Oper Dent. 2019 Nov/Dec;44(6):E289-E298. doi: 10.2341/18-052-L. Epub 2019 May 14.
This study evaluated the microtensile bond strength (μTBS) of resin-based composite (RBC) to dentin after different immediate dentin sealing (IDS) strategies and surface-conditioning (SC) methods and on two water storage times. Human molars (n=48) were randomly divided into eight experimental groups involving four different IDS strategies-IDS-1L with one layer of adhesive, IDS-2L with two layers of adhesive, IDS-F with one layer of adhesive and one layer of flowable RBC, and DDS (delayed dentin sealing) with no layer of adhesive (control)-and two different SC methods-SC-P with pumice rubbing and SC-PC with pumice rubbing followed by tribochemical silica coating. The μTBS test was performed after one week and after six months of water storage, being recorded as the "immediate" and "aged" μTBS, respectively. Composite-adhesive-dentin microspecimens (0.9×0.9×8-9 mm) were stressed in tension until failure to determine the μTBS. Failure mode and location of failure were categorized. Two-way analysis of variance was applied to analyze the data for statistically significant differences between the experimental groups (<0.05). Two-way analysis of variance revealed no significant differences between the one-week μTBS specimens for IDS strategy (=0.087) and SC methods (=0.806). However, the interaction of IDS strategy and SC methods appeared statistically significant (=0.016). The six-month specimen evaluation showed no significant difference in μTBS for SC (=0.297) and SC/IDS interaction (=0.055), but the μTBS of the IDS strategies differed significantly among them (=0.003). For tribochemical silica-coated IDS, no significant effect of aging on μTBS was recorded (=0.465), but there was a highly significant difference in μTBS depending on the IDS strategy (<0.001). In addition, the interaction of IDS and aging was borderline statistically significant (=0.045). The specimens failed mainly at the adhesive-dentin interface for all experimental groups. Dentin exposure during clinical procedures for indirect restorations benefits from the application of IDS, which was shown to result in higher bond strength. No significant differences were found between cleaning with solely pumice or pumice followed by tribochemical silica coating.
本研究评估了不同即刻牙本质封闭（IDS）策略和表面处理（SC）方法以及两种水储存时间对牙本质的树脂基复合材料（RBC）的微拉伸结合强度（μTBS）。将 48 个人类磨牙随机分为 8 个实验组，涉及四种不同的 IDS 策略：用一层黏合剂的 IDS-1L、用两层黏合剂的 IDS-2L、用一层黏合剂和一层可流动 RBC 的 IDS-F，以及没有用黏合剂的 DDS（延迟牙本质封闭）（对照组），和两种不同的 SC 方法：用浮石摩擦的 SC-P 和用浮石摩擦后进行摩擦化学硅烷涂层的 SC-PC。在一周和六个月的水储存后进行 μTBS 测试，分别记录为“即刻”和“老化”μTBS。将复合-黏合剂-牙本质微样本（0.9×0.9×8-9mm）在张力下受力直至失效，以确定 μTBS。对失效模式和失效位置进行分类。采用双因素方差分析对实验数据进行分析，以检验实验之间的差异（<0.05）。双因素方差分析显示，IDS 策略（=0.087）和 SC 方法（=0.806）在一周时的 μTBS 标本之间无显著差异。然而，IDS 策略和 SC 方法之间的相互作用具有统计学意义（=0.016）。六个月时的标本评估显示，SC（=0.297）和 SC/IDS 相互作用（=0.055）的 μTBS 无显著差异，但 IDS 策略之间的 μTBS 有显著差异（=0.003）。对于经摩擦化学硅烷涂层的 IDS，老化对 μTBS 没有显著影响（=0.465），但 IDS 策略的 μTBS 有显著差异（<0.001）。此外，IDS 和老化的相互作用具有边缘统计学意义（=0.045）。所有实验组的样本主要在黏合剂-牙本质界面处失效。在间接修复体的临床操作过程中，牙本质暴露会受益于 IDS 的应用，因为它可以提高黏合强度。单独用浮石清洁或用浮石清洁后再用摩擦化学硅烷涂层处理之间没有发现显著差异。
