牙本质粘结系统:从牙本质胶原结构到粘结保存及临床应用。

Dentin bonding systems: From dentin collagen structure to bond preservation and clinical applications.

机构信息

Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna-Alma Mater Studiorum, Bologna, Italy.

Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna-Alma Mater Studiorum, Bologna, Italy; School of Dentistry, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.

出版信息

Dent Mater. 2018 Jan;34(1):78-96. doi: 10.1016/j.dental.2017.11.005. Epub 2017 Nov 26.

Abstract

OBJECTIVES

Efforts towards achieving durable resin-dentin bonds have been made for decades, including the understanding of the mechanisms underlying hybrid layer (HL) degradation, manufacturing of improved adhesive systems, as well as developing strategies for the preservation of the HL.

METHODS

This study critically discusses the available peer-reviewed research concerning the formation and preservation of the HL, the mechanisms that lead to the degradation of the HL as well as the strategies to prevent it.

RESULTS

The degradation of the HL occurs through two main mechanisms: the enzymatic degradation of its collagen fibrils, and the leaching of the resin from the HL. They are enabled by residual unbound water between the denuded collagen fibrils, trapped at the bottom of the HL. Consequently, endogenous dentinal enzymes, such as the matrix metalloproteinases (MMPs) and cysteine cathepsins are activated and can degrade the denuded collagen matrix. Strategies for the preservation of the HL over time have been developed, and they entail the removal of the unbound water from the gaps between the collagen fibrils as well as different modes of silencing endogenous enzymatic activity.

SIGNIFICANCE

Although there are many more hurdles to be crossed in the field of adhesive dentistry, impressive progress has been achieved so far, and the vast amount of available research on the topic is an indicator of the importance of this matter and of the great efforts of researchers and dental material companies to reach a new level in the quality and longevity of resin-dentin bonds.

摘要

目的

几十年来,人们一直在努力实现持久的树脂-牙本质粘结,包括了解混合层(HL)降解的机制、制造改进的粘结系统,以及开发保存 HL 的策略。

方法

本研究批判性地讨论了有关 HL 的形成和保存、导致 HL 降解的机制以及防止 HL 降解的策略的现有同行评议研究。

结果

HL 的降解通过两种主要机制发生:其胶原纤维的酶降解,以及 HL 中的树脂浸出。它们是由 HL 底部裸露胶原纤维之间残留的未结合水所允许的。因此,内源性牙本质酶,如基质金属蛋白酶(MMPs)和半胱氨酸组织蛋白酶被激活并可以降解裸露的胶原基质。为了长时间保存 HL,已经开发了各种策略,这些策略涉及从胶原纤维之间的间隙中去除未结合的水,以及不同模式的沉默内源性酶活性。

意义

尽管在粘结牙科领域还有许多障碍需要克服,但迄今为止已经取得了令人瞩目的进展,而且大量关于这个主题的研究表明了这个问题的重要性,以及研究人员和牙科材料公司为在树脂-牙本质粘结的质量和持久性方面达到新水平所付出的巨大努力。

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