人深层牙本质粘结时牙髓反应的短期评价  

Short-term Evaluation of the Human Pulpo-dentin Complex Response to Dentin Adhesive Systems Applied in Deep Dentinal Surface

作　　者：黄翠[1] 程祥荣[1] 张智星[1] 郑铁丽[1] 张帼[1] 邓东来[1] 王飒[1] 韩伟[1] 

机构地区：[1]武汉大学口腔医学院口腔修复科,湖北武汉430079

出　　处：《口腔医学研究》2004年第5期504-507,共4页Journal of Oral Science Research

摘　　要：目的 :评价两种不同体系的牙本质粘结系统直接用在人深层牙本质上时牙髓 -牙本质复合体在短期内的反应。方法 :局麻下在 2 4颗因正畸治疗需要而计划拔除的前磨牙的颊面颈部预备深Ⅴ类洞 ,随机分为两组 ,一组牙齿的窝洞各壁直接应用全酸蚀牙本质粘结系统Prime&BondNT ,光固化复合树脂充填 (PB组 ) ;另一组的窝洞内则直接使用自酸蚀牙本质粘结系统XenoⅢ (Xeno组 )。以上所有的牙齿在术后 7～ 2 0d之间拔除 ,常规组织病理切片预备 ,HE、Masson’strichrome、BrownandBrenn染色 ,显微镜下盲法评价其牙髓 -牙本质复合体的反应。结果 :PB组中有大量粘结树脂成分沿着牙本质小管扩散 ,同时牙髓出现较为明显的炎症反应和组织结构紊乱。相比之下 ,Xeno组牙髓的不良反应较小。结论 :在深窝洞中直接使用全酸蚀牙本质粘结系统Prime&BondNT是不恰当的 ,此时使用自酸蚀牙本质粘结系统XenoⅢ较为安全。Objective: To evaluate the response of pulpo-dentin complex following application of two different dentin adhesive systems in deep dentinal surface performed in human teeth. Methods: Deep class V cavities were prepared on the buccal surfaces of 24 premolars. In Group one, the cavity walls were conditioned with 36% phosphoric acid and the dentin adhesive system Prime &Bond NT was applied (Group PB). In Group two, the self-etching dentin adhesive system Xeno Ⅲ was applied (Group Xeno). The cavites were restored with light-cured Spectrum TPH composite resin. The teeth were extracted between 7 and 20 days and prepared for microscopic assessment. Serial sections were stained with HE, Masson's trichrome and Brown and Brenn techniques. Result: In Group PB, the inflammatory response was more evident than in Group Xeno. Diffusion of dental material components across dentinal tubules was observed in Group PB, in which the intensity of the pulp response increased as the remaining dentin thickness. Bacteria were not evidenced in these two Groups. Conclusion: It was concluded that total acid etching followed by application of Prime & Bond NT bonding agent can not be recommended in deep cavites. In this clinical condition, the self-etching adhesive system Xeno Ⅲ seems to be safe to the human pulp.

关 键 词：牙本质粘结 牙髓反应 自酸蚀 预备 拔除 牙齿 复合体 NT 系统 PB 

分 类 号：R783.3[医药卫生—口腔医学]