Một Đánh Giá Phê Phán Về Độ Bền Của Sự Gắn Kết Với Tổ Chức Răng: Phương Pháp Và Kết Quả
Tóm tắt
Hiệu quả liên kết tức thì của các loại keo hiện đại là khá khả quan, không phụ thuộc vào phương pháp được sử dụng. Về lâu dài, hiệu quả gắn kết của một số loại keo giảm mạnh, trong khi sức mạnh liên kết của các loại keo khác lại ổn định hơn. Bài viết này xem xét các quá trình cơ bản dẫn đến sự giảm sút độ bám dính của vật liệu sinh học với men răng và ngà răng theo thời gian. Các thử nghiệm lâm sàng không sâu răng lớp V vẫn là phương pháp thử nghiệm tối ưu để đánh giá hiệu quả bám dính, nhưng bên cạnh việc có chi phí cao, chúng còn mất nhiều thời gian và công sức, đồng thời cung cấp ít thông tin về nguyên nhân thực sự của sự thất bại lâm sàng. Do đó, một số quy trình trong phòng thí nghiệm đã được phát triển để dự đoán độ bền của liên kết. Bài báo này đánh giá một cách nghiêm túc các phương pháp tập trung vào các mẫu hình phân hủy hóa học như thủy phân và sự giải phóng các thành phần giao diện, cũng như các thiết lập thử nghiệm theo cơ học, chẳng hạn như đo độ mỏi và độ bền gãy. Một tương quan giữa dữ liệu in vitro và in vivo cho thấy, hiện nay, phương pháp được xác thực nhiều nhất để đánh giá độ bền của sự bám dính liên quan đến việc lão hóa các mẫu vi của vật liệu sinh học được liên kết với men hoặc ngà răng. Sau khoảng 3 tháng, tất cả các loại keo đều thể hiện bằng chứng cơ học và hình thái học của sự phân hủy giống như các tác động lão hóa in vivo. Một so sánh giữa các loại keo hiện đại cho thấy rằng các loại keo etch-and-rinse ba bước vẫn giữ vị trí 'tiêu chuẩn vàng' về độ bền. Bất kỳ sự đơn giản hóa nào trong quy trình áp dụng lâm sàng đều dẫn đến việc giảm hiệu quả bám dính. Chỉ có các loại keo tự etch hai bước là gần đạt tiêu chuẩn vàng và có một số lợi ích lâm sàng bổ sung.
Từ khóa
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