Department of Pediatric Dentistry and Orthodontics, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil.
Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, C/Santiago Ramón Y Cajal, s/n., Alfara del Patriarca, 46115, Valencia, Spain.
Clin Oral Investig. 2022 Jun;26(6):4391-4405. doi: 10.1007/s00784-022-04402-3. Epub 2022 Feb 11.
This study aimed at evaluating the microtensile bond strength (μTBS) and the resin-dentine ultramorphology (24 h and 10 months ageing) of contemporary universal adhesives applied in self-etch (SE) or etch-and-rinse (ER) mode.
Sixty-four sound human molars were collected and randomly allocated in 4 main experimental groups (n = 16) according to the adhesive system employed and subsequently divided into two subgroups depending on their application mode SE or ER (n = 8): ZipBond X (ZBX-SE; ZBX-ER), Prime and Bond Active (PBA-SE; PBA-ER), Clearfil Universal Bond Quick (CBQ-SE; CBQ-ER) or Scotchbond Universal (SCH-SE; SCH-ER). The specimens were cut into sticks with a cross-sectional area of approximately 0.9 mm and subjected to μTBS testing at 24 h or after 10 months of ageing in artificial saliva (AS). Five representative fractured specimens from each group were analysed using field-emission scanning electron microscopy (FE-SEM). Resin-dentine slabs (Ø 0.9mm) from each experimental group were immersed in Rhodamine B and subsequently analysed using confocal microscopy analysis (CLSM). The μTBS results were analysed using a two-way ANOVA and Newman-Keuls multiple-comparison test (α = 0.05).
ZBX, PBA and SCH exhibited greater μTBS values than CQB at 24 h in both SE and ER modes (p < 0.05). CQB showed a significant decrease in μTBS values after ageing both when used in SE and ER mode (p < 0.05). ZBX-ER exhibited no significant differences in the μTBS test after ageing (p > 0.05), while a significant drop in μTBS was seen in SCH-ER and APB-ER after 10-month ageing (p < 0.05). Clear signs of degradation were evident in the resin-dentine interface created with CQB regardless of the application mode or the ageing time. In APB-ER and SCH-ER groups, such signs of degradation were evident after ageing in AS. ZBX showed slight dye infiltration both when used in ER and SE mode.
The long-term bonding performance of modern universal adhesives is usually influenced by the adhesive strategy employed; self-etching application should be prioritised during dentine bonding. Moreover, the use of shortened bonding protocols may compromise the quality of the resin-dentine interface and the bonding performance of most modern universal adhesives.
The use of etch-and-rinse bonding procedures, as well as "shortened" application protocols should be eluded when using modern universal adhesives in dentine. However, new generation universal adhesives based on innovative chemical formulations may probably allow clinicians to achieve long-term bonding performance with such simplified system also when employed in ER mode.
本研究旨在评估在自酸蚀（SE）或酸蚀-冲洗（ER）模式下应用的当代通用型胶粘剂的微拉伸粘结强度（μTBS）和树脂-牙本质超微形态（24 小时和 10 个月老化）。
从 64 颗健康的人磨牙中采集样本，根据所使用的胶粘剂系统随机分为 4 个主要实验组（n=16），随后根据其应用模式 SE 或 ER 分为两个亚组（n=8）：ZipBond X（ZBX-SE；ZBX-ER）、Prime and Bond Active（PBA-SE；PBA-ER）、Clearfil Universal Bond Quick（CBQ-SE；CBQ-ER）或 Scotchbond Universal（SCH-SE；SCH-ER）。将标本切割成横截面面积约为 0.9mm 的棒状，并在 24 小时或人工唾液（AS）老化 10 个月后进行 μTBS 测试。从每组中选取 5 个具有代表性的断裂标本进行场发射扫描电子显微镜（FE-SEM）分析。从每个实验组的树脂-牙本质薄片（Ø 0.9mm）中提取 Rhodamine B，然后使用共聚焦显微镜分析（CLSM）进行分析。使用双向方差分析和 Newman-Keuls 多重比较检验（α=0.05）对 μTBS 结果进行分析。
在 SE 和 ER 模式下，ZBX、PBA 和 SCH 在 24 小时时的 μTBS 值均高于 CQB（p<0.05）。CQB 在 SE 和 ER 模式下老化后，μTBS 值均显著下降（p<0.05）。ZBX-ER 老化后的 μTBS 测试无显著差异（p>0.05），而 SCH-ER 和 PBA-ER 组在 10 个月老化后 μTBS 值明显下降（p<0.05）。在 CQB 形成的树脂-牙本质界面中，无论应用模式或老化时间如何，都可以明显看到降解迹象。在 PBA-ER 和 SCH-ER 组中，AS 老化后也可以明显看到这种降解迹象。ZBX 在 ER 和 SE 模式下使用时，染料渗透现象轻微。
现代通用型胶粘剂的长期粘结性能通常受所采用的粘结策略影响；在牙本质粘结时，应优先采用自酸蚀应用。此外，缩短粘结方案可能会影响大多数现代通用型胶粘剂的树脂-牙本质界面质量和粘结性能。
在牙本质中使用现代通用型胶粘剂时，应避免使用酸蚀-冲洗粘结程序和“缩短”应用方案。然而，基于创新化学配方的新一代通用型胶粘剂可能允许临床医生在 ER 模式下使用这种简化系统也能实现长期粘结性能。
