一般開業医が達成した象牙質への接着

Bonding to dentin achieved by general practitioners.

• Serge Bouillaguet
• Michel Degrange
• Maria Cattani
• Chantal Godin
• Jean-Marc Meyer

抄録

本研究の目的は，（1）象牙質に対する接着剤のせん断接着強さに対する操作者のばらつきの影響を調べること，（2）異なる種類の接着剤の接着性能に対する教育の効果を調べることである．30名の一般開業医が、地域の郵送によるCEコースに募集されました。彼らは、牛の象牙質を基質として、診療で日常的に使用している接着システムと他の2つの材料を接着した（経験なし）。各接着剤OptiBond FL，ScotchBond Multipurpose Plus，ScotchBond 1，Clearfil SEをメーカーの指示に従って塗布し，直ちにせん断接着強さ試験を行った。接着剤と象牙質の間のせん断接着強さを、接着の原理と材料に関する90分の講義の前後で比較しました。材料の使用経験がある歯科医師とない歯科医師では，講義の前後で統計的に有意な差は見られなかった（ペアのt検定，p < or = 0.05）。しかし，いずれの場合も，講義後の接着強さは講義前よりも高くなった（改善率の範囲は15～150％）．特定の材料を日常的に使用している歯科医師の場合，講義後はすべての材料が統計的に同等であったが，OptiBond FLが最も高かった。特定の材料の使用経験がない歯科医師に対しては，ScotchBond 1は講義後に他の材料よりも低い接着強さを示した。歯科医師の接着システムを正しく操作する能力には大きな幅がありました。しかし，歯科医師が十分な経験を積み，十分な教育を受ければ，これらの材料のいずれも妥当な結果を得ることができます。

The objectives of this study were (1) to investigate the effect of operator variability on the shear bond strength of adhesives to dentin and (2) to determine the effectiveness of education on bonding performance for different types of adhesives. Thirty general practitioners were recruited for a CE course by a regional mailing. They used bovine dentin as a substrate for bonding the adhesive system they routinely used in practice and two other materials (no previous experience). Each adhesive OptiBond FL, ScotchBond Multipurpose Plus, ScotchBond 1 and Clearfil SE was applied according to manufacturer's instructions and immediately tested using a shear bond strength test. Shear bond strengths between adhesives and dentin were compared before and after a 90 min lecture on bonding principles and materials. For dentists with and without previous experience with a material, there were no statistically significant differences seen before and after the lecture (paired t-tests, p < or = 0.05). However, in every case, the bond strengths after the lecture were higher than those before (range of improvement from 15 to 150%). For dentists with routine experience with a particular material, all materials were statistically equivalent after the lecture, although the OptiBond FL was the highest. For dentists who had no previous experience with a material, the ScotchBond 1 had lower bond strengths than the other materials after the lecture. There was a large range in the ability of dentists to manipulate adhesive systems correctly. However, if a dentist has sufficient experience and receives sufficient education, any of these materials can give reasonable results.