Self-etching adhesives and postoperative sensitivity.
Self-etching adhesives and postoperative sensitivity.
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DOI：
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发表时间：
2004
影响因子：
1.4
通讯作者：
M. Unemori;Y. Matsuya;A. Akashi;Y. Goto;A. Akamine
中科院分区：
文献类型：
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作者：
M. Unemori;Y. Matsuya;A. Akashi;Y. Goto;A. Akamine
目的验证无衬里自酸蚀/自吸（SE/SP）牙本质粘结系统比早期全酸蚀（TE）粘结系统更能预防树脂基复合材料牙本质粘结术后过敏的假设。方法：对接受复合治疗的患者进行为期4年的临床随访。每个洞的深度分为浅、中、深三种，并对每个修复体的牙髓保护需求进行评估。三种不同的自蚀刻/自底漆（SE/SP）粘合剂系统进行了比较，三种不同的全蚀刻（TE）粘合剂系统。术后敏感（IPS）的发生率在修复体放置后1周通过标准化程序进行检查。患者年龄在16-83岁之间。结果SE/SP组150例患者中，活髓牙共放置了330个修复体，TE组70例患者中，共放置了126个修复体。在SE/SP组中，IPS在按深度分层的所有复发病例中的发生率分别为14%（深腔）、6%（中等深度腔）和5%（浅腔）; TE组中，IPS的发生率分别为35%（深腔）、16%（中等深度腔）和4%（浅腔）。Fisher精确检验显示深龋洞和中龋洞的IPS发生率显著高于浅龋洞（P< 0.05）和中龋洞（P< 0.05）。该测试还显示，在放置有SE/SP粘合剂系统的牙体中，存在或不存在保护衬垫或基底在中浅腔中的IPS中没有显著差异，而在深腔中，与没有保护（0%）相比，使用这种保护层产生了显著更高的IPS（21%）（P< 0.05）。当使用SE/SP牙本质粘结系统时，没有保护衬垫或基底不会导致深洞术后敏感。
PURPOSE To test the hypothesis that the prevention of postoperative sensitivity in resin-based composite restorations is better achieved with a self-etching/self-priming (SE/SP) dentin bonding system without lining than with an early generation total-etch (TE) bonding system. METHODS Over a 4-year period, clinical follow-ups were conducted on patients who had received composite restorations. The depth of each cavity was categorized as being shallow, medium or deep, and an evaluation was made regarding the need for pulpal protection for each restoration. Three different self-etching/self-priming (SE/SP) adhesive systems were compared to three different total-etch (TE) adhesive systems. The incidences of postoperative sensitivity (IPS) were examined by a standardized procedure 1 week after placement of the restoration. Patients' ages varied between 16-83 years. RESULTS The total number of restorations placed in vital teeth were 330 for 150 patients in the SE/SP group, and 126 for 70 patients in the TE group. Incidences of IPS in the total number of restorations stratified for depth were 14% in deep cavities, 6% in medium depth cavities and 5% in shallow cavities in the SE/SP group, and 35% in deep cavities, 16% in medium and 4% in shallow cavities in the TE group. Fisher's exact test showed the incidence of IPS was significantly higher in cases of deep (P< 0.05) and medium (P< 0.05) cavities. The test also revealed that in restorations placed with the SE/SP adhesive systems, the presence or absence of a protective liner or base made no significant difference in the IPS in medium and shallow cavities, while the use of such protective layers produced a significantly higher IPS (21%), compared with no protection (0%), in deep cavities (P< 0.05). The absence of protective liners or bases did not result in postoperative sensitivity in deep cavities, when the SE/SP dentin bonding systems were used.