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牙本质粘结界面的降解与失效现象。

Degradation and Failure Phenomena at the Dentin Bonding Interface.

作者信息

Mokeem Lamia Sami, Garcia Isadora Martini, Melo Mary Anne

机构信息

Ph.D. Program in Biomedical Sciences, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.

Division of Operative Dentistry, Department of General Dentistry, University of Maryland School of Dentistry, Baltimore, MD 21201, USA.

出版信息

Biomedicines. 2023 Apr 23;11(5):1256. doi: 10.3390/biomedicines11051256.

Abstract

Damage in the bonding interface is a significant factor that leads to premature failure of dental bonded restorations. The imperfectly bonded dentin-adhesive interface is susceptible to hydrolytic degradation and bacterial and enzyme attack, severely jeopardizing restorations' longevity. Developing caries around previously made restorations, also called "recurrent or secondary caries," is a significant health problem. The replacement of restorations is the most prevailing treatment in dental clinics, leading to the so-called "tooth death spiral". In other words, every time a restoration is replaced, more tooth tissue is removed, increasing the size of the restorations until the tooth is eventually lost. This process leads to high financial costs and detriment to patients' quality of life. Since the complexity of the oral cavity makes prevention a challenging task, novel strategies in Dental Materials and Operative fields are required. This article briefly overviews the physiological dentin substrate, features of dentin bonding, challenges and clinical relevance. We discussed the anatomy of the dental bonding interface, aspects of the degradation at the resin-dentin interface, extrinsic and intrinsic factors affecting dental bonding longevity, perspectives on resin and collagen degradation and how these subjects are connected. In this narrative review, we also outlined the recent progress in overcoming dental bonding challenges through bioinspiration, nanotechnology and advanced techniques to reduce degradation and improve dental bonding longevity.

摘要

粘结界面的损伤是导致牙科粘结修复体过早失效的一个重要因素。牙本质-粘结剂界面粘结不完美易受水解降解以及细菌和酶的侵蚀,严重危及修复体的使用寿命。在先前制作的修复体周围发生龋齿,也称为“复发性或继发性龋齿”,是一个重大的健康问题。在牙科诊所,更换修复体是最普遍的治疗方法,这导致了所谓的“牙齿死亡螺旋”。换句话说,每次更换修复体时,都会去除更多的牙齿组织,增加修复体的尺寸,直到牙齿最终脱落。这个过程导致高昂的经济成本,并损害患者的生活质量。由于口腔的复杂性使得预防成为一项具有挑战性的任务,因此牙科材料和手术领域需要新的策略。本文简要概述了生理性牙本质基质、牙本质粘结的特点、挑战及临床相关性。我们讨论了牙科粘结界面的解剖结构、树脂-牙本质界面的降解情况、影响牙科粘结寿命的外在和内在因素、树脂和胶原蛋白降解的观点以及这些主题之间的联系。在这篇叙述性综述中,我们还概述了通过生物启发、纳米技术和先进技术克服牙科粘结挑战以减少降解并提高牙科粘结寿命的最新进展。

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