Developing and clinical application of a highly reliable dentin-bonding system.

用旋转器械对牙洞进行机械预备后，在牙本质表面形成涂抹层。由于树脂对牙本质黏附的干扰，通常需要用回声去除玷污层，通过树脂分子扩散到脱矿后的牙本质来实现与牙本质的牢固粘结。在某些情况下，树脂聚合后脱矿的牙本质残留在洞壁周围。剩余的脱矿牙本质会发生水解，严重影响牙本质粘结的耐久性。为减少剩余脱矿牙本质的数量，应尽可能保持胶原结构的完整性。此外，应尽可能减少脱矿牙本质的厚度。因此，应使用较温和的刺激剂，以在杂化层中留下较多的羟基磷灰石。杂化层中的树脂含量也很重要。结果表明，粘结耐久性与牙本质基质的性质有关。然而，有关牙本质基质条件对粘结耐久性的影响的研究报道很少。人们普遍认为，扩散树脂可以在脱矿牙本质层中聚合和杂交。在本研究中，根据这一概念建立了一种可靠的光固化牙本质粘结剂。在湿法粘接技术中，树脂对脱矿牙本质的扩散能力可以通过反复预涂的方法来提高。杂化层中树脂含量增加。建立了高质量的胶粘层。乙二胺四乙酸乙二酯可以去除玷污层，并使健全牙本质下的牙本质脱矿(厚度：1μm~2μm)。这一层中的单体与牙本质聚合并杂交。用波长为473 nm的蓝光激光固化脱矿牙本质层中的树脂单体。建立了商品牙本质粘结剂的可靠固化体系。

After mechanical preparation of the tooth cavity with rotating instrument, the smear layer is formed on the dentin surface. Owing to the disturbance of resin adhesion to dentin, smear layer is always removedby an echant, The strong bonding to dentin can be achieved by the diffusion of resin molecules to the resulting demineralized dentin. Under some circumstances, the demineralized dentin was left surround the cavity wall after resin polymerization. The remaining demineralized dentin would be hydrolyzed and impairs the dentin bond durability greatly. For reducing the amount of residual demineralized dentin, the integrity of collagen structure should be preserved as possible. In addition, the thickness of demineralized dentin should be reduced as possible. Therefore, the milder echant should be used to leave more hydroxyapatite in the hybrid layer. The resin content in the hybrid layer is also important. It is suggested that the bond durability is attributed to the property of dentin substrate. However, few studies have reported on the effect of dentin substrate condition on bond durability. It is well accepted that the diffused resin could be polymerized and hybridized in the demineralized dentin layer. In this study, a reliable light-curing dentin bonding agent was established according to this concept. In wet bonding technique, the diffusion ability of resin to demineralized dentin can be increased by repeated priming procedure. The resin content was increased in the hybrid layer. A high quality adhesive layer was established. EDTA is known to remove the smear layer and demineralized the underneath sound dentin (thickness : 1μm〜2μm). Monomer in this layer is polymerized and hybridized with dentin. A blue laser with the wave-length of 473 nm, can be used to cure the resin monomer in the demineralized dentin layer. A reliable curing system for curing commercial dentin bonding agents was established.