Cascales Álvaro Ferrando, Moscardó Agustín Pascual, Toledano Manuel, Banerjee Avijit, Sauro Salvatore
Faculty of Health Sciences. San Antonio de Murcia Catholic University (UCAM), Murcia, Spain; Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.
J Dent. 2022 Apr;119:104075. doi: 10.1016/j.jdent.2022.104075. Epub 2022 Feb 26.
The aim of this study was to evaluate the bonding performance after 1 year storage of an experimental dental adhesive containing analogues of phosphoproteins and fluoride-doped bioglass (EXP), applied in self-etching (SE) or etch & rinse (ER) mode, to caries-affected dentine after selective caries removal.
Fifty human molars with dentine carious lesions were excavated selectively using Carisolv gel and then connected to simulated pulpal pressure system. Teeth were divided randomly into five groups based on the tested materials: EXP-SE, EXP-ER, a resin-modified glass-ionomer cement (RMGIC), a three-step adhesive system (OPT) and a universal adhesive applied in SE mode (UA-SE). The specimens were submitted to different analytical tests (μTBS, SEM fractographic analysis and dye-enhanced confocal microscopy) at baseline (T0) and after 1 year (T1).
At T0 there was no difference in bond strength between the tested materials (p>0.05). At T1, EXP-SE and EXP-ER were the only materials to show no significant reduction in bond strength (p<0.05). The SEM showed a clear presence of minerals deposited on the dentine surface after bonding in the EXP-SE and EXP-ER groups. The specimens restored with RMGIC showed no exposure of the dentine surface after failure. The OPT and UA-SE specimens showed clear signs of degradation at the interface. Confocal microscopy imaged mineral precipitation at the interface of the EXP groups.
Conventional adhesives may have inadequate bonding performance with evident degradation at the dentine-bonded interface over time. Although the RMGIC may present a drop in bond strength after prolonged storage, the bonding interface may result less affected by degradation over time. Innovative ion-releasing adhesives may remineralise the caries-affected dentine and achieve a stable bond over time.
GIC-based materials may represent an appropriate dentine replacement material after selective chemo-mechanical caries removal rather than conventional adhesive systems.
本研究旨在评估一种含有磷蛋白类似物和氟掺杂生物玻璃的实验性牙科粘合剂（EXP），在选择性龋损去除后，以自酸蚀（SE）或酸蚀冲洗（ER）模式应用于龋损牙本质，储存1年后的粘结性能。
使用Carisolv凝胶选择性地去除50颗患有牙本质龋损的人类磨牙的龋坏组织，然后连接到模拟牙髓压力系统。根据测试材料将牙齿随机分为五组：EXP-SE、EXP-ER、树脂改性玻璃离子水门汀（RMGIC）、三步粘结系统（OPT）和以SE模式应用的通用粘合剂（UA-SE）。在基线（T0）和1年后（T1）对标本进行不同的分析测试（微拉伸粘结强度测试（μTBS）、扫描电子显微镜断口分析和染料增强共聚焦显微镜）。
在T0时，测试材料之间的粘结强度没有差异（p>0.05）。在T1时，EXP-SE和EXP-ER是仅有的粘结强度没有显著降低的材料（p<0.05）。扫描电子显微镜显示，EXP-SE和EXP-ER组粘结后牙本质表面有明显的矿物质沉积。用RMGIC修复的标本在失效后未暴露牙本质表面。OPT和UA-SE标本在界面处有明显的降解迹象。共聚焦显微镜成像显示EXP组界面处有矿物质沉淀。
传统粘合剂可能具有不足的粘结性能，随着时间的推移，牙本质粘结界面会出现明显降解。尽管RMGIC在长期储存后可能会出现粘结强度下降，但随着时间的推移，粘结界面受降解的影响可能较小。创新的离子释放粘合剂可能会使龋损牙本质再矿化，并随着时间的推移实现稳定的粘结。
基于玻璃离子水门汀的材料可能是选择性化学机械去龋后合适的牙本质替代材料，而不是传统的粘结系统。
