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中华口腔医学研究杂志(电子版) ›› 2026, Vol. 20 ›› Issue (05) : 389 -403. doi: 10.3877/cma.j.issn.1674-1366.2026.05.006

专家笔谈

自酸蚀类树脂水门汀的临床应用与未来展望
肖宇昕1, 沈子暄1, 魏义航1, 李歆琦1, 周怡萱1, 付佳乐2,†()   
  1. 1中国医科大学口腔医学院,沈阳 110002
    2中国医科大学口腔医学院口腔修复学教研室,中国医科大学附属口腔医院数字化口腔修复中心,沈阳 110002
  • 收稿日期:2026-01-23 出版日期:2026-10-01
  • 通信作者: 付佳乐

Clinical applications and future prospects of self-etch resin cements

Yuxin Xiao1, Zixuan Shen1, Yihang Wei1, Xinqi Li1, Yixuan Zhou1, Jiale Fu2,†()   

  1. 1School of Stomatology, China Medical University, Shenyang 110002, China
    2Department of Prosthodontics, Digital Prosthodontic Center, School and Hospital of Stomatology, China Medical University, Shenyang 110002, China
  • Received:2026-01-23 Published:2026-10-01
  • Corresponding author: Jiale Fu
  • Supported by:
    Science and Technology Plan Joint Project of Liaoning Province (Natural Science Foundation - General Project)(2025-MSLH-743); China Medical University College Students Innovation and Entrepreneurship Training Program(202610159015)
引用本文:

肖宇昕, 沈子暄, 魏义航, 李歆琦, 周怡萱, 付佳乐. 自酸蚀类树脂水门汀的临床应用与未来展望[J/OL]. 中华口腔医学研究杂志(电子版), 2026, 20(05): 389-403.

Yuxin Xiao, Zixuan Shen, Yihang Wei, Xinqi Li, Yixuan Zhou, Jiale Fu. Clinical applications and future prospects of self-etch resin cements[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2026, 20(05): 389-403.

自酸蚀类树脂水门汀是一种兼具美观与性能的口腔修复材料,近年来凭借着操作简便、较低的技术敏感性和低术后敏感发生率等独特优势,在口腔修复学领域备受关注,并广泛应用于临床间接修复体的粘固操作。本文梳理了自酸蚀类树脂水门汀的化学组成及粘接机制,归纳不同临床场景下的注意事项,并对其未来发展趋势进行探讨。口腔医师应充分了解材料特性,熟悉各类应用场景的操作要点,并关注相关研究,以提供更精准与规范的临床操作。伴随临床对高效操作的追求和粘接技术的更新迭代,如何在简化操作的同时保证粘接强度有望成为未来的发展方向。

Self-etch resin cements are dental restorative materials that combine aesthetic appeal with outstanding performance. In recent years, they have gained significant attention in the field of prosthodontics owing to their unique advantages, such as simplified procedures, low technique sensitivity, and a reduced incidence of postoperative sensitivity. Consequently, they have been widely adopted for the cementation of indirect restorations clinically. This review systematically analyzes the chemical composition and bonding mechanisms of self-etch resin cements, summarizes clinical considerations across various situations, and discusses future development trends. Dental clinicians should thoroughly understand the material properties, master the operational essentials for different applications, and stay informed about relevant research to ensure precise and standardized clinical practice. With the increasing demand for clinical efficiency and the iteration and updating of bonding technology, balancing simplified procedures with the maintenance of optimal bonding performance remains a key direction for future advancement.

