Buonocore memorial lecture. Adhesion to enamel and dentin: current status and future challenges.
Buonocore memorial lecture. Adhesion to enamel and dentin: current status and future challenges.
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发表时间：
2003-05
影响因子：
2.2
通讯作者：
B. Van Meerbeek;J. de Munck;Y. Yoshida;S. Inoue;M. Vargas;P. Vijay;Kirsten L. Van Landuyt;P. Lambrechts;G. Vanherle
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作者：
B. Van Meerbeek;J. de Munck;Y. Yoshida;S. Inoue;M. Vargas;P. Vijay;Kirsten L. Van Landuyt;P. Lambrechts;G. Vanherle
可以通过“蚀刻”、“自蚀刻”或“玻璃离聚物”方法来实现与牙齿组织的结合。本文通过牙齿-生物材料界面相互作用的超微形态学和化学表征，论证了这三种方法与牙釉质和牙本质的基本结合机制。此外，根据其在预测临床性能方面的价值和相关性，对粘合强度测试和边缘密封有效性测量（实验室中确定“粘合有效性”的两种最常用方法）进行了评价。介绍了一种新的动态疲劳测试方法，该方法采用了一种新研制的微旋转疲劳测试装置。最终，今天的粘合剂将在不同的实验室研究和临床试验中对其性能进行重要评估。特别关注的是蚀刻与自蚀刻方法的优点/缺点以及这些粘合剂的长期性能。将实验室收集的数据与临床结果相关联清楚地表明，实验室研究可以预测临床有效性。尽管有简化粘合程序的趋势，但所提供的数据证实，传统的三步蚀刻粘合剂仍然表现最佳，并且从长远来看最可靠。然而，自蚀刻方法可能具有最好的未来前景。在临床上，当粘合剂不再需要“蚀刻”步骤时，应用时间以及可能更重要的是，技术敏感性大大降低。特别是“温和”的两步自蚀刻粘合剂，通过与牙齿组织的组合微机械和化学相互作用进行粘合，在粘合性能方面接近传统的三步系统。
Bonding to tooth tissue can be achieved through an "etch," "self-etch" or "glass-ionomer" approach. In this paper, the basic bonding mechanism to enamel and dentin of these three approaches is demonstrated by means of ultramorphological and chemical characterization of tooth-biomaterial interfacial interactions. Furthermore, bond-strength testing and measurement of marginal-sealing effectiveness (the two most commonly employed methodologies to determine "bonding effectiveness" in the laboratory) are evaluated upon their value and relevance in predicting clinical performance. A new dynamic methodology to test biomaterial-tooth bonds in a fatigue mode is introduced with a recently developed micro-rotary fatigue-testing device. Eventually, today's adhesives will be critically weighted upon their performance in diverse laboratory studies and clinical trials. Special attention has been given to the benefits/drawbacks of an etch versus a self-etch approach and the long-term performance of these adhesives. Correlating data gathered in the laboratory with clinical results clearly showed that laboratory research CAN predict clinical effectiveness. Although there is a tendency to simplify bonding procedures, the data presented confirm that conventional three-step etch adhesives still perform most favorably and are most reliable in the long-term. Nevertheless, a self-etch approach may have the best future perspective. Clinically, when adhesives no longer require an "etch" step, the application time, and probably more importantly, the technique-sensitivity are substantially reduced. Especially "mild," two-step self-etch adhesives that bond through a combined micromechanical and chemical interaction with tooth tissue closely approach conventional three-step systems in bonding performance.