Boutsiouki Christina, Frankenberger Roland, Lücker Susanne, Krämer Norbert
J Adhes Dent. 2023 Jan 12;25:13-22. doi: 10.3290/j.jad.b3801065.
This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model.
The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm2, crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM.
CTRL exhibited significantly higher μTBS at baseline in comparison to PRIM (p = 0.000), BOND (p = 0.002), and PEAK (p = 0.000). After undergoing the caries model, CTRL demonstrated significantly lower μTBS compared to DENT (p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL.
CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives.
本研究通过在全自动人工口腔模型中进行生物加载后评估牙本质粘结强度，比较了2%洗必泰（CHX）牙本质预处理与三种含CHX的粘结剂（在底漆或粘结剂中实验性混合0.1% CHX，或在通用粘结剂中工业添加0.2% CHX）。
暴露50颗新鲜拔除的人类第三磨牙的咬合面牙本质，根据粘结剂方案将牙齿随机分为5组（n = 10）：1. 对照组，Scotchbond多功能粘结剂（3M口腔护理产品；CTRL）；2. 2% CHX牙本质预处理（DENT）；3. 0.1% CHX实验性混合到底漆中（PRIM）；4. 0.1% CHX实验性混合到粘结剂中（BOND）；5. 含0.2% CHX的Peak通用粘结剂（Ultradent公司；PEAK）。用复合树脂修复牙齿。在蒸馏水中储存24小时（基线）后或在用变形链球菌进行2天生物加载（脱矿1小时/再矿化5小时）后进行微拉伸粘结强度测试（粘结面积0.46 mm²±0.04 mm²，十字头速度1 mm/min）。记录断裂模式，并在扫描电子显微镜下评估典型样本。
与PRIM（p = 0.000）、BOND（p = 0.002）和PEAK（p = 0.000）相比，CTRL在基线时表现出显著更高的微拉伸粘结强度（μTBS）。在经历龋病模型后，与DENT（p = 0.000）、PRIM（p = 0.008）和PEAK（p = 0.000）相比，CTRL的μTBS显著降低。BOND与DENT（p = 0.000）、PRIM（p = 0.003）和PEAK（p = 0.001）相比也观察到相同的情况。生物加载后，DENT（p = 0.041）、PRIM（p = 0.000）和BOND（p = 0.000）的粘结性断裂明显少于CTRL。
在底漆中添加CHX可保护牙本质粘结强度在生物加载后不下降。因此，在复合树脂修复体周围抑制继发龋方面可能具有一些临床优势。然而，由于将2% CHX用作牙本质预处理时基线时的粘结损失较少，因此可以认为这是一个更安全的选择。这样粘结就不会因CHX与粘结剂之间潜在的化学相互作用而受到影响。
