Fracture Research Articles

Ethnomedicinal Plants of Betul District, Madhya Pradesh

The paper deals with ethnomedicinal information on 54 plant species (belonging to 33 families) collected from field survey amongst three tribes viz., Gond, Korku and Gaiki of Betul district, Madhya Pradesh. An analysis of data has indicated that eight plant species are employed as antidote to snake bite and scorpion sting, six to treat fever. five for rheumatism, four to treat cold, cough, skin diseases, as anthelmintic and tonic, and three for stomach diseases while two species to treat impotency, cuts, wounds and as diuretic. On the other hand, only single species has been referred for a number of other ailments like eye diseases, spermatorrhoea, spleen enlargement, tuberculosis, mouth sore, boil, asthma, liver disorder, toothache, bone fracture, abortifacient, antifertility, and in veterinary. Further, a comparison with the concerned literature has revealed that 23 ethnomedicinal uses of plants have not been reported earlier.

Durability of Titanium Implants Following Type II Thyroplasty for Adductor Type Spasmodic Dysphonia.

To determine the durability of current titanium implants (TI) used in voice improvement surgery for adductor spasmodic dysphonia (ADSD), which is type II thyroplasty (T2T), and identify the effects of their fractures on vocal functions. A total of 36 ADSD patients who underwent T2T had the following exams: The CT scans of the larynx were performed 1 year after the surgery to assess the fractures of TI. The improvement in the mean voice handicap index 10 (VHI-10) scores and the success rate between nonfractured (NFR) and fractured (FR) groups were compared. It was indicated that TI was broken in 21 cases (58.3%). In one case (2.7%), a fracture on the part of the bridge that connects both sides of the plates was observed, and fractures at holes placed on the plates in the other 35 cases (55.6%). The mean VHI-10 score improved from 27.2 ± 8.1 to 11.4 ± 7.9 in the NFR group and from 26.3 ± 4.9 to 9.7 ± 7.9 in the FR group. The success rates were 66.6% in the NFR group and 71.5% in the FR group. No statistical difference was observed in the improvement in the mean VHI-10 scores, and the success rate between the two groups. However, two cases resulted in failure in the FR group, whereas no worsened case was observed in the NFR group. The current TI used in T2T has low durability and could result in the worsening of vocal symptoms after the surgery. 4 Laryngoscope, 133:3028-3033, 2023.

Механические свойства регенерата зоны перелома бедренной кости при применении имплантатов с различным модулем упругости

Проведено экспериментальное исследование на бедренных костях кроликов породы шиншилла. Бедренные кости брали из 4 экспериментальных групп наблюдения: контрольной группы, в которой оперативное вмешательство не проводилось, и трех исследуемых групп. Все кролики опытных групп получали в подвертельной области перелом с последующим металлоостеосинтезом металлическими стержнями. Животным второй группы был выполнен металлоостеосинтез стержнем из нержавеющей стали (316L), третьей — из титано-ванадиевого (ВТ-6) и четвертой — из циркониево-титанового сплава (Zr-Ti). Животных выводили из эксперимента через 90 суток после консолидации перелома бедренной кости. Определяли механические характеристики костей на растяжение и сжатие.Установлено, что биомеханические показатели костей на растяжение уступают подобным показателям при сжатии, кости с наличием металлофиксаторов имеют большую прочность в зоне сросшегося перелома, чем кости контрольной группы. При исследовании работы костного регенерата на растяжение и сжатие наилучшие результаты прочности определены в образцах костей с наличием металлофиксатора из β-Zr-Ti-сплава. Проведенное исследование доказывает целесообразность разработки и внедрения в клиническую практику травматологов-ортопедов имплантатов на основе низкомодульного β-Zr-Ti-сплава, что позволит улучшить результаты лечения переломов длинных костей и уменьшить процент послеоперационных осложнений.

