Kearns Jennifer O, Barry John G, Fleming Garry J P
Materials Science Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Lincoln Place, Trinity College Dublin, Dublin 2, Ireland.
Materials Science Unit, Division of Oral Biosciences, Dublin Dental University Hospital, Lincoln Place, Trinity College Dublin, Dublin 2, Ireland.
J Dent. 2014 Aug;42(8):970-6. doi: 10.1016/j.jdent.2014.05.013. Epub 2014 Jun 3.
To assess the adhesive performance of three universal bonding systems (self-etch and total-etch protocols) with cuspal deflection and cervical microleakage score.
Fifty-six standardised sound maxillary premolar teeth with uniform mesio-occlusal-distal (MOD) cavities were randomly allocated to six groups. Restoration with resin-based composite (RBC) was performed in conjunction with a universal bonding system facilitated by a quartz-tungsten-halogen light-curing-unit. The dependent variable was the universal bonding protocol (self-etch or total-etch). Buccal and palatal cuspal deflections were recorded at 0, 30, 60 and 180s post-irradiation using a twin channel deflection measuring gauge. Following restoration, the teeth subjected to 500 thermocycles, immersed in a 0.2% basic fuchsin dye for 24h, sectioned and examined for cervical microleakage.
Comparing between bonding protocol (self-etch or total-etch), a decrease in total cuspal deflection and a concomitant increase in cervical microleakage were evident when employing the total-etch compared with the self-etch protocol for two of the three universal dental adhesives.
The 'Adhesion-Decalcification concept' suggests a trend towards 'mild self-etch' adhesives. Differences in adhesive performance (cuspal deflection and cervical microleakage) between the teeth restored using the self-etch or total-etch protocols is suggested to be a result of the pH of the self-etch solutions. 'Mild self-etch' (pH∼2.0) adhesives out-performed ultra-mild (pH>2.5) or strong (pH<1.5) self-etch solutions.
Poorly performing adhesives could be identified using the cuspal deflection and cervical microleakage protocol reported which could save the complications encountered clinically with Class II RBC restorations.
通过尖牙偏移和颈部微渗漏评分评估三种通用粘结系统（自酸蚀和全酸蚀方案）的粘结性能。
将56颗具有均匀近中-咬合-远中（MOD）洞型的标准化完好上颌前磨牙随机分为六组。使用基于树脂的复合材料（RBC）进行修复，并结合由石英-钨-卤素光固化单元辅助的通用粘结系统。因变量是通用粘结方案（自酸蚀或全酸蚀）。使用双通道偏移测量仪在照射后0、30、60和180秒记录颊侧和腭侧尖牙偏移。修复后，对牙齿进行500次热循环，浸入0.2%碱性品红染料中24小时，切片并检查颈部微渗漏。
在三种通用牙科粘结剂中的两种中，与自酸蚀方案相比，采用全酸蚀方案时，总尖牙偏移减少，颈部微渗漏随之增加。
“粘结-脱钙概念”表明有向“轻度自酸蚀”粘结剂发展的趋势。使用自酸蚀或全酸蚀方案修复的牙齿之间粘结性能（尖牙偏移和颈部微渗漏）的差异被认为是自酸蚀溶液pH值的结果。“轻度自酸蚀”（pH约为2.0）粘结剂的性能优于超轻度（pH>2.5）或强（pH<1.5）自酸蚀溶液。
使用所报道的尖牙偏移和颈部微渗漏方案可以识别性能不佳的粘结剂，这可以避免临床上II类RBC修复中遇到的并发症。
