Effect of remineralizing agents on resin-dentin bond durability of adhesive restorations

To prolong the clinical success and durability of bonded restorations, hybrid layer stabilization is crucial for better adhesion between the resin and tooth substrate.<b>Aim: </b>To assess the ability of self assembling peptide (curodont protect) and a remineralizing agent (MI paste plus) in promoting biomimetic remineralization for the stabilization of hybrid layer to improve the resin-dentin bond durability. <b>Materials and Method</b>: Standardized mesio and disto-occlusal cavities were prepared on 60 mandibular molars. Prior to bonding procedure half of MO cavities were pretreated with curodont protect and another half with MI paste plus. Half of DO cavities (n=30) were pretreated with chlorhexidine whereas, other half didnot receive any treatment. Half samples from each group (n=15) were subjected to thermomechanical load cycles. Bond strength was tested with universal testing machine, and the type of bond failure was assessed under scanning electron microscope. Data obtained in megapascals was analyzed by one-way ANOVA and Tukey’s multiple posthoc test with significance level set at p≤0.05. <b>Results: </b>Immediate bond strength values were significantly high for control group and low for MI paste plus group (p=0.002). Significant difference was not observed between curodont protect and chlorhexidine (p=0.0514). In all groups bond strength values were decreased significantly after thermomechanical cyclic loading (p=0.0001). Adhesive failures were reported more in failure mode analysis. <b>Conclusion</b>: All groups exhibited reduced µTBS values after aging. The dentin treated with chlorhexidine, curodont protect, MI paste plus produced more durable bonding than control group.<br>

为提升粘接修复体的临床留存效果与使用寿命，粘接界面混合层（hybrid layer）的稳定化对于实现树脂与牙体组织间的优异粘接至关重要。
目的：本研究旨在评估自组装多肽（self-assembling peptide，Curodont Protect）与再矿化制剂（MI Paste Plus）促进仿生再矿化的能力，以稳定混合层，进而提升树脂-牙本质粘接的耐久性。
材料与方法：选取60颗下颌磨牙，制备标准化的近中-咬合面（mesio-occlusal，MO）与远中-咬合面（disto-occlusal，DO）龋洞。粘接操作前，将半数近中-咬合面龋洞用Curodont Protect预处理，剩余半数用MI Paste Plus预处理。对于远中-咬合面龋洞（n=30），半数用氯己定（chlorhexidine）预处理，另一半不做任何处理。每组中半数样本（n=15）接受热机械循环载荷处理。采用万能试验机测试粘接强度，并通过扫描电子显微镜（scanning electron microscope）评估粘接失效模式。以兆帕（MPa）为单位收集的实验数据采用单因素方差分析（one-way ANOVA）与Tukey多重比较事后检验进行统计学分析，显著性水平设定为p≤0.05。
结果：对照组的即刻粘接强度显著高于其余各组，MI Paste Plus组即刻粘接强度最低（p=0.002）。Curodont Protect组与氯己定组之间未观察到显著差异（p=0.0514）。经热机械循环载荷处理后，所有组别粘接强度均出现显著下降（p=0.0001）。粘接失效模式分析显示，粘接界面失效占比更高。
结论：所有组别经老化处理后微拉伸粘接强度（micro-tensile bond strength，µTBS）均出现下降。经氯己定、Curodont Protect及MI Paste Plus处理的牙本质样本，其粘接耐久性均优于对照组。