Фіксація перелому ключиці в пацієнтів із флотуючою грудною кліткою й політравмою

Актуальність. 10 % вікончастих переломів ребер трапляються в комбінації з переломом ключиці. Додаткова втрата функції ключицею веде до зростання дихальної недостатності. Мета: встановити показання для фіксації перелому ключиці, асоційованого з вікончастим переломом ребер і політравмою. Матеріали та методи. Дане дослідження проводилось на базі комунальної 8­ї міської клінічної лікарні м. Львова, у якій відділення інтенсивної терапії повністю забезпечене кваліфікованими травматологами й лікарями. Для відбору пацієнтів була використана лікарняна база даних з 2016 по 2018 рік. Результати. Перед призначенням 100% О2 в обох групах вимірювались SpO2 і частота дихальних рухів, суттєвої різниці між результатами вимірів не знайдено: середні значення — 83,70 ± 0,52 % і 43 дихальні рухи за хвилину відповідно. Після хірургічної стабілізації ключиці в групі 2 отримано такі результати: SpO2 зросла до 88,4 ± 0,7 %, частота дихальних рухів зменшилась до 27 за хвилину без підтримки О2. Після призначення 100% О2 SpO2 зросла до 98,3 ± 0,3 %, частота дихальних рухів зменшилась до 22 за хвилину. Середня тривалість проведення штучної вентиляції легень становила 9,67 дня в групі 1 і 5,34 дня — в групі 2, тривалість перебування у відділенні інтенсивної терапії для групи 1 — 15,72 дня, для групи 2 — 12,46 дня, середня тривалість перебування в лікарні для групи 1 становила 32 дні, для групи 2 — 22 дні. Пацієнти, які отримували оперативне лікування, на противагу пацієнтам, які отримували консервативне, не мали потреби в проведенні трахеостомії — 25 % (n = 2). Ми також помітили нижчу частоту ускладнень, асоційованих зі штучною вентиляцією легень: у групі 1 було зареєстровано 2 випадки пневмонії (25 %), у групі 2 не було зареєстровано жодного випадку. Летальність становила 12,5 % у групі 1 (n = 1), усі пацієнти, які отримували оперативне лікування, вижили. Для встановлення рівня значущості використовувався показник SpO2. Для статистичної обробки даних використовувалась програма Microsoft Excel, функція T.DIST.2T. Імовірність нульової гіпотези Н0 р < 0,001. Висновки. У групі пацієнтів, які отримували хірургічне лікування, нижча летальність, менша тривалість перебування у відділенні інтенсивної терапії, тривалість перебування в лікарні, краща дихальна функція зі зменшенням надмірних зусиль. У цій групі також значно менша тривалість штучної вентиляції легень і, відповідно, менша частота пневмоній і потреби в трахеостомії. Ключицю можна назвати воротарем грудної клітки. Показання для фіксації перелому ключиці в пацієнтів із політравмою й вікончастим переломом ребер такі: критичний стан пацієнта, незадовільний стан м’яких тканин, наростаюча дихальна недостатність. Зовнішня фіксація є методом вибору, тому що вона забезпечує: мінімальний ризик інфікування, мінімальну крововтрату, мінімальне пошкодження джерел кровопостачання, контроль пошкоджень.

Variable Selection by sNML Criterion in Logistic Regression with an Application to a Risk-Adjustment Model for Hip Fracture Mortality

When comparing the performance of health care providers, it is important that the effect of such factors that have an unwanted effect on the performance indicator (eg. mortality) is ruled out. In register based studies randomization is out of question. We develop a risk adjustment model for hip fracture mortality in Finland by using logistic regression. The model is used to study the impact of the length of the register follow-up period on adjusting the performance indicator for a set of comorbidities. The comorbidities are congestive heart failure, cancer and diabetes. We also introduce an implementation of the minimum description length (MDL) principle for model selection in logistic regression. This is done by using the normalized maximum likelihood (NML) technique. The computational burden becomes too heavy to apply the usual NML criterion and therefore a technique based on the idea of sequentially normalized maximum likelihood (sNML) is introduced. The sNML criterion can be evaluated efficiently also for large models with large amounts of data. The results given by sNML are then compared to the corresponding results given by the traditional AIC and BIC model selection criteria. All three comorbidities have clearly an effect on hip fracture mortality. The results indicate that for congestive heart failure all available medical history should be used, while for cancer it is enough to use only records from half a year before the fracture. For diabetes the choice of time period is not as clear, but using records from three years before the fracture seems to be a reasonable choice.

