Abstract:

Objective　To compare the effects of different types of adhesives on the strength and durability of dentin bonding, so as to provide references for clinical selection of adhesives. Methods　A total of 50 patients were selected from the Department of Stomatology of Shenzhen Baoan Women's and Children's Hospital Affiliated to Jinan University from January 2019 to June 2020, including 25 males and 25 females, aged (42.21±8.27) years. Fifty complete caries-free human discrete third molars were removed for treatment, which were divide into group A, B, C, D, and E by the random number table method, 10 tooth in each group. Group A was treated by total acid corrosion adhesive, group B was treated by two-step self-acid corrosion adhesive, group C was treated by one-step acid corrosion adhesive, group D was treated by general adhesive, and group E was treated by total acid corrosion + general adhesive. Each group shall conduct resin bonding operation strictly according to the instructions, and 60 dentine-resin strips were cut out in each group, which were further subdivided into two subgroups according to the storage time, 30 in each group. After storing in artificial saliva for 24 h and 12 months, the specimens were cut and made, and the bonding strength of each specimen was tested. The fracture mode of the specimens was analyzed by stereomicroscope, and the bonding strength and fracture mode of 5 kinds of dental adhesives were compared. Univariate ANOVA was used for multiple-group comparison of the measurement data, SNK-q test was used for pairwise comparison between groups, paired t test was used for intra-group comparison, and rank sum test was used for the ranked data. Results　There was no statistically significant difference in the bonding strength between group A and group B after 24 h of storage [(30.73±2.56) MPa vs. (31.42±9.17) MPa] (P>0.05); the bonding strength of group A and group B were higher than those of group C [(22.22±5.67) MPa], group D [(25.04±1.87) MPa], and group E [(24.54±2.09) MPa] (P<0.05); the bonding strength of group D was higher than that of group C (P<0.05). The bonding strength of each group after 12 months of storage was: group B [(30.56±2.54) MPa] >group A [(28.35±3.25) MPa] > group D [(24.91±6.46) MPa] > group E [(20.18±3.08) MPa] > group C [(17.43±1.28) MPa], with a statistically significant difference (P<0.05). The bonding strength of group A, group C, and group E after 12 months of storage were higher than those after 24 h of storage, with statistically significant differences (all P<0.05); there was no statistically significant difference in the bonding strength of group B or group D (both P>0.05). After storage for 24 h and 12 months respectively, the number of mixed fractures was always the largest in each group, and there was no statistically significant difference in the constituent ratio of fracture structure among each group (P>0.05). Conclusions　The bonding strength of dentin treated with two-step self-acid corrosion adhesive and total acid corrosion adhesive are the highest; the bonding strength of one-step self-acid corrosion adhesive is the lowest. As time goes on, the bonding strength of dentin treated with two-step self-acid corrosion adhesive is still the highest, and that of dentin treated with one-step self-acid corrosion adhesive decreases most obviously.

Key words: Adhesive, Dentin, Bonding strength, Fracture mode, Storage time

摘要： 目的　比较不同类型粘接剂对牙本质粘接强度及耐久性的影响，从而为临床上选择粘接剂提供参考。方法　选取2019年1月至2020年6月在暨南大学附属深圳市宝安区妇幼保健院口腔科就诊患者50例，其中男25例、女25例，年龄（42.21±8.27）岁。患者因治疗需要拔除50颗完整无龋人离体第三磨牙，采用随机数字表法将其分A、B、C、D、E组，每组各10颗。A组采用全酸蚀粘接剂处理方法，B组采用二步法自酸蚀粘接剂处理方法，C组采用一步法自酸蚀粘接剂处理方法，D组采用通用型粘接剂处理方法，E组采用全酸蚀处理+通用型粘接剂处理方法。严格按照说明书进行树脂粘接操作，每组牙可以切割出60个牙本质-树脂条，按照储存时间再分为2个亚组，每组30个，分别在人工唾液中储存24 h及12个月后，切割制作试件，测试每个试件的粘接强度，并用体视显微镜分析试件的断裂模式，并比较5种牙齿粘接剂的粘接强度及断裂模式。计量资料多组间比较采用单因素方差分析，进一步组间两两比较采用SNK-q检验，组内比较采用配对t检验；等级资料采用秩和检验。结果　A组、B组储存24 h后的粘接强度比较，差异无统计学意义（P>0.05）；A组（30.73±2.56）MPa、B组（31.42±9.17）MPa储存24 h后的粘接强度均大于C组（22.22±5.67）MPa、D组（25.04±1.87）MPa、E组（24.54±2.09）MPa，差异有统计学意义（P<0.05），且D组储存24 h后的粘接强度大于C组，差异有统计学意义（P<0.05）。各组储存12个月后的粘接强度比较，B组（30.56±2.54）MPa>A组（28.35±3.25）MPa>D组（24.91±6.46）MPa>E组（20.18±3.08）MPa>C组（17.43±1.28）MPa，差异有统计学意义（P<0.05）。A组、C组、E组储存12个月后粘接强度均小于储存24 h的粘接强度，差异均有统计学意义（均P<0.05）；B组、D组储存12个月后粘接强度与储存24 h的粘接强度比较，差异均无统计学意义（均P>0.05）。各组试件分别储存24 h、12个月后，混合断裂的数量始终最多，每组断裂结构构成比之间比较，差异均无统计学意义（均P>0.05）。结论　二步法自酸蚀粘接剂处理与全酸蚀粘接剂处理后牙本质粘接强度最高，一步法自酸蚀粘接剂处理后粘接强度最低。随着时间推移，二步法自酸蚀粘接剂处理后的牙本质粘接强度仍然最高，一步法自酸蚀粘接剂处理后的粘接强度下降最明显。

关键词: 粘接剂, 牙本质, 粘接强度, 断裂模式, 储存时间