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黏接牙科:当前概念与临床关注点。

Adhesive dentistry: Current concepts and clinical considerations.

机构信息

Department of Restorative Sciences, Division of Operative Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.

Department of Comprehensive Care, School of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

出版信息

J Esthet Restor Dent. 2021 Jan;33(1):51-68. doi: 10.1111/jerd.12692. Epub 2020 Dec 2.

Abstract

OBJECTIVES

To address contemporary concepts in adhesive dental materials with emphasis on the evidence behind their clinical use.

OVERVIEW

Adhesive dentistry has undergone major transformations within the last 20 years. New dental adhesives and composite resins have been launched with special focus on their user-friendliness by reducing the number of components and/or clinical steps. The latest examples are universal adhesives and universal composite resins. While clinicians prefer multipurpose materials with shorter application times, the simplification of clinical procedures does not always result in the best clinical outcomes. This review summarizes the current evidence on adhesive restorative materials with focus on universal adhesives and universal composite resins.

CONCLUSIONS

(a) Although the clinical behavior of universal adhesives has exceeded expectations, dentists still need to etch enamel to achieve durable restorations; (b) there is no clinical evidence to back some of the popular adjunct techniques used with dental adhesives, including glutaraldehyde-based desensitizers and matrix metalloproteinase inhibitors; and (c) the color adaptation potential of new universal composite resins has simplified their clinical application by combining multiple shades without using different translucencies of the same shade.

CLINICAL SIGNIFICANCE

New adhesive restorative materials are easier to use than their predecessors, while providing excellent clinical outcomes without compromising the esthetic quality of the restorations.

摘要

目的

重点介绍黏接性牙科材料的当代概念及其临床应用背后的证据。

概述

在过去的 20 年中,黏接性牙科发生了重大变革。新型牙科黏接剂和复合树脂问世,特别注重其易用性,减少了组件和/或临床步骤的数量。最新的例子是通用黏接剂和通用复合树脂。虽然临床医生更喜欢具有更短应用时间的多用途材料,但临床操作的简化并不总是能带来最佳的临床效果。本综述总结了黏接性修复材料的最新证据,重点关注通用黏接剂和通用复合树脂。

结论

(a) 尽管通用黏接剂的临床性能超出预期,但牙医仍需要酸蚀釉质以实现持久的修复;(b) 一些与牙科黏接剂一起使用的流行辅助技术(包括基于戊二醛的脱敏剂和基质金属蛋白酶抑制剂)缺乏临床证据支持;(c) 新型通用复合树脂的颜色适应潜力通过将多种色调组合在一起而无需使用同一色调的不同半透明度,简化了其临床应用。

临床意义

新型黏接性修复材料比其前代产品更易于使用,同时在不影响修复体美观质量的前提下提供了出色的临床效果。

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