Department of Operative Dentistry, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
J Esthet Restor Dent. 2021 Mar;33(2):371-379. doi: 10.1111/jerd.12613. Epub 2020 Jun 29.
Teeth bleaching causes an immediate decrease in resin composite bonding ability. This study aimed to investigate the influence of various antioxidants on resin composite bond strength to bleached enamel.
One hundred and ten human maxillary incisors were used. A negative control (group A) (n = 10) was assigned (no bleaching-no antioxidant). The remaining teeth were divided into two groups (n = 50) according to the bleaching agent used: group B (40% hydrogen peroxide) and group C (35% carbamide peroxide). Both groups were subdivided into five subgroups (n = 10). A positive control subgroup (no antioxidant) and other four subgroups according to the antioxidant solution used (10% sodium ascorbate, 10% grape seed extract, 10% green tea extract, and 5% alpha-lipoic acid). After resin composite building, the micro-shear bond strength test was performed. Fracture analysis was examined using a stereomicroscope. Statistical analysis was performed using a two-way analysis of variance and Tukey's HSD post hoc test.
Bond strength significantly decreased after bleaching and there was no significant difference between bleaching agents (P < .0848). Except for alpha-lipoic acid subgroups, the other antioxidants subgroups revealed significantly higher bond strengths than bleached control subgroups (P < .0001).
All antioxidants used except alpha-lipoic acid were effective in the reversal of compromised bonding after bleaching.
Immediate bonding procedures after bleaching are requisite when bleaching fails to treat teeth discoloration and the direct composite veneer is considered, also when shades of old composite restorations become mismatched after bleaching and should be replaced. Immediate reestablishment of resin bond strengths after bleaching can be achieved by using several antioxidants without the need for delay.
牙齿漂白会导致树脂复合粘接能力立即下降。本研究旨在探讨各种抗氧化剂对漂白牙釉质后树脂复合粘接强度的影响。
使用 110 个人上颌切牙。阴性对照组（A 组）（n = 10）不进行漂白也不使用抗氧化剂。其余牙齿根据使用的漂白剂分为两组（n = 50）：B 组（40%过氧化氢）和 C 组（35%过氧化脲）。两组均进一步分为五个亚组（n = 10）。根据使用的抗氧化剂溶液，其中一个亚组（无抗氧化剂）作为阳性对照组，其余四个亚组分别为 10%抗坏血酸钠、10%葡萄籽提取物、10%绿茶提取物和 5%α-硫辛酸。完成树脂复合体构建后，进行微剪切粘接强度测试。使用立体显微镜检查断裂分析。使用双因素方差分析和 Tukey 的 HSD 事后检验进行统计分析。
漂白后粘接强度显著降低，两种漂白剂之间无显著差异（P<.0848）。除α-硫辛酸亚组外，其他抗氧化剂亚组的粘接强度均显著高于漂白对照组亚组（P<.0001）。
除α-硫辛酸外，所用的所有抗氧化剂在漂白后都能有效逆转粘接受损。
当漂白未能治疗牙齿变色且考虑直接复合贴面，或者当旧复合修复体的颜色在漂白后不匹配且需要更换时，漂白后需要进行即刻粘接程序。通过使用几种抗氧化剂，可以在不需要延迟的情况下，在漂白后立即恢复树脂的粘接强度。
