Dentin bonding systems: From dentin collagen structure to bond preservation and clinical applications
Dentin bonding systems: From dentin collagen structure to bond preservation and clinical applications
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DOI：
10.1016/j.dental.2017.11.005
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发表时间：
2018-01-01
期刊：
影响因子：
5
通讯作者：
Mazzoni, Annalisa
中科院分区：
文献类型：
--
作者：
Breschi, Lorenzo;Maravic, Tatjana;Mazzoni, Annalisa
目标.几十年来，人们一直在努力实现持久的树脂-牙本质粘结，包括理解混合层（HL）降解的机制，制造改进的粘合剂系统，以及开发用于保存HL的策略。本研究批判性地讨论了现有的同行评议的研究有关的形成和保存的HL，机制，导致HL的降解，以及防止它的策略。HL的降解通过两种主要机制发生：其胶原纤维的酶促降解和树脂从HL中沥滤。它们是通过裸露的胶原纤维之间残留的未结合水实现的，被困在HL的底部。因此，内源性牙本质酶，如基质金属蛋白酶（MMP）和半胱氨酸组织蛋白酶被激活，并可以降解裸露的胶原蛋白基质。随着时间的推移，HL的保存策略已经开发出来，它们需要从胶原纤维之间的间隙中去除未结合的水，以及沉默内源性酶活性的不同模式。虽然在牙科粘接领域还有更多的障碍需要克服，但迄今为止已经取得了令人印象深刻的进展，关于该主题的大量可用研究表明了这一问题的重要性，以及研究人员和牙科材料公司为达到树脂-牙本质粘结的质量和寿命的新水平所做的巨大努力。(C)2017年牙科材料学院。由爱思唯尔有限公司出版。保留所有权利。
Objectives. Efforts towards achieving durable resin-dentin bonds have been made for decades, including the understanding of the mechanisms underlying hybrid layer (HL) degradation, manufacturing of improved adhesive systems, as well as developing strategies for the preservation of the HL.Methods. This study critically discusses the available peer-reviewed research concerning the formation and preservation of the HL, the mechanisms that lead to the degradation of the HL as well as the strategies to prevent it.Results. The degradation of the HL occurs through two main mechanisms: the enzymatic degradation of its collagen fibrils, and the leaching of the resin from the HL. They are enabled by residual unbound water between the denuded collagen fibrils, trapped at the bottom of the HL. Consequently, endogenous dentinal enzymes, such as the matrix metalloproteinases (MMPs) and cysteine cathepsins are activated and can degrade the denuded collagen matrix. Strategies for the preservation of the HL over time have been developed, and they entail the removal of the unbound water from the gaps between the collagen fibrils as well as different modes of silencing endogenous enzymatic activity.Significance. Although there are many more hurdles to be crossed in the field of adhesive dentistry, impressive progress has been achieved so far, and the vast amount of available research on the topic is an indicator of the importance of this matter and of the great efforts of researchers and dental material companies to reach a new level in the quality and longevity of resin-dentin bonds. (C) 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.