Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
Department of Orthodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq.
Sci Rep. 2019 Jul 3;9(1):9579. doi: 10.1038/s41598-019-45980-9.
Orthodontic treatment is widely used to correct irregular teeth and/or jaw discrepancies to improve oral function and facial aesthetics. However, it is frequently associated with enamel damage that include chipping, demineralisation, and white spot formation. So far, current bonding systems that can maintain shear bond strengths (SBS) suitable for clinical performance are unable to limit enamel demineralisation, adhesive remnants and damage caused on removal of brackets after treatment. This study reports a novel "safe enamel etch" clinically viable procedure that was accomplished via application of novel etchant pastes developed with β-tricalcium phosphate and monocalcium phosphate monohydrate powders mixed with citric acid (5 M) or phosphoric acid (37% PA) to yield BCA and BPA etchants respectively. Although enamel etched with clinically used PA gel yielded higher SBS than the BCA/BPA etchants, it exhibited greater adhesive remnants with evidence of enamel damage. In contrast, the experimental etchants resulted in unblemished enamel surfaces with zero or minimal adhesive residue and clinically acceptable SBS. Furthermore, the BPA etchant caused lower enamel decalcification with extensive calcium-phosphate precipitation. The study conclusively showed that BPA facilitated in vitro enamel adhesion without detrimental effects of the aggressive PA gel with potential for remineralisation and saving time at the post-debonding step.
正畸治疗被广泛用于矫正不规则的牙齿和/或颌骨差异,以改善口腔功能和面部美观。然而,它常伴随着釉质损伤,包括碎裂、脱矿和形成白斑。到目前为止,现有的黏合系统虽然能够保持适合临床性能的剪切黏结强度(SBS),但无法限制釉质脱矿、黏附残余物和治疗后去除托槽时造成的损伤。本研究报告了一种新颖的“安全釉质酸蚀”临床可行的方法,通过应用含有β-磷酸三钙和一水磷酸一钙粉末与柠檬酸(5M)或磷酸(37% PA)混合制成的新型酸蚀糊剂来实现,分别产生 BCA 和 BPA 酸蚀剂。尽管用临床使用的 PA 凝胶酸蚀的釉质产生的 SBS 高于 BCA/BPA 酸蚀剂,但它表现出更多的黏附残余物,并有釉质损伤的证据。相比之下,实验酸蚀剂导致釉质表面无瑕疵,无黏附残余物或极少的黏附残余物,且 SBS 达到临床可接受的水平。此外,BPA 酸蚀剂导致脱矿程度较低,有广泛的钙磷沉淀。该研究结论表明,BPA 促进了体外釉质黏附,而不会产生具有潜在再矿化作用的腐蚀性 PA 凝胶的有害影响,并在脱黏附后步骤节省时间。