Bond Stability of Universal Adhesives Applied To Dentin Using Etch-And-Rinse or Self-Etch Strategies

Abstract This study evaluated the immediate and 6-month dentin bond strength of universal adhesives used in etch-and-rinse or self-etch bonding strategies. The adhesives tested were Ambar Universal, G-Bond, Single Bond Universal, Tetric N-Bond Universal, and Ybond Universal. Gold standard adhesives (Scotchbond Multipurpose Plus and Clearfil SE Bond) were controls. Microtensile dentin bond strength (n=5 teeth), pH, and C=C conversion (n=3) were evaluated. Data were analyzed at α=0.05. All adhesives showed differences in pH. Ybond had intermediately strong aggressiveness, whereas the others were ultra-mild. The C=C conversion was different in most adhesives. In the etch-and-rinse strategy, all adhesives showed similar results generally except for G-Bond, which had lower bond strength than most adhesives. G-Bond and Tetric-N-Bond showed lower bond strengths after 6 months compared with 24 h, whereas the other adhesives had stable dentin bonds. In the self-etch strategy, G-Bond had lower bond strength than most adhesives. After 6 months, Ambar was the only adhesive showing lower dentin bond strength compared with 24 h. Most adhesives had discreet drops in bond strength during aging when used in the self-etch strategy. The failure modes were also material dependent, with a general pattern of increased adhesive and/or pre-testing failures after storage. In conclusion, the bonding performance of universal adhesives to dentin is material dependent. Most adhesives had stable dentin bonds with results comparable to the gold standard materials, particularly when applied in the self-etch mode. In general, it seems the use of universal adhesives in dentin should not be preceded by phosphoric acid etching.

摘要 本研究评估了通用粘接剂分别采用酸蚀-冲洗（etch-and-rinse）或自酸蚀（self-etch）粘接策略时的即刻及6个月牙本质粘接强度。受试粘接剂包括Ambar Universal、G-Bond、Single Bond Universal、Tetric N-Bond Universal及Ybond Universal；金标准（gold standard）粘接剂Scotchbond Multipurpose Plus与Clearfil SE Bond作为对照。本研究检测了微拉伸牙本质粘接强度（microtensile dentin bond strength，样本量n=5颗牙）、pH值及碳碳双键（C=C）转化率（样本量n=3），数据以α=0.05为显著性水平进行统计分析。所有受试粘接剂的pH值均存在差异。Ybond的腐蚀性处于中等偏强水平，其余粘接剂均为超温和型。多数粘接剂的碳碳双键转化率存在显著差异。采用酸蚀-冲洗策略时，除G-Bond的粘接强度低于多数受试粘接剂外，其余粘接剂的粘接强度整体相近。G-Bond与Tetric-N-Bond在6个月老化后的粘接强度较24小时即刻测试结果更低，其余粘接剂的牙本质粘接强度均保持稳定。采用自酸蚀策略时，G-Bond的粘接强度仍低于多数受试粘接剂。6个月老化后，仅Ambar的牙本质粘接强度较24小时即刻测试结果出现下降。采用自酸蚀策略时，多数粘接剂在老化过程中粘接强度均出现小幅下降。粘接失效模式同样受材料属性影响，存储后粘接层失效及/或预测试失效的比例普遍升高。综上，通用粘接剂的牙本质粘接性能存在材料依赖性。多数粘接剂的牙本质粘接强度可保持稳定，且其效果可与金标准粘接剂媲美，尤其当采用自酸蚀模式应用时。总体而言，牙本质粘接时使用通用粘接剂前似乎无需进行磷酸酸蚀处理。