NTAPP处理对牙本质粘接界面的稳定性及相关机制研究

Degradation of the resin-dentin bonding interface can reduce the longevity of bonding restorations. The existing dentin bonding strategies cannot prevent the interface degradation thoroughly. At present, it is urgent to develop a new strategy with higher clinical transformation. Non-thermal atmospheric pressure plasma (NTAPP) can produce excited species and reactive gases. This technique is considered to be safe, clean and effective, which has been widely used in tooth whitening, sterilization and material surface modification. Recent research shows that NTAPP treatment could improve the immediate bond strength of resin composite to dentin. Nevertheless, there were deficient researches on dentin bonding durability with NTAPP treatment. Furthermore, the appropriate treating methods, the relevant parameters and the specific mechanism are not clear. This research is aimed to find appropriate conditions of NTAPP treatment on dentin bonding, investigate the interaction of NTAPP, dentin, adhesive agent and bonding interface, by using a series of experimental techniques of molecular biology, biomechanics and chemical analysis. The launching of this study is important to elucidate the specific mechanism of increasing dentin bonding durability by NTAPP treatment, offer a new way to prolong the longevity of bonding restorations, find out canonical technical parameters for the clinical transformation of NTAPP, and provide a theoretical basis.

现有提高牙本质粘接的策略不能彻底解决牙本质粘接持久性的问题，亟待研究临床转化性更高的新策略。低温常压等离子体安全、清洁，常用于材料表面改性。将NTAPP技术与口腔粘接学交叉融合，可改善牙本质即刻粘接效果，但缺乏粘接持久性研究，其适宜处理方式、相关参数及具体作用机制均不明确。本研究拟借助K型热电偶、红外成像技术、生物力学分析和超微结构观察，筛选NTAPP处理牙本质粘接界面的最佳方式；进行老化模拟实验，评价NTAPP处理对牙本质粘接长期稳定性的作用效果；采用分子生物学、分析化学等技术， 从NTAPP改性脱矿牙本质、改善粘接剂聚合能力、增强界面杂化作用、抑制牙源性MMPs等多个角度，综合分析NTAPP与牙本质粘接界面的相互作用机制。该课题的开展对阐明NTAPP提高牙本质粘接界面耐久性的具体机制有重要的研究意义，为延长粘接修复体使用寿命提供新的研究思路并奠定理论基础。

本项目针对现有提高牙本质粘接的策略不能彻底解决牙本质粘接持久性的问题，将低温常压等离子体表面改性技术与口腔粘接学交叉融合，从处理方式、参数选择及作用机制等角度，系统研究了该技术改善牙本质粘接耐久性的作用。（1）筛选出NTAPP 处理矿化牙本质及脱矿牙本质的最佳方式，从牙本质表面微观形貌、粘接界面混合层、树脂突等微观结构的角度，明确了NTAPP 处理牙本质粘接界面，以低功率、低剂量、短期处理为前提条件。（2）从全酸蚀、自酸蚀粘接两个角度，评价NTAPP 处理对不同种类粘接剂—牙本质的长期粘接效果。（3）明确了NTAPP处理对粘接剂聚合能力、牙本质润湿性能、胶原纤维理化性能的影响，探明了NTAPP处理对游离型基质金属蛋白酶的抑制作用。