL of distilled water or 15 μL of distilled water with 2% CHX for 60s. Two coats of primer, followed by neat resin were applied and light-cured for 40s. Resin composite build-ups were placed and bonded specimens were sectioned for bond strength testing after 24 h and 12 months' storage in artificial saliva. Bond strength data were analyzed using 3-way ANOVA and SNK tests. Interfacial nanoleakage was evaluated after 24 h and 12 months using a field-emission scanning electron microscopy and data were analyzed using Kruskal-Wallis test.

RESULTS

Significant differences were observed for the three factors: "substrate" (p<0.001), "rewetting agents" (p<0.001) and "time" (p<0.001) on bond strength. Incorporation of 2% CHX to EWB preserved bond strength to SD and CAD and reduced interfacial nanoleakage after 12 months. Incorporation of 2% CHX to WWB also preserved bond strength to SD after ageing.

CONCLUSIONS

Incorporation of chlorhexidine to ethanol-wet bonding has an interaction effect on preservation of bond durability to sound and caries-affected dentine.

CLINICAL SIGNIFICANCE

Incorporation of chlorhexidine to ethanol-wet bonding with hydrophobic adhesive enhances the success rate of aesthetic bonded restorations.

摘要

目的

研究洗必泰(CHX)辅助应用和乙醇湿粘结(EWB)对疏水性粘结剂与健康牙本质(SD)及龋损牙本质(CAD)粘结耐久性和纳米渗漏的影响。

方法

去除龋坏组织后对磨牙牙本质表面进行酸蚀处理,并随机分为四组(n = 12)。第1组和第2组牙本质表面分别用2 ml 100%乙醇或含2% CHX的2 ml乙醇浸润60秒。第3组和第4组牙本质表面分别用15 μL蒸馏水或含2% CHX的15 μL蒸馏水浸润60秒。涂抹两层底漆,随后涂抹纯树脂并光照固化40秒。放置树脂复合体,粘结标本在人工唾液中储存24小时和12个月后切片进行粘结强度测试。粘结强度数据采用三因素方差分析和SNK检验进行分析。使用场发射扫描电子显微镜在24小时和12个月后评估界面纳米渗漏情况,数据采用Kruskal-Wallis检验进行分析。

结果

在粘结强度方面,观察到“底物”(p < 0.001)、“再湿润剂”(p < 0.001)和“时间”(p < 0.001)这三个因素存在显著差异。在EWB中加入2% CHX可保持对SD和CAD的粘结强度,并在12个月后减少界面纳米渗漏。在WWB中加入2% CHX在老化后也能保持对SD的粘结强度。

结论

在乙醇湿粘结中加入洗必泰对保持与健康及龋损牙本质的粘结耐久性具有交互作用。

临床意义

在乙醇湿粘结中加入洗必泰与疏水性粘结剂可提高美学粘结修复的成功率。

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