表1 全酸蚀类、自酸蚀类与自粘接类树脂水门汀的比较
树脂水门汀类型 操作步骤 粘接机制 性能特点 边缘封闭性 抗水解性与耐久性 常见问题
全酸蚀类树脂水门汀 需单独使用酸蚀剂处理基牙表面,釉质冲洗后吹干;牙本质表面需保持一定湿度,再涂布底漆处理剂与粘接剂,最后使用树脂水门汀[5]。 微机械嵌合+化学结合:通过磷酸蚀使牙釉质脱矿形成微机械嵌合;去除牙本质表面玷污层,暴露胶原纤维网形成混合层[4]。 粘接强度最高,技术敏感性最高,操作步骤最繁琐,长期稳定性最高[6,7]。 优[8] 高(推荐在磷酸处理面涂布氯己定)[9] 操作繁琐,易受污染,牙本质"湿粘接"技术具有高度技术敏感性[10]。
自酸蚀类树脂水门汀 无需单独酸蚀;使用含酸性功能单体的通用型粘接剂或专用处理剂处理基牙,再使用树脂水门汀[5]。 微机械嵌合+化学结合:处理剂或粘接剂中酸性功能单体部分溶解玷污层,渗入牙本质形成混合层[4]。 粘接强度居中,技术敏感性较低,操作复杂性居中,对牙髓刺激性较低,术后敏感较少,长期稳定性较高[11]。 良好[8] 中[12] 需使用"选择性酸蚀"技术处理牙釉质粘接界面[13]。
自粘接类树脂水门汀 无需在基牙表面使用粘接剂;直接将树脂水门汀用于修复体与基牙之间即可[14]。 主要依赖化学结合,含酸性单体轻度脱矿釉质和牙本质,形成一定程度的微机械嵌合[4]。 粘接强度最低,技术敏感性最低,操作最简便,对牙髓刺激性低,但边缘封闭性略差,长期稳定性差[11]。 一般(具有材料依赖性)[15] 一般(具有材料依赖性)[16] 粘接强度波动较大,对粘接基底敏感[17]。
表2 自酸蚀类树脂水门汀及其粘接系统的主要化学组成
图1 自酸蚀类树脂水门汀粘接界面分层示意图 MMA:甲基丙烯酸甲酯;Bis-GMA:双酚A-二甲基丙烯酸缩水甘油酯;UDMA:二甲基丙烯酸氨基甲酸酯;TEGDMA:三乙二醇二甲基丙烯酸酯;10-MDP:10-甲基丙烯酰氧基癸基磷酸二氢酯;HAP:羟基磷灰石;MMP:基质金属蛋白酶。
表3 临床常见的自酸蚀类树脂水门汀(粘接剂/处理剂+水门汀)
厂家 产品 主要组分 膜厚度 颜色选择 pH值 适应证
BISCO,美国 All-Bond Universal®通用型粘接剂 Bis-GMA、MMA、HEMA、10-MDP <10 μm 淡黄色(Pale Yellow) 2.5 ~ 3.5 ①直接修复:树脂基复合树脂、树脂改性玻璃离子、桩核核成形修复等;②间接修复体粘接:金属、玻璃陶瓷、氧化锆/氧化铝等材质修复体;③牙本质脱敏治疗、牙体封闭处理;④口内修补修复:崩瓷修补、现有直接修复体追加充填修补等;⑤玻璃离子充填体的护洞漆/保护涂层应用;⑥正畸托槽粘接;⑦根管纤维桩粘接固位。
  DUO-Link Universal™ Resin Luting Cement双固化树脂水门汀 Bis-GMA、TEGDMA、UDMA 12 ~ 15 μm 通用色(Universal),乳白色(Milky White) - ①间接修复体:金属/复合材料/瓷/陶瓷/氧化锆/氧化铝/全冠、固定桥、嵌体、高嵌体;②纤维桩、复合材料桩、金属桩或氧化锆桩;③种植体基台、种植体支持的全冠和固定桥;④复合材料贴面、全瓷贴面和氧化锆贴面。
GC,日本 G-Multi Primer粘接剂增强底漆 10-MDP、硅烷偶联剂 单分子层 无色(Colorless) - ①玻璃陶瓷、混合陶瓷、氧化锆、氧化铝、复合树脂及金属材质间接修复体的粘接面进行底涂预处理;②破损/折裂的陶瓷、混合陶瓷、氧化锆、氧化铝、复合树脂材质间接修复体口内、口外修补。
  G-CEM ONE™双固化树脂水门汀 PAE、SiO2、UDMA 5 μm A2,半透明(Translucent),AO3,BO1白色不透明(White Opaque) - ①各类全瓷、树脂、金属材质嵌体、高嵌体、全冠、固定桥的粘接固位;②金属桩、陶瓷桩、纤维桩、铸造桩核的粘接固位;③全瓷贴面、树脂贴面的粘接固位;④种植基台上方全冠、固定桥的最终粘接固位。
沪鸽Huge,中国 美益汀®光固化牙体粘接剂 - - 透明 - ①树脂充填粘接;②隐形矫治器附件粘接;③光固化复合树脂粘接;④纤维桩粘接;⑤全瓷修复体粘接;⑥与树脂水门汀配套使用。
美益汀®粘固用树脂水门汀(双固化) - - 透明,白色不透明 -
Ivoclar Vivadent,列支敦士登 Multilink®N Primer A/B自酸蚀粘接剂 HEMA、膦酸丙烯酸酯 - 透明 - 全瓷/金属/复合树脂等多种材料的嵌体、高嵌体、全冠、固定桥和根管桩的粘接。
Multilink®N双固化树脂水门汀 UDMA、HEMA、Bis-GMA - 透明,黄色(Yellow) - ①玻璃陶瓷、二硅酸锂玻璃陶瓷、复合树脂修复体(嵌体、高嵌体、部分冠、全冠、固定桥)的永久粘接固位;②氧化锆等氧化物陶瓷、金属材质不透光修复体的永久粘接固位;③根管桩的永久粘接固位。
