Oper Dent. 2019 Sep/Oct;44(5):510-520. doi: 10.2341/17-252-L.
This study investigated the bonding performance of three universal adhesive systems applied using etch-and-rinse (ER) or self-etch (SE) strategies on natural dentin caries.
Sixty human third molars were selected for this study: 30 naturally carious (CAD) and 30 sound (SD) teeth. The dentin surfaces were exposed, and teeth were randomly assigned to each evaluated adhesive system: Scotchbond Universal (SBU), Futurabond U (FBU), and Prime&Bond Elect (PBE) and an adhesive strategy: ER or SE. The adhesive systems were applied following the manufacturer's instructions, and the teeth were restored using a resin composite (Filtek Supreme Ultra, 3M). After 24 hours (distilled water at 37°C), samples were sectioned and evaluated using microtensile bond strength analysis (μTBS), micro-Raman spectroscopy to evaluate the degree of conversion within the hybrid layer (DC), and scanning electronic microscopy (SEM) to describe the morphology of the hybrid layer. The μTBS and DC data were analyzed using three-way analysis of variance and Tukey's test for means comparison (α=0.05). The SEM images were analyzed qualitatively.
Reduced μTBS values were observed when comparing CAD with SD, regardless of adhesive system or strategy (<0.0001). SBU showed statistically higher μTBS for both dentin substrates and strategies (<0.0001). Furthermore, SBU showed greater integrity of the hybrid layer and resin tag formation compared with FBU and PBE. Mean μTBS values for FBU were higher for SD in the SE mode, whereas higher mean μTBS values were observed for CAD in the ER mode, both compared with PBE (<0.001).
Bonding performance is reduced on a caries-affected substrate. The ER strategy was not able to improve the bonding performance on natural CAD for universal adhesive systems. Improved bonding performance was obtained when using the Scotchbond Universal system.
本研究旨在探讨三种通用粘结剂系统在处理天然牙龋损时,采用酸蚀-冲洗(etch-and-rinse,ER)或自酸蚀(self-etch,SE)策略的粘结性能。
本研究共选取 60 颗人类第三磨牙,其中 30 颗为天然龋(caries-affected,CAD),30 颗为正常(sound,SD)牙。暴露牙本质表面后,随机将牙齿分配至每个评估的粘结系统:Scotchbond Universal(SBU)、Futurabond U(FBU)和 Prime&Bond Elect(PBE)以及粘结策略:ER 或 SE。按照制造商的说明应用粘结剂系统,使用树脂复合材料(Filtek Supreme Ultra,3M)进行牙体修复。24 小时后(37°C 蒸馏水中),将样本进行微拉伸粘结强度分析(microtensile bond strength analysis,μTBS)、微拉曼光谱评估混合层内的转化率(degree of conversion within the hybrid layer,DC)和扫描电子显微镜(scanning electronic microscopy,SEM)描述混合层的形态。采用三因素方差分析和 Tukey 检验进行 μTBS 和 DC 数据的均值比较(α=0.05)。SEM 图像进行定性分析。
与 SD 牙相比,CAD 牙的 μTBS 值降低,无论粘结系统或策略如何(<0.0001)。SBU 在两种牙本质基底和两种策略下均表现出统计学上更高的 μTBS 值(<0.0001)。此外,与 FBU 和 PBE 相比,SBU 显示混合层和树脂突形成更完整。在 SE 模式下,SD 牙的 FBU 平均 μTBS 值更高,而在 ER 模式下,CAD 牙的平均 μTBS 值更高,均高于 PBE(<0.001)。
在龋损牙本质上,粘结性能降低。通用粘结剂系统的 ER 策略无法改善天然 CAD 的粘结性能。当使用 Scotchbond Universal 系统时,可获得更好的粘结性能。