止血剤で汚染された象牙質に対するユニバーサルアドヒーシブの接着強さについて

Bond Strengths of Universal Adhesives to Dentin Contaminated with a Hemostatic Agent.

抄録

目的:

止血剤で汚染された象牙質に対する3種の万能接着剤の微小引張接着強さ（μTBS）を評価すること。

PURPOSE: To evaluate the microtensile bond strength (µTBS) of three universal adhesives to dentin contaminated with a hemostatic agent.

材料および方法:

96本のヒト小臼歯を切削し，歯冠中央象牙質を露出させた．対照群（非汚染象牙質）と止血剤を塗布した実験群（汚染象牙質）に無作為に分けた。各群は，ユニバーサル接着剤（SBU（Single Bond Universal），OPU（OptiBond Universal），CBQ（Clearfil Universal Bond Quick））およびエッチングモード（ER（etch and rinse）またはSE（Selfetch））によってさらに6サブグループに分類された．接着剤塗布後，コンポジットを2分割して配置し，光硬化させた．試験片は蒸留水中で37°C，24時間保存した．万能試験機を用いてμTBS試験を実施した．故障モードは光学顕微鏡を用いて評価した．データは，三元配置の分散分析に続いてScheffeの検定を用いて統計的に分析した（p＜0.05）．レジン-象牙質界面は走査型電子顕微鏡で観察した．

MATERIALS AND METHODS: Ninety-six human premolars were cut to expose mid-coronal dentin. The teeth were randomly divided into a control group (uncontaminated dentin) and an experimental group in which a hemostatic agent was applied (contaminated dentin). Each group was further divided into 6 subgroups according to universal adhesives - SBU (Single Bond Universal), OPU (OptiBond Universal), CBQ (Clearfil Universal Bond Quick) - and etching mode, either etch-and-rinse (ER) or self-etch (SE). Following adhesive application, composite was placed in two increments and light cured. The specimens were stored in distilled water at 37°C for 24 h. The µTBS test was performed using a universal testing machine. Failure mode was assessed using a light microscope. The data were statistically analyzed using three-way ANOVA followed by Scheffe's test (p < 0.05). The resin-dentin interface was observed using scanning electron microscopy.

結果:

万能接着剤をSEモードで汚染象牙質に接着させた場合，有意に低い接着強度が認められた（p＜0.05）．一方，ERモードでは，万能接着剤のµTBSは汚染の影響を受けなかった（p＞0.05）．CBQの汚染象牙質に対するµTBSは，他の接着剤に比べ有意に低かった．レジン-象牙質界面の観察から，汚染象牙質に対してSEモードで万能接着剤を塗布した場合，レジンの浸透は限定的であることが示唆された．

RESULTS: Significantly lower bond strength was observed when the universal adhesives were bonded to contaminated dentin in SE mode (p < 0.05). In contrast, the µTBS of the universal adhesives in ER mode was not affected by contamination (p > 0.05). The µTBS of CBQ to contaminated dentin was significantly lower than that of the other adhesives. Observation of the resin-dentin interface revealed limited resin penetration when the universal adhesive was applied in SE mode on contaminated dentin.

結論:

止血剤による象牙質への汚染は，SEモードにおける汎用接着剤のµTBSを有意に低下させた．しかし，ERモードで使用した場合には，このような悪影響は認められなかった．

CONCLUSION: Contaminating the dentin with a hemostatic agent significantly reduced the µTBS of the universal adhesives in SE mode. However, this adverse effect was not found when the universal adhesives were used in ER mode.