Kerr,美国 OptiBond™ eXTRa Universal通用型粘接剂 HEMA、GPDM、GDMA - 淡黄色 >2 ①所有间接修复应用(包括贴面、CAD/CAM修复体、陶瓷、瓷、树脂、金属修复体);②贴面粘接(可使用双固化或光固化型);③需要无限操作时间的多单位修复(推荐使用光固化型);④适用于自酸蚀或全酸蚀粘接技术。
  NX3 Nexus™ Third Generation光固化树脂水门汀 Bis-EMA、TEGDMA、UDMA、HEMA 9 μm 透明,白色,黄色,漂白色(Bleach),白色不透明 -
Kuraray Noritake,日本 可乐丽菲露™ SE ONE自酸蚀粘接剂 Bis-GMA、HEMA、10-MDP - 黄色 ≤2.5 ①配合光固化复合树脂进行牙体直接修复;②间接修复体粘接前的窝洞封闭预处理;③暴露牙根面的牙体脱敏与封闭治疗;④牙本质敏感牙的脱敏治疗;⑤口内折裂修复体的口内修补修复;⑥配合双固化或自固化复合树脂完成根管桩粘接固位;⑦配合光固化、双固化或自固化核成型材料进行桩核核体构筑修复;⑧配合复合树脂水门汀,完成嵌体、高嵌体、全冠、固定桥及贴面的粘接固位。
  可乐丽菲露™ DC CORE ONE双固化复合树脂 Bis-GMA、钡玻璃粉、氧化铝填料 - 牙本质色(Dentin),白色 - ①使用直接法进行基牙构筑;②使用间接法进行基牙构筑。
  可乐丽菲露™ SE BOND两步法自酸蚀粘接剂 Bis-GMA、HEMA、10-MDP 40 ~ 80 μm 黄色 ≤2.5 ①使用光固化复合树脂或复合体的直接充填修复;②间接修复体的预处理;③窝洞封闭;④过敏性和/或暴露根面的脱敏治疗;⑤使用光固化复合树脂进行瓷、混合陶瓷或复合树脂制贴面冠的崩裂修补;⑥瓷、混合陶瓷及已固化复合树脂制成的修复体(修复器械)的表面处理。
  帕娜碧亚™ V5牙质粘合处理剂 10-MDP、HEMA - 透明 <2.3 ①冠、桥、嵌体及高嵌体的粘接;②贴面的粘接;③桩核的粘接;④氧化锆的粘接。
  帕娜碧亚™ V5修复体处理剂 硅烷偶联剂、10-MDP - 透明 -  
  帕娜碧亚™ V5糊剂双固化树脂水门汀(不透明色仅为化学固化) Bis-GMA、TEGDMA、HEMA 12 μm 通用色,透明,白色,褐色(Brown),不透明 -  
Shofu,日本 AZ-Primer 6-MPHA - 透明(Clear) - ①氧化铝或氧化锆修复体的树脂粘接;②使用树脂水门汀进行修复体的粘固;③使用复合树脂对碎裂的修复体进行修补。
  ResiCem®双固化树脂水门汀 UDMA、TEGDMA、HEMA、4-AET、羧酸单体 9 μm 通用色,透明,象牙色(Ivory),不透明 - ①氧化铝或氧化锆修复体的粘接性粘固;②瓷或间接复合树脂材料制作的贴面、牙冠、牙桥、嵌体、高嵌体及金属增强型间接修复体的粘固;③各类桩及核材料的粘固。
Solventum,美国(原3M) Scotchbond™ Universal通用型粘接剂 Bis-GMA、硅烷化SiO2、HEMA 5 ~ 10 μm 黄色 2.7 ①配合光固化复合树脂或复合体材料,进行各类窝洞的充填;②配合其他产品进行间接修复体粘固;③粘接由光固化复合树脂或专用核材料制作的核;④修补复合树脂充填体、复合体充填体;口内修复复合树脂修复体、烤瓷熔附金属冠及全瓷修复体(无需额外预处理剂);⑤银汞合金修复前窝洞封闭,间接修复体临时粘固前窝洞封闭及牙体预备面封闭;⑥根面脱敏处理;⑦作为玻璃离子充填体的保护性漆;⑧粘接窝沟封闭剂。
  RelyX™ Ultimate双固化树脂水门汀 TEGDMA、硅烷化处理剂、Bis-EMA 12 μm 半透明,漂白色(B0.5),A1,A3不透明 -
Tokuyama,日本 BONDMER LightlessⅡ通用型粘接剂 Bis-GMA、TEGDMA、HEMA、3D-SR Monomer、MTU-6 5 ~ 10 μm 绿色(固化前) - ①前后牙直接修复;②口内修复复合树脂修复体、烤瓷熔附金属修复体、金属修复体及全瓷修复体,无需额外使用预处理剂;③配合光固化、双固化及自固化树脂水门汀进行间接修复体及贴面的粘固;④核充填材料的核成型粘接;⑤义齿树脂与金属基托、卡环或附着体的粘接;⑥带有金属基托、卡环或附着体的义齿修补;⑦遮色树脂与金属基底粘接。
  ESTECEMⅡ PLUS双固化树脂水门汀 Bis-GMA、TEGDMA、HEMA、MTU-6 10 μm 通用色,透明,褐色,白色不透明 - ①玻璃/瓷/氧化锆/氧化铝/金属/贵金属/非贵金属/树脂材料等制成的冠、桥、嵌体和高嵌体;②折裂的饰面冠和所有陶瓷修复体;③贴面、粘接桥、金属/树脂核、金属或玻璃纤维桩的粘接。
图2 修复体粘接策略决策树
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