Fracture propagation in an initially stressed anisotropic reservoir under shear: Reorientation and fluid lag

We study the propagation of a fracture in an initially stressed anisotropic reservoir under shear. The focus is made on the deviation of the fracture from the principal direction due to the shearing conditions. An asymptotic model is developed, which yields the solution in terms of the effective K2c and the deviation angle. Then, we analyse formation of the fluid lag during propagation of a hydraulic fracture in the cases of plane and radial fracture. It is shown that there is lag between the fluid and the fract ure tip, which may be as large as half of the fracture at early stages of fracture propagation and its actual length is highly dependent on the compressibility of the reservoir rock, tectonic strength and leak-off conditions at the fracture face. In this case the speed of the fracture tip exceeds that of the fluid and is related to the length of the lag. The influence of the fluid front structure on the law of fracture propagation is studied. It is revealed that the magnitude of pressure gradient and its distribution along the fracture have a significant impact on the lag size.

Superplastic behavior of fine-grained extruded ZK61 Mg alloy

The superplasticity of a fine-grained extruded ZK61 magnesium (Mg) alloy was investigated by tensile testing at various elevated temperatures and strain rates. The results demonstrated the strain rate sensitivity (m-value) ~0.51 and ~0.4 and stress exponent (n-value) ~1.96 and ~2.5 at temperatures 673 K and 623 K, respectively. The numerical simulation revealed that the activation energy (Q-value) was in the range of 92.9–146.7 kJ/mol. Therefore, the high elongation to fracture (FE) ~400% and ~334% were achieved at temperatures 673 K and 623 K under tensile loading at a strain rate of 0.001 s−1. The microstructure was thermally stable at elevated temperatures and attributed to MgZn2 phase particles. Based on m-value, n-value, FE, average Q-value ~114 kJ/mol, and thermally stable microstructure, it was found that the governing deformation mechanism was the intra-granular slip. These all feathers assisted in understanding the superplastic behavior of the ZK61 Mg alloy.

Impact Strength Comparison with Carburization Case Depth Variation for Gear Steel by Instrumented Charpy, Izod and Brugger Tests

Impact strength of gear steel assist in estimating the sudden load bearing capacity of the steel. Traditional Charpy and Izod tests provide qualitative assessment of impact strength of steel. Brugger method is evaluated in this paper for case hardened steel. The instrumented impact test results are compared by all the methods for case hardened EN353 steel. The impact results are also compared by varying case depth to assess its influence on test methods. New co-relation is proposed for verification of Brugger impact strength. Fracture surface of impact specimens were characterized using SEM to analyze the associated failure modes and mechanisms. Compared to traditional methods, Brugger method found effective for quantitative impact strength determination of case hardened steels.

Fracture properties and tensile strength of three typical sandstone materials under static and impact loads

The failure behavior and tensile strength of sandstone materials under different strain rates are greatly different, especially under static loads and impact loads. In order to clearly investigate the failure mechanism of sandstone materials under static and impact loads, a series of Brazilian disc samples were used by employing green sandstone, red sandstone and black sandstone to carry out static and impact loading splitting tensile tests, and the failure properties subjected to two different loading conditions were analyzed and discussed. Subsequently, the failure behavior of sandstone materials also were simulated by finite element code. The good agreement between simulation results and experimental results can obtain the following significantly conclusions: (1) The relationship of the tensile strength among sandstone materials is that green sandstone red sandstone > black sandstone; (2) The mainly cause for the difference of dynamic tensile strength of sandstone materials is that the strength of crystal particles in sandstone material, and the tensile strength of sandstone is proportional to the fractal dimension; (3) The dynamic failure behavior of sandstone is greatly different from that of static failure behavior, and the dynamic tensile failure rate in dynamic failure behavior is about 54.92%.

