Pithon Matheus Melo, Campos Matheus Souza, Coqueiro Raildo da Silva
Aust Orthod J. 2016 May;32(1):23-30.
To test the hypothesis that enamel surface deproteinisation with different concentrations of bromelain in association with 10% papain increases the shear bond strength (SBS) of brackets bonded with orthodontic composite and resin modified glass ionomer cement (RMGIC).
Orthodontic brackets were attached according to the following protocols to 195 bovine incisors, which were acquired and divided into 13 groups: 1) Transbond XT (TXT) according to the manufacturer's recommendations; 2) Deproteinisation with 3% bromelain (BD) plus 10% papain and TXT; 3) 6% BD plus 10% Papain and TXT; 4) RMGIC, without enamel deproteinisation and without acid etching; 5) RMGIC, with 3% BD plus 10% papain and without acid etching; 6) RMGIC, with 6% BD plus 10% papain and without acid etching; 7) attachment using RMGIC following etching with polyacrylic acid; 8) 3% BD plus 10% papain, attachment using RMGIC and etching with polyacrylic acid; 9) 6% BD plus 10% papain, and attachment using RMGIC following etching with polyacrylic acid; 10) etching with 37% phosphoric acid and attachment using RMGIC; 11) 3% BD plus 10% papain, etching with 37% phosphoric acid and attachment using RMGIC; 12) 6% BD plus 10% papain, etching with 37% phosphoric acid and attachment using RMGIC; 13) deproteinisation with 2.5% sodium hypochlorite (NaOCl), etching with polyacrylic acid and RMGIC. After bonding, the brackets were removed by a universal mechanical testing machine, which recorded shear bond strength at failure. The material remaining on the tooth was assessed using the adhesive remnant index (ARI).
Deproteinisation with 3% and 6% bromelain gel plus papain significantly increased the shear bond strength (p < 0.05), when acid etching was performed with phosphoric acid, followed by primer application and attachment using Transbond XT (Group 3) and when attached with RMGIC without etching. Deproteinisation with 6% bromelain gel plus papain significantly increased (p < 0.05) the ARI score only when attachment was performed using RMGIC, without etching (Group 6).
Deproteinisation with bromelain associated with papain in a gel increased the shear bond strength and is recommended before orthodontic bracket attachment.
验证以下假设，即使用不同浓度的菠萝蛋白酶联合10%木瓜蛋白酶进行牙釉质表面脱蛋白处理，可提高用正畸复合树脂和树脂改良玻璃离子水门汀（RMGIC）粘结的托槽的剪切粘结强度（SBS）。
按照以下方案将正畸托槽粘结到195颗牛切牙上，这些牛切牙购得后分为13组：1）按照制造商的建议使用Transbond XT（TXT）；2）用3%菠萝蛋白酶（BD）加10%木瓜蛋白酶进行脱蛋白处理后使用TXT；3）6% BD加10%木瓜蛋白酶后使用TXT；4）使用RMGIC，不进行牙釉质脱蛋白处理且不进行酸蚀；5）使用3% BD加10%木瓜蛋白酶进行脱蛋白处理后使用RMGIC，不进行酸蚀；6）使用6% BD加10%木瓜蛋白酶进行脱蛋白处理后使用RMGIC，不进行酸蚀；7）用聚丙烯酸蚀刻后使用RMGIC进行粘结；8）3% BD加10%木瓜蛋白酶，用聚丙烯酸蚀刻后使用RMGIC进行粘结；9）6% BD加10%木瓜蛋白酶，用聚丙烯酸蚀刻后使用RMGIC进行粘结；10）用37%磷酸蚀刻后使用RMGIC进行粘结；11）3% BD加10%木瓜蛋白酶，用37%磷酸蚀刻后使用RMGIC进行粘结；12）6% BD加10%木瓜蛋白酶，用37%磷酸蚀刻后使用RMGIC进行粘结；13）用2.5%次氯酸钠（NaOCl）进行脱蛋白处理，用聚丙烯酸蚀刻后使用RMGIC。粘结后，用万能机械试验机拆除托槽，记录失效时的剪切粘结强度。使用粘结剂残留指数（ARI）评估牙齿上残留的材料。
当用磷酸进行酸蚀，随后涂抹底漆并使用Transbond XT进行粘结时（第3组），以及在不进行蚀刻的情况下使用RMGIC进行粘结时，用3%和6%菠萝蛋白酶凝胶加木瓜蛋白酶进行脱蛋白处理可显著提高剪切粘结强度（p < 0.05）。仅在不进行蚀刻的情况下使用RMGIC进行粘结时（第6组），用6%菠萝蛋白酶凝胶加木瓜蛋白酶进行脱蛋白处理可显著提高（p < 0.05）ARI评分。
凝胶状菠萝蛋白酶联合木瓜蛋白酶进行脱蛋白处理可提高剪切粘结强度，建议在正畸托槽粘结前使用。
