不同脱敏酸蚀模式对牙本质小管封闭效果及粘接强度的影响  

Effect of different desensitizing and etching procedures on the tubule occluded and the shear bond strength of composite resin to dentin

作　　者：岳阳丽[1] 陈艺鑫[1] 解韫亦 YUE Yang-li;CHEN Yi-xin;XIE Yun-yi(Department of Endodontics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院牙体牙髓科,河南郑州450052

出　　处：《河南医学研究》2019年第7期1158-1161,共4页Henan Medical Research

基　　金：河南省科技厅科技攻关项目(162102310129);河南省高等学校大学生创新创业训练计划项目(201710459100)

摘　　要：目的研究不同脱敏酸蚀模式对牙本质小管封闭效果及牙本质粘接强度的影响。方法收集2017年11月至2018年1月郑州大学第一附属医院因正畸需要拔除的健康完整的前磨牙45颗。其中40颗前磨牙平行于牙体长轴去除近中邻面釉质,制备平滑的牙本质面,采用随机数表法分为4组:A组(全酸蚀)、B组(全酸蚀+Gluma脱敏剂)、C组(全酸蚀+Gluma脱敏剂+二次酸蚀)、D组(自酸蚀)。最终完成粘接及光固化树脂的堆塑,用万能实验机进行剪切强度测试。对另外5颗前磨牙进行扫描电镜观察不同处理方法下牙本质小管的封闭效果。结果 4组粘接强度大小为D组>B组>A组>C组,差异无统计学意义(P>0.05)。扫描电镜观察发现,Gluma脱敏剂能使酸蚀后的牙本质小管部分封闭,而随后的二次酸蚀使部分封闭的牙本质小管重新敞开;自酸蚀处理后的牙本质小管封闭效果最为完全。结论在酸蚀后进行Gluma脱敏处理不会影响粘接强度;Gluma脱敏处理后二次酸蚀并不能增强牙本质粘接强度,自酸蚀粘接剂具有粘接和封闭牙本质小管的双重效果。Objective To evaluate the influence of different desensitizing and etching procedures on the tubule occluded and the shear bond strength of dentin.Methods A total of 45 healthy premolars that needed to be removed from orthodontics were collected from November 2017 to January 2018 in the First Affiliated Hospital of Zhengzhou University.Forty premolars were removed the enamel of the proximal middle surface parallel to the long axis of the tooth,and the smooth dentin surface was prepared.They were divided into 4 groups by random digital table:group A(etch-and-rinse adhesive system),group B(acid etching+Gluma desensitizer),group C(acid etching+Gluma desensitizer+re-etching),group D(self-etching adhesive system).Composite resin was used to create a 3-mm-thick build-up.The bond strength was measured by using a universal testing machine with a cross-speed of 1 mm/min.Scanning electron microscope was used to observe the occlusion of dentin tubules of the other 5 premolars after different treatments.Results Group D recorded the highest shear bond strength values,followed by group B and group A,while the lowest values were found in group C.There was no significant difference among the four groups(P>0.05).SEM showed that dentin tubules were occluded partially after Gluma desensitizer,and dentinal tubules reopened completely due to the re-etching.The effect of dentine tubules occluded in the self-etching adhesive group was the best.Conclusion The bonding strength will not be affected by Gluma desensitizer after acid etching.Re-etching after Gluma desensitizer cannot enhance the bonding strength of dentin.Self-etching adhesive has the dual effect of bonding and sealing dentin tubules.

关 键 词：粘接强度 脱敏剂 酸蚀 牙本质小管 

分 类 号：R781[医药卫生—口腔医学]