Carvalho Marco A, Lazari-Carvalho Priscilla C, Maffra Paulo E T, Izelli Thábata F, Gresnigt Marco, Estrela Carlos, Magne Pascal
School of Dentistry, Evangelical University of Goiás (UniEVANGÉLICA), Anápolis, Brazil.
Department of Prevention and Oral Rehabilitation, School of Dentistry, University of Goiás, Goiânia, Brazil.
J Esthet Restor Dent. 2025 Jan;37(1):39-47. doi: 10.1111/jerd.13395. Epub 2025 Jan 6.
Chemicals used during canal disinfection and endodontic sealers have a deleterious effect on dentin bond strength. The aim of this study was to evaluate a novel clinical sequence to improve the resin-dentin microtensile bond strength (μTBS) to endodontically treated teeth.
Twenty human molars were distributed in four experimental groups (n = 5, N = 20): C-control group without exposure to any endodontic chemical substances (2.5% sodium hypochlorite, 17% EDTA and endodontic cement); LDh-late dentin hybridization (Dh) with Dh at the time of final restoration, after exposure to chemical substances; IPDS-immediate pre-endodontic dentin sealing, with Dh before exposure to chemical substances; and PLDh-late Dh after exposure to chemical substances and after dentin repreparation with ultrasonic diamond tip. Teeth were restored with resin composite and the microtensile test was performed after 24 h.
The highest bond strength values were found in the PLDh, IPDS, and C groups, without statistically significant differences among them. The lowest value was found in the LDh group. The LDh group presented a decrease of 70% when compared with the control group.
The resin-dentin microtensile bond strength was significantly improved by dentin hybridization before exposure to chemicals used during endodontics. Otherwise, substantial dentin repreparation is necessary to restore the bond strength after this exposure.
Early dentin hybridization (IPDS) before endodontic treatment not only improves the microtensile bond strength to dentin but also omitting this procedure would require significant repreparation of the exposed dentin after endodontic treatment to restore the bond strength. Hence, it allows the preservation of healthy tooth structure (no need for repreparation), as well as the reinforcement of weakened cusps and improvement of isolation (if combined with deep margin elevation, when necessary).
根管消毒过程中使用的化学物质以及根管封闭剂会对牙本质粘结强度产生有害影响。本研究的目的是评估一种新的临床操作流程，以提高树脂与经根管治疗牙齿的牙本质之间的微拉伸粘结强度（μTBS）。
将20颗人磨牙分为四个实验组（n = 5，N = 20）：C对照组，未接触任何根管化学物质（2.5%次氯酸钠、17%乙二胺四乙酸和根管封闭剂）；LDh - 晚期牙本质杂交（Dh）组，在接触化学物质后，于最终修复时进行Dh；IPDS - 根管治疗前即刻牙本质封闭组，在接触化学物质前进行Dh；PLDh - 在接触化学物质后以及用超声金刚石尖重新制备牙本质后进行晚期Dh。用树脂复合材料修复牙齿，并在24小时后进行微拉伸试验。
PLDh组、IPDS组和C组的粘结强度值最高，且它们之间无统计学显著差异。LDh组的值最低。与对照组相比，LDh组降低了70%。
在接触根管治疗中使用的化学物质之前进行牙本质杂交可显著提高树脂 - 牙本质微拉伸粘结强度。否则，在此接触后需要大量重新制备牙本质以恢复粘结强度。
根管治疗前早期牙本质杂交（IPDS）不仅能提高与牙本质的微拉伸粘结强度，而且省略此操作将需要在根管治疗后对暴露的牙本质进行大量重新制备以恢复粘结强度。因此，它有助于保留健康的牙齿结构（无需重新制备），以及加固薄弱牙尖并改善隔离效果（必要时若与加深边缘提升相结合）。