Body Mass Index Vs Fracture Risk Value Primary Osteoporosis (A Case Study on Women Ages 40-45 Years at Sub-Urban Area)

This study aims to determine the relationship between BMI and fracture risk value primary osteoporosis in women aged 40-45 years in sub-urban areas. And how to optimize social activities in the environment as an effort to reduce the risk of osteoporosis. Body mass index is one of the important risk factors for osteoporosis fractures because the protective effects of subcutaneous fat tissue on bone in elderly women are calculated using FRAX®tool. The WHO in collaboration with the Sheffield's University central of metabolic bone disease has created a calculating device, the WHO risk assessment fracture tool (FRAX®tool). FRAX®tool is an online-based device used to calculate the risk of osteoporosis fractures in major bones, namely proximal humerus, wrist, vertebrae, and femur bone in the next ten years. This research is an analytical study using a cross sectional design, the number of samples is 70 female respondents aged 40–45 years in Kelurahan Melong Asih, Cimahi. The relationship between body mass index and the risk of primary osteoporosis fracture, used the rank spearman correlation test. The results of this study indicate a strong negative correlation between body mass index and the risk value of osteoporosis major, while the relationship between body mass index and risk value for osteoporosis femur fracture was found to be a moderate negative correlation. From the results of the risk of major osteoporosis fracture the lower a person's body mass index, the greater the risk of major primary osteoporosis fracture, whereas the results of the risk of femur fracture are only in obese grade II that is low, while other criteria have the same value, so it cannot be concluded if the lower a person's body mass index, the greater the risk value of the femur fracture. Keywords : Body Mass Index; Fracture Risk Value; Osteoporosis.

CORR Insights®: Minimal Pain Decrease Between 2 and 4 Weeks after Nonoperative Management of a Displaced Midshaft Clavicle Fracture Is Associated with a High Risk of Symptomatic Nonunion.

CORR Insights®: Minimal Pain Decrease Between 2 and 4 Weeks after Nonoperative Management of a Displaced Midshaft Clavicle Fracture Is Associated with a High Risk of Symptomatic Nonunion.

TnR Nasal Mesh®를 이용한 내시경적 안와내벽외향골절 정복술 2예

TnR Nasal Mesh®를 이용한 내시경적 안와내벽외향골절 정복술 2예

Total Flavonoids of Rhizoma Drynariae Enhances Angiogenic-Osteogenic Coupling During Distraction Osteogenesis by Promoting Type H Vessel Formation Through PDGF-BB/PDGFR-β Instead of HIF-1α/ VEGF Axis.

Background: Total flavonoids of Rhizoma Drynariae (TFRD), extracted from the kidney-tonifying traditional Chinese medicine Rhizoma Rrynariae, has been proved to be effective in treating osteoporosis, bone fractures and defects. However, pharmacological effects of TFRD on type H vessels, angiogenic-osteogenic coupling in distraction osteogenesis (DO) and the mechanism remain unclear. This study aims at investigating whether type H vessels exist in the DO model, effects of TFRD on angiogenic-osteogenic coupling and further elucidating the underlying mechanism. Methods: Rats models of DO and bone fracture (FR) were established, and then were separately divided into TFRD and control subgroups. Imageological and histological analyses were performed to assess bone and vessel formation. Immunofluorescent staining of CD31 and endomucin (Emcn) was conducted to determine type H vessel formation. Matrigel tube formation, ALP and Alizarin Red S staining assays were performed to test the effects of TFRD on angiogenesis or osteogenesis of endothelial precursor cells (EPCs) or bone marrow-derived mesenchymal stem cells (BMSCs). Additionally, expression levels of HIF-1α, VEGF, PDGF-BB, RUNX2 and OSX were determined by ELISA, qPCR or western blot, respectively. Results: The in vivo results indicated more formed type H vessels in DO groups than in FR groups and TFRD obviously increased the abundance of type H vessels. Moreover, groups with higher abundance of type H vessels showed better angiogenesis and osteogenesis outcomes. Further in vitro experiments showed that TFRD significantly promoted while blocking PDGF-BB remarkably suppressed the angiogenic activity of EPCs under stress conditions. The levels of p-AKT and p-ERK1/2, downstream mediators of the PDGF-BB pathway, were up-regulated by TFRD but blocked by function blocking anti-PDGF-BB antibody. In contrast, the activated AKT and ERK1/2 and corresponding tube formation were not affected by the HIF-1α inhibitor. Besides, blocking PDGF-BB inhibited the osteogenic differentiation of the stretched BMSCs, but TFRD enhanced the osteogenic activity of BMSCs and ameliorated the inhibition, with more calcium nodes, higher ALP activity and mRNA and protein levels of RUNX2 and OSX. Conclusion: Type H vessels exist in the DO model and TFRD enhances angiogenic-osteogenic coupling during DO by promoting type H vessel formation via PDGF-BB/PDGFR-β instead of HIF-1α/VEGF axis.

