Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, 34-Hospital Road, Sai Ying Pun, Hong Kong, China.
School of Dentistry, The University of Western Australia, 17-Monash Avenue, Nedlands, Western Australia 6009, Australia.
J Dent. 2017 Dec;67:94-101. doi: 10.1016/j.jdent.2017.10.004. Epub 2017 Oct 12.
To compare bonding of dental adhesive to hypomineralized enamel (HE) after pre-treatment with either 5% sodium hypochlorite (NaOCl) solution or papain-based papacarie gel.
Normal enamel (NE) and HE obtained from hypomineralized first permanent molars were acid-etched with 32% phosphoric acid and randomly allocated into no deproteinization, deproteinization using 5% NaOCl, or deproteinization usping papacarie gel groups. Subsequently, the specimens were bonded, packed with composite resins and subjected to micro-shear bond strength (MSBS) testing and the data analysed using 2-way ANOVA and Tukey tests. Furthermore, specimens from all groups were subjected for qualitative analysis using scanning electron microscope.
Two way-ANOVA showed that the factor "enamel substrate" was significant (p<0.001), "enamel pre-treatment" was not significant and interaction of the two factors was significant (p=0.005). HE produced inferior bonding with dental adhesive compared to NE. Enamel pre-treatment with deproteinization agents enhanced bonding to HE. No significant difference in MSBS was evident between the two deproteinization agents (p>0.05). Qualitative analysis of acid-etched moderate HE showed barely visible enamel rods with irregular etching pattern. Following acid etching and deproteinization, Type I and II etching patterns were observed in moderate HE; while a porous enamel surface with more profound etching patterns in severe HE.
Papain-based papacarie could be an alternative deproteinization agent for bonding dental adhesive to HE.
Papain-based papacarie, a natural deproteinization agent and a proven chemo-mechanical caries removal agent could be an alternative to NaOCl for enhancement of bond durability of adhesive restorations to HE.
比较经 5%次氯酸钠（NaOCl）溶液或木瓜蛋白酶基 Papacarie 凝胶预处理后，牙本质黏结剂对低矿化牙本质（HE）的黏结效果。
从低矿化第一恒磨牙中获得正常牙釉质（NE）和 HE，用 32%磷酸酸蚀，并随机分为无脱蛋白组、5%NaOCl 脱蛋白组和 Papacarie 凝胶脱蛋白组。随后，对标本进行黏结，用复合树脂填充，进行微剪切结合强度（MSBS）测试，并采用双因素方差分析和 Tukey 检验对数据进行分析。此外，对所有组别的标本进行扫描电子显微镜定性分析。
双因素方差分析显示，“牙釉质底物”因子具有统计学意义（p<0.001），“牙釉质预处理”因子无统计学意义，两者的相互作用具有统计学意义（p=0.005）。HE 与牙本质黏结剂的黏结效果明显劣于 NE。用脱蛋白剂对牙釉质进行预处理可增强对 HE 的黏结效果。两种脱蛋白剂之间的 MSBS 无显著差异（p>0.05）。对中度 HE 酸蚀后的定性分析显示，牙釉质可见几乎不可见的釉柱，其酸蚀模式不规则。酸蚀和脱蛋白后，在中度 HE 中观察到 I 型和 II 型酸蚀模式；而在严重 HE 中，牙釉质表面呈多孔状，酸蚀模式更深。
基于木瓜蛋白酶的 Papacarie 可作为黏结牙本质黏结剂到 HE 的替代脱蛋白剂。
基于木瓜蛋白酶的 Papacarie 是一种天然的脱蛋白剂，也是一种已被证实的化学机械性龋损去除剂，可替代 NaOCl，增强黏结修复剂对 HE 的黏结耐久性。
