Oper Dent. 2017 Nov/Dec;42(6):E188-E196. doi: 10.2341/16-178-L.
The aim of this study was to evaluate the effect of proteolytic inhibitors on the bond strength of a universal adhesive system (etch-and-rinse mode) applied to artificial carious and eroded dentin.
Ninety molars were prepared and randomly divided into three groups according to the substrate: N, no challenges; ACD, artificial carious dentin simulation and ERO, artificial erosion simulation with orange juice. All groups were redivided into three subgroups according to the dentin pretreatment: W, water; CHX, 2% digluconate chlorhexidine; and E-64 (trans-epoxysuccinyl-L-leucylamido-[4-guanidino] butane), 5 μM E-64 inhibitor. They constituted a total of nine groups (n=10): N-W, N-CHX, N-E64, ACD-W, ACD-CHX, ACD-E64, ERO-W, ERO-CHX, and ERO-E64. All specimens were restored with Adper Single Bond Universal/Filtek Z250. Beams (0.64 mm) were obtained and subjected to the microtensile test (μTBS) in a universal testing machine at 0.5 mm/min. The failure mode of the interfaces was determined by optical microscopy (40× magnification). Data were statistically analyzed by three-way analysis of variance and Tukey tests (p<0.05).
All individual factors (p<0.0001) and the interaction between substrate and treatment (p=0.0011) and between substrate and time (p=0.0003) were statistically significant. The caries substrate contributed negatively to bond strength. Chlorhexidine reduced bond strength for normal and eroded conditions. Only the normal substrate was negatively affected by time despite the pretreatment.
The universal bonding system appears to be a promising bonding strategy for the maintenance of bond strength to affected dentin. E-64 did not affect bonding to the dentin in contrast to the use of chlorhexidine, which, when associated with the universal system, did affect the microtensile bond strength for artificial carious dentin.
本研究旨在评估蛋白酶抑制剂对通用粘结剂系统（酸蚀冲洗模式）在人工龋和酸蚀牙本质粘结强度的影响。
将 90 颗磨牙制备并随机分为三组，根据基底分为：N，无挑战；ACD，人工龋模拟；ERO，橙汁酸蚀模拟。所有组根据牙本质预处理进一步分为三组：W，水；CHX，2%葡萄糖酸氯己定；E-64（反式-环氧琥珀酰基-L-亮氨酰氨基-[4-胍基]丁烷），5μM E-64 抑制剂。共分为 9 组（n=10）：N-W、N-CHX、N-E64、ACD-W、ACD-CHX、ACD-E64、ERO-W、ERO-CHX 和 ERO-E64。所有标本均用 Adper Single Bond Universal/Filtek Z250 进行修复。在万能试验机上以 0.5mm/min 的速度获得 0.64mm 的梁，并进行微拉伸试验（μTBS）。通过光学显微镜（40×放大倍数）确定界面的失效模式。数据采用三因素方差分析和 Tukey 检验进行统计学分析（p<0.05）。
所有个体因素（p<0.0001）、基底与处理之间的相互作用（p=0.0011）以及基底与时间之间的相互作用（p=0.0003）均具有统计学意义。龋病基底对粘结强度有负面影响。氯己定降低了正常和酸蚀条件下的粘结强度。尽管预处理，但只有正常基底受到时间的负面影响。
通用粘结系统似乎是一种有前途的粘结策略，可维持受影响牙本质的粘结强度。E-64 对牙本质的粘结强度没有影响，而氯己定则没有，当与通用系统联合使用时，会影响人工龋牙本质的微拉伸粘结强度。
