Mikromorfologija hibridnog sloja i otpornost na silu smicanja adhezivne veze formirane između pojednostavljenih potpuno nagrizajućih i samonagrizajućih adheziva sa zdravim i karijesno izmenjenim dentinom
Sažetak
Apstrakt
Uvod/Cilj. Uklanjanjem karijesno inficiranog dentina tokom preparacije kaviteta, značajne površine na njegovim zidovima ostaju pokrivene karijesno izmenjenim dentinom. Povezivanje sa karijesno izmenjenim dentinom karakteriše manja jačina veze i slabiji kvalitet gradnje hibridnog sloja. Cilj rada je poređenje otpornosti adhezivne veze na silu smicanja (SBS) aktuelnih adhezivnih sistema sa zdravim (SD) i karijesno izmenjenim dentinom (CAD), kao i analiza mikromorfologije hibridnog sloja. Metode. Šezdeset ekstrahovanih humanih molara sa karijesom okluzalne površine izabrani su kao eksperimentalna grupa, a šezdeset ekstrahovanih intaktnih humanih molara (impaktirani treći molari) izabrani su kao kontrolna grupa. Karijesno izmenjen dentin prepoznat je upotrebom vizuelne identifikacije (North Carolina Dentin Sclerosis Scale). Zubi obe grupe podeljeni su u tri podgrupe zavisno od primenjenog kompozitnog sistema: Adper Single Bond Plus/Filtek Supreme XT (ASB/FS) (3M ESPE), AdheSE One/Tetric EvoCeram (AO/TEC) (IvoclarVivadent), Prime&Bond NT/CeramX Mono (PB/CXM) (Dentsply). Adhezivna procedura sprovedena je u skladu sa uputstvima proizvođača. SBS je merena na univerzalnoj kidalici. Mikromorfologija hibridnog sloja analizirana je upotrebom skening elektronskog mikroskopa (SEM). Otpornost adhezivne veze na silu smicanja u srednjim vrednostima (MPa) i debljina hibridnog sloja u µm statistički su analizirani pomoću t-testa, Mann-Whitney U-testa, ANOVA i Holmovog testa. Rezultati. Srednje vrednosti SBS ± standardna devijacija iznosile su: ASB/FS na SD = 10,56 ± 3,49; ASB/FS na CAD = 10,06 ± 2,55; AO/TEC na SD = 7,01 ± 2,05; AO/TEC na CAD = 6,73 ± 1,66; PB/CXM na SD = 9,01 ± 2,47; PB/CXM na CAD = 7,83 ± 1,42. Statistički značajna razlika uočena je između ASB/FS i AO/TEC na obe forme dentina: na zdravom i na karijesno izmenjenom dentinu, a između ASB/FS i PB/CXM samo na karijesno izmenjenom dentinu. Debljina hibridnog sloja je bila statistički značajno veća za ASB/FS nego za PB/CXM sistem. Kod sistema ASB/FS debljina hibridnog sloja je bila statistički značajno veća na CAD nego na SD. Nije uočeno postojanje hibridnog sloja kod AO/TEC sistema. Zaključak. Svi testirani kompozitni sistemi se jednako dobro vezuju sa zdravim i karijesno-izmenjenim dentinom. Tolhesivi sa potpunim nagrizanjem ostvaruju veće vrednosti jačine veze. Adper Single Bond Plus-Filtek Supreme XT system formira statistički značajno tanji hibridni sloj na oba tipa dentina u odnosu na Prime&Bond NT-CeramX Mono sistem.
Reference
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