纳米羟基磷灰石糊剂脱敏处理对三种自酸蚀粘接剂粘接强度的影响  

Effect of a nano hydroxyapatite desensitizing paste application on dentin bond strength of three self-etch adhesive systems

作　　者：裴丹丹[1] 刘思颖[2] 杨宏业[3] 甘婧[4] 黄翠[3] 

机构地区：[1] 西安交通大学口腔医学院陕西省颅颌面精准医学研究重点实验室,710004 [2] 武汉大学口腔医学院口腔颌面外科,430079 [3]武汉大学口腔医学院口腔修复科,430079 [4] 西安交通大学口腔医学院口腔修复科,710004

出　　处：《中华口腔医学杂志》2017年第5期278-282,共5页Chinese Journal of Stomatology

基　　金：国家自然科学基金（81371191、81400551）

摘　　要：目的 研究纳米羟基磷灰石（hydroxyapatite,HA）糊剂脱敏处理对3种自酸蚀粘接剂粘接强度的影响,为临床纳米HA脱敏处理后选择合适的粘接剂提供参考.方法 取2颗第三磨牙（武汉大学口腔医学院口腔颌面外科提供）用慢速锯切成约1 mm厚的牙本质片,取3片分别进行无任何处理、1%柠檬酸处理20 s、1%柠檬酸处理20 s＋纳米HA糊剂处理,扫描电镜观察牙本质小管封闭情况.将36颗完整、无龋的第三磨牙（武汉大学口腔医学院口腔颌面外科提供）用慢速锯垂直于牙体长轴去除牙釉质,1%柠檬酸处理20 s;用随机数字表法随机分成2组,每组18颗：对照组不处理,纳米HA组用纳米HA糊剂脱敏处理.每组再用随机数字表随机分成3个亚组,每亚组6颗牙,分别采用粘接剂A（一步法自酸蚀粘接剂G-Bond）、B（一步法自酸蚀粘接剂Clearfil S3 Bond）、C（两步法自酸蚀粘接剂FL-BondⅡ）粘接.复合树脂分层堆塑后制备微拉伸试件,于粘接完成24 h（老化前）和水储存6个月后（老化后）测试粘接强度（每组每种粘接剂老化前后各15个试件）.结果 扫描电镜可见柠檬酸处理使牙本质小管完全敞开;而使用纳米HA糊剂处理后,大多数牙本质小管被大量细小的针状纳米HA颗粒封闭.对于粘接剂A,老化前纳米HA组粘接强度[（41.14±8.91）MPa]显著高于对照组[（34.27±6.16）MPa]（P〈0.05）;老化后两组粘接强度差异无统计学意义（P〉0.05）.对于粘接剂B,老化前后纳米HA组粘接强度[分别为（30.87±6.41）和（25.73±6.99）MPa]均显著低于对照组[分别为（36.73±5.82）和（32.33±5.08）MPa]（P〈0.05）.对于粘接剂C,老化前后对照组和纳米HA组粘接强度差异均无统计学意义（P〉0.05）.各亚组断裂模式半数以上均为粘接界面断裂.结论 纳米HA糊剂脱敏处理对粘接剂A和C的粘接效果无不利影响,但可降低粘接剂B的粘接效果.Objective To evaluate a nano-hydroxyapatite （nano-HA） desensitizing paste application on the bond strength of three self-etch adhesives. Methods Three dentin specimens of about 1 mm thick were cut from two teeth. Scanning electron microscope （SEM） was used to evaluate the dentin surfaces without treatment, after citric acid treatment and after nano-HA treatment. Thirty-six intact third molars extracted for surgical reasons were cut to remove the occlusal enamel with isomet, and then were etched with 1% citric acid for 20 s to simulate the sensitive dentin and divided into two groups randomly using a table of random numbers （n=18）： the control group （no treatment） and the HA treated group （with nano-HA paste treatment）. Each group was divided into three subgroups randomly using a table of randomnumbers （n=6）. Subgroup A, B and C was bonded with G-Bond, Clearfil S3 Bond and FL-BondⅡaccording to the manufacture＇s instruction separately. At 24 h after bonding procedure, and after water storage for 6 months, microtensile bond strength of the specimens was tested and the failure mode was analyzed. Results SEM obeservation showed that citric acid could open the dentin tubules to set up the sensitive dentin model, and the nano-HA could occlude the dentin tubules effectively. For subgroup A, bonding strength of specimens treated with nano-HA （[41.14 ± 8.91] MPa） was significantly high than that of the control group （[34.27 ± 6.16] MPa） at 24 h after bonding procedure （P〈0.05）. However, after 6 month water ageing, the bonding strength of the control group and the HA treated group showed no significant difference （P〉0.05）. For subgroup B, specimens with nano-HA application showed lower bonding strength （[30.87 ± 6.41] MPa） than that of the control group （[36.73±5.82] MPa） at 24 h after bonding procedure （P〈0.05）, and after 6 month water ageing, the bond strength of nano-HA application （[25.73 ± 6.99] MPa） was also lower than that of the control group �

关 键 词：牙本质过敏 羟基磷灰石类 牙本质粘结剂 

分 类 号：R783.1[医药卫生—口腔医学]