酪蛋白磷酸多肽钙磷复合体的应用顺序对乳牙牙本质粘结强度的影响

Effect of the application sequence of casein phosphopetide-amorphic calcium phosphat pretreatment on bond strength of deciduous dentin

目的探讨酪蛋白磷酸多肽钙磷复合体(casein phosphopetide-amorphic calcium phosphat, CPP-ACP)应用顺序对乳牙牙本质粘结强度及对乳牙牙本质小管封闭作用的影响。方法选取人56颗无龋乳磨牙,磨除牙合面釉质,制备牙本质平面。将其中48颗乳磨牙随机分3大组(n=16)。A组:仅酸蚀15 s。B组:涂CPP-ACP后酸蚀15 s。C组:酸蚀15 s后涂CPP-ACP。各组分为2小组(n=8),其中AN,BN,CN组使用Prime&Bond NT(NT)全酸蚀粘结剂,AS,BS,CS组使用Single bond 2(SB2)全酸蚀粘结剂。制作树脂粘结试件,电子万能试验机测定剪切强度(SBS值)。其余8个乳磨牙随机分成4组(n=2),分别为空白组(S1组)、酸蚀组(S2组)、酸蚀后涂CPP-ACP组(S3组)、涂CPP-ACP后酸蚀组(S4组)分别用扫描电镜观察粘结前牙本质小管封闭情况。结果剪切实验结果为AN组、BN组、CN组剪切强度无统计学差异(P>0.05);AS组,BS组,CS组剪切强度也无统计学差异(P>0.05);AN组>AS组,BN组>BS组,CN组>CS组差异有统计学意义(P<0.05)。扫描电镜结果为S3组中牙本质小管封闭数目最多。结论在酸蚀后应用CPP-ACP处理乳牙牙本质不影响NT和SB2两种全酸蚀粘结剂的粘结强度;可以达到有效的牙本质小管封闭;Prime&Bond NT(NT)全酸蚀粘结系统的粘结强度高于Single bond 2(SB2)。

Objective To investigate the effect of the application sequence of casein phosphopetide-amorphic calcium phosphat(CPP-ACP) pretreatment on bond strength of deciduous dentin and tubule occlusion. Methods Fifty-six fresh and not crack primary molars were randomly selected and the enamel of tooth surface was grinded to form the dentin plane. Forty-eight primary molars were randomly divided into 3 groups(n=16).Group A was etched with 35% phosphoric acid for 15 s. Group B was treated with CPP-ACP. Afterward, these groups were etched with 35% phosphoric acid for 15 s. Group C was initially etched and then treated with CPP-ACP. In each group, samples were equally distributed into two subgroups(n=8) to bond with either Adper Single Bond 2(SB) or Prime & Bond NT(PB).The shear bond strengths(SBS) were tested. The remaining 8 primary molars were randomly divided into 4 groups(n=2), respectively blank group(Group S1), acid etching group(Group S2), CPP-ACP after acid etching group(Group S3), and acid etching after CPP-ACP group(Group S4). Then the scanning electron microscope was used to observe the sealing situation of dentinal tubule before bonding. Results The shear bond strength(SBS) results showed that there was no significant difference among the three groups of AN,BN,CN(P>0.05). And there was also no significant difference among the three groups of AS,BS,CS(P>0.05). Group AN>group AS,group BN>group BS,group CN>group CS,the difference was statistically significant(P<0.05). However, the number of dentine tubule occlusion was the largest in the CPP-ACP group after acid etching. Conclusion CPP-ACP treatment of deciduous dentin after acid etching does not affect the bond strength of NT and SB2, and the effective closure of dentin tubules can be realized. The adhesive strength of Prime & Bond NT(NT) is higher than that of Single bond 2(SB2).