Wang Y, Liang Y H
Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2017 Feb 18;49(1):105-9.
To evaluate the influence of sodium hypochlorite (NaOCl) solution used during root canal therapy on dentin bond strength.
In the study, 15 freshly extracted human third molars with complete dental crowns, caries and filling-free were selected. The occlusal enamel was removed perpendicular to the long axis of the tooth to expose middle flat surfaces of sound dentin. The occlusal dentin surfaces were then polished using 600-grit silicon papers for 1 min and rinsed with deionized water for 1 min. The teeth were randomly divided into three groups according to the treatment received: group A (negative control group), the samples were immersed in deionized water for 20 min; group B, the dentin surfaces were immersed in 2.50% NaOCl solution for 20 min, with the solution being renewed every 5 min; group C, the dentin surfaces were immersed in 5.25% NaOCl solution for 20 min, with the solution being renewed every 5 min. All the treated dentin surfaces were bonded using a self-etching adhesive system (SE bond) with a 5 mm in height resin composite (AP-X). After storage in deionized water at 37 °C for 24 h, the adhesive samples were sectioned longitudinally to produce 1.0 mm×1.0 mm stick specimens(n=45) for micro-tensile bond strength testing (MPa). Failure modes (adhesive failure, cohesive failure or mixed failure) at the dentin-resin interface were observed using a stereomicroscope. The micro-tensile bond strength data among the three groups were analyzed by a one-way ANOVA, then the Post-hoc test(LSD) was employed for pairwise comparison. The distribution of failure modes among the groups were analyzed by chi-square test.
Significant decreased bond strength values were found for the 2.50% NaOCl-treated group (26.04±5.74) MPa and 5.25% NaOCl-treated group (24.46±3.77) MPa when compared with the strength of negative control group (48.71±7.77) MPa,P=0.000. Compared with the negative control group, themicro-tensile bond strength of the 2.50% NaOCl-treated group and 5.25% NaOCl-treated grouphad dropped by 46.5% and 50.2%. However, there was no significant difference of bond strength between the 2 NaOCl-treated groups (P=0.214). The distribution of failure modes showed significant difference in all the three groups (2=56.324, P=0.000). The mixed failure (68.9%) was the most mode of fracture in the negative control group, followed by adhesive failure(24.4%), and the cohesive failure was least(6.7%). The proportion of adhesive failure mode was higher in NaOCl-treated groups than in negative control group (P=0.000). There was no significant difference of the distribution of failure modes between the 2.50% NaOCl-treated group and 5.25% NaOCl-treated group(P=0.197), and there was no cohesive failure mode detected in the two groups.
The micro-tensile bond strength of dentin to composite resin was lower after exposure to NaOCl solution.
评估根管治疗期间使用的次氯酸钠(NaOCl)溶液对牙本质粘结强度的影响。
本研究选取15颗新鲜拔除的、牙冠完整、无龋坏和充填物的人类第三磨牙。垂直于牙长轴去除咬合面釉质,以暴露健康牙本质的中间平面。然后用600目砂纸对咬合面牙本质表面进行1分钟的打磨,并用去离子水冲洗1分钟。根据接受的治疗将牙齿随机分为三组:A组(阴性对照组),样本浸入去离子水中20分钟;B组,牙本质表面浸入2.50%的NaOCl溶液中20分钟,每5分钟更换一次溶液;C组,牙本质表面浸入5.25%的NaOCl溶液中20分钟,每5分钟更换一次溶液。所有处理过的牙本质表面均使用自酸蚀粘结系统(SE bond)和高度为5mm的树脂复合材料(AP-X)进行粘结。在37℃的去离子水中储存24小时后,将粘结样本纵向切片,制成1.0mm×1.0mm的柱状标本(n = 45),用于微拉伸粘结强度测试(MPa)。使用体视显微镜观察牙本质-树脂界面的失效模式(粘结失效、内聚失效或混合失效)。对三组之间的微拉伸粘结强度数据进行单因素方差分析,然后采用事后检验(LSD)进行两两比较。通过卡方检验分析各组失效模式的分布情况。
与阴性对照组(48.71±7.77)MPa的强度相比,2.50% NaOCl处理组(26.04±5.74)MPa和5.25% NaOCl处理组(24.46±3.77)MPa的粘结强度值显著降低,P = 0.000。与阴性对照组相比,2.50% NaOCl处理组和5.25% NaOCl处理组的微拉伸粘结强度分别下降了46.5%和50.2%。然而,两个NaOCl处理组之间的粘结强度没有显著差异(P = (此处原文有误,推测应为P = 0.214))。失效模式的分布在所有三组中显示出显著差异(χ² = 56.324,P = 0.000)。混合失效(68.9%)是阴性对照组中最主要的断裂模式,其次是粘结失效(24.4%),内聚失效最少(6.7%)。NaOCl处理组中粘结失效模式的比例高于阴性对照组(P = 0.000)。2.50% NaOCl处理组和5.25% NaOCl处理组之间的失效模式分布没有显著差异(P = 0.197),且两组均未检测到内聚失效模式。
暴露于NaOCl溶液后,牙本质与复合树脂的微拉伸粘结强度降低。