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根管治疗后和再治疗牙齿的形态分析及与根管牙本质的粘结强度:一项离体研究。

Morphological Analysis and Bond Strength to Root Canal Dentin of Endodontically Treated and Retreated Teeth: An Ex Vivo Study.

出版信息

J Adhes Dent. 2024 Oct 14;26:231-240. doi: 10.3290/j.jad.b5780319.

Abstract

PURPOSE

To assess the bond strength and the hybrid layer (HL) micro-morphological characteristics at the cement-dentin interface (CD-i) between root canal walls and two adhesive resin cements [self-etch (SERc) and self-adhesive (SARc)] in root-canal-treated (RCT) and naturally aged retreated teeth (RCR-T).

MATERIALS AND METHODS

Vital (n = 16) and RCT (n = 16) teeth were, respectively, endodontically treated or retreated. Fiber posts were luted either with SERc (Clearfil Universal Bond Quick + DC Core Plus) or SARc (iCEM). Samples were then sectioned into 1 mm thick slices perpendicular to the fiber post and submitted to push-out bond strength test. Vital (n = 4) and RCT (n = 4) first maxillary molars were also selected and prepared to evaluate CD-i morphology through confocal laser scanning microscopy (CLSM). Three-way analysis of variance (ANOVA) and Tukey post-hoc tests were assessed to statistically analyze the obtained data (p 0.05).

RESULTS

Bond strength was significantly jeopardized in retreated teeth and in the root apical half, while the cements had no significant influence. Most failures occurred between dentin and resin cement. HL thickness was also hindered in retreated teeth. iCEM produced a thinner HL compared to SERc. Resin tag formation was significantly hampered in the root apical half.

CONCLUSIONS

SARc performed as well as SERc on aged RCT radicular dentin. Clinicians can rely on simplified one-step luting systems when adhesion is required in unfavorable substrates such as the root canal post space of aged RCT teeth.

摘要

目的

评估两种黏结树脂水泥(自酸蚀黏结剂 [SERc] 和自黏结剂 [SARc])在根管治疗牙(RCT)和重新治疗的自然老化牙(RCR-T)根管壁与牙本质界面(CD-i)的粘结强度和混合层(HL)微观形态特征。

材料和方法

活髓牙(n=16)和 RCT 牙(n=16)分别进行根管内治疗或重新治疗。纤维桩分别用 SERc(Clearfil Universal Bond Quick+DC Core Plus)或 SARc(iCEM)黏结。然后将样本沿纤维桩垂直切成 1 毫米厚的切片,并进行推出粘结强度测试。还选择了 4 颗活髓(n=4)和 RCT(n=4)上颌第一磨牙,并用共聚焦激光扫描显微镜(CLSM)评估 CD-i 形态。采用三因素方差分析(ANOVA)和 Tukey 事后检验对获得的数据进行统计学分析(p<0.05)。

结果

重新治疗的牙齿和根尖部的粘结强度显著降低,而粘结剂没有显著影响。大多数失败发生在牙本质和树脂粘结剂之间。HL 厚度在重新治疗的牙齿中也受到阻碍。与 SERc 相比,iCEM 产生的 HL 更薄。树脂标签的形成在根尖部受到严重阻碍。

结论

SARc 在老化的 RCT 根管牙本质上的性能与 SERc 相当。当需要在老化 RCT 牙齿的根管桩空间等不利基底上进行粘结时,临床医生可以依赖简化的一步法黏结系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c01/11748033/486ca79b3cab/jad-26-231-g001.jpg

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