Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
Eur Rev Med Pharmacol Sci. 2023 Sep;27(18):8350-8359. doi: 10.26355/eurrev_202309_33757.
This study aimed to assess the impact of various cavity disinfection methods on the adhesive bond integrity of composite resin to caries-affected dentin (CAD). Additionally, it will evaluate the micro tensile bond strength (µTBS) of different dentin substrates [CAD and sound dentin (SD)] using various adhesive agents.
The sample consisted of twenty human mandibular molars with sound dentin (SD) and eighty with CAD. All samples were positioned in a group of polyvinyl pipes with an internal diameter of 3 mm and were positioned perpendicularly up against the cementoenamel junction (CEJ). A total of 60 CAD samples (n=10) were used for shear bond strength (SBS) testing. CAD samples were disinfected with erbium chromium-doped yttrium, scandium, gallium and garnet (Er, Cr: YSGG) laser in group 1, Diode laser in group 2, neodymium-doped yttrium aluminum garnet (Nd: YAG) laser in group 3, riboflavin in group 4, curcumin in group 5, and chlorhexidine in group 6. Sixty CAD samples were treated with Scotchbond™ Etchant and Scotchbond™ multi-purpose primer and bonded with composite for SBS testing. On the twenty remaining CAD samples that did not undergo any type of disinfection, as well as the twenty samples that had sound dentin (SD), two different types of adhesive systems were used for micro tensile testing. For ten of each CAD and SD sample, 3c™ Adper™ Scotchbond™ multi-purpose adhesive was applied to the dentin surfaces. For the remaining ten CAD and SD samples, the All-Bond 2 adhesive system was used. The samples were prepared for µTBS testing. In all specimens, bond failure was assessed using a stereomicroscope. Analysis of variance (ANOVA) and Tukey Honestly Significant Difference (HSD) tests were used to compare the means of multiple groups, at a significance level of p<0.05.
CAD disinfected with chlorhexidine (CHX) (17.19±1.02 MPa) exhibited the highest SBS values. Samples in group 5 disinfected with curcumin activated by photodynamic therapy (PDT) showed the lowest SBS (12.49±1.11 MPa). Scotchbond adhesive displayed comparable µTBS (p>0.05) when applied on CAD and SD. Moreover, All-Bond 2 adhesive, when applied on CAD, exhibited µTBS significantly lower than All-Bond 2 adhesive on SD (p<0.05). Analysis of debonded CAD surface after SBS showed that a cohesive type of failure was dominant in different experimental groups, followed by adhesive CONCLUSIONS: CAD disinfection with Er:Cr: YSGG, Diode Laser, and Riboflavin activated by photodynamic therapy have the potential to be used as an alternative to CHX for acceptable shear bond strength. The use of Adper™ Scotchbond™ multi-purpose adhesive on CAD and SD did not significantly compromise µTBS.
本研究旨在评估不同窝洞消毒方法对复合树脂与龋损牙本质（CAD）之间黏结完整性的影响。此外，将使用不同的黏结剂评估不同牙本质基底[CAD 和正常牙本质（SD）]的微拉伸黏结强度（µTBS）。
样本由 20 颗下颌磨牙组成，其中 10 颗具有正常牙本质（SD），80 颗具有 CAD。所有样本均置于内径为 3 毫米的聚氯乙烯管中，并垂直放置于牙釉质牙骨质交界处（CEJ）上方。共有 60 个 CAD 样本（n=10）用于进行剪切黏结强度（SBS）测试。CAD 样本在第 1 组中用掺铒铬钇钪镓石榴石（Er, Cr: YSGG）激光、第 2 组中用二极管激光、第 3 组中用掺钕钇铝石榴石（Nd: YAG）激光、第 4 组中用核黄素、第 5 组中用姜黄素、第 6 组中用洗必泰进行消毒。60 个 CAD 样本用 Scotchbond™ 酸蚀剂和 Scotchbond™ 多用途底漆处理并用复合树脂进行 SBS 测试。在剩余的 20 个未进行任何类型消毒的 CAD 样本以及 20 个具有正常牙本质（SD）的样本上，使用两种不同类型的黏结系统进行微拉伸测试。对于每个 CAD 和 SD 样本的十个样本，将 3c™ Adper™ Scotchbond™ 多用途黏结剂应用于牙本质表面。对于剩余的十个 CAD 和 SD 样本，使用 All-Bond 2 黏结剂系统。为 µTBS 测试制备样本。在所有样本中，使用立体显微镜评估黏结失败情况。使用方差分析（ANOVA）和 Tukey Honestly Significant Difference（HSD）检验比较多个组的均值，显著性水平为 p<0.05。
用洗必泰（CHX）消毒的 CAD（17.19±1.02 MPa）表现出最高的 SBS 值。用姜黄素激活光动力疗法（PDT）消毒的第 5 组样本表现出最低的 SBS（12.49±1.11 MPa）。Scotchbond 黏结剂在 CAD 和 SD 上表现出相当的 µTBS（p>0.05）。此外，在 CAD 上应用 All-Bond 2 黏结剂时，其 µTBS 显著低于在 SD 上应用 All-Bond 2 黏结剂（p<0.05）。SBS 后对脱黏 CAD 表面的分析表明，在不同的实验组中，以牙本质内聚型破坏为主，其次是黏结破坏。
用 Er:Cr: YSGG、二极管激光和核黄素激活光动力疗法对 CAD 进行消毒，可能成为 CHX 的替代品，以获得可接受的 SBS。在 CAD 和 SD 上使用 Adper™ Scotchbond™ 多用途黏结剂不会显著降低 µTBS。