Epidemiología de la fractura de cadera en la Argentina

La Asociación Argentina de Ortopedia y Traumatología a través del Comité de Morbi-Mortalidad confeccionó una encuesta sobre fracturas de cadera, con el fin de caracterizar este cuadro en nuestro país. Al completarse las primeras 1000 encuestas se elaboró este informe descriptivo. Se estima que, en la Argentina, la prevalencia de fracturas de cadera es de aproximadamente 264/100.000 habitantes. Estas lesiones resultaron más frecuentes en mujeres que en hombres (relación 2,7:1). El 80% de los pacientes tenía >70 años y múltiples comorbilidades (hipertensión arterial, diabetes, anemia y osteoporosis, entre las más frecuentes). El 60% deambulaba solo dentro del domicilio. La incidencia de fracturas intertrocantéricas y mediales fue similar: 53% y 47%, respectivamente. La tasa de complicaciones posoperatorias fue de aproximadamente el 13%, y la infección fue la complicación más frecuente. La tasa de mortalidad en los primeros meses posteriores a la cirugía osciló entre el 3,8% y el 4,85%.
 Palabras clave: Fractura de cadera; morbilidad; mortalidad; prevalencia; epidemiología.Nivel de Evidencia: IV
 
 
 

Protocolo de tratamento conservador em fraturas radiculares horizontais de terço cervical – Relato de caso

Os traumas dentais possuem uma significante ocorrência na odontologia. As fraturas radiculares podem ser consideradas como politraumatismos por envolverem diferentes tipos de tecido: dentina, cemento, polpa e periodonto. Objetivo: mostrar uma opção de protocolo terapêutico conservador no tratamento de fraturas radiculares horizontais a fim de preservar a estrutura dental levando em consideração a condição socioeconômica do paciente. Relato de caso: paciente do sexo masculino, 15 anos, procurou a clínica de Odontologia da Universidade Federal de Alagoas onde procurou atendimento após sofrer um trauma. Ao exame clínico, observou-se que o incisivo central superior (11) apresentava fratura radicular horizontal cervical e discreto deslocamento palatino. Optou-se pela instalação de contenção semirrígida como tratamento imediato. Posteriormente uma pulpectomia do segmento coronal até a linha de fratura foi realizada com medicação intracanal composta por hidróxido de cálcio e clorexidina gel a 2%. Após 2 semanas foi realizada obturação do canal com MTA. Conclusão: O tratamento endodôntico foi realizado com sucesso, seu prognóstico depende do tipo de reparo tecidual na linha de fratura e saúde dos tecidos periodontais.

Generalidades de las fracturas de escafoides

Las fracturas del escafoides son comunes y presentan una incidencia que viene en aumento. Se requiere de una alta sospecha clínica y de estudios complementarios para llegar al diagnóstico, donde el examen físico tiene alta sensibilidad pero baja especificidad. Las radiografías presentan un bajo valor predictivo negativo y una alta tasa de falsos negativos, mientras que la resonancia magnética es el estudio de elección por su alta sensibilidad y efectividad, además de que detecta lesiones ligamentarias y presenta una relación costo-beneficio favorable. La sensibilidad de la tomografía axial computarizada es similar, y tiene gran utilidad en el planeamiento quirúrgico. La clasificación de Herbert es la más utilizada y tiene utilidad para definir el tratamiento, el cual depende del momento del diagnóstico, la localización y la estabilidad de la fractura. Como indicaciones quirúrgicas destacan la inestabilidad, el desplazamiento mayor a 1mm, las fracturas del polo proximal y las oblicuas. El manejo quirúrgico puede ser tanto volar como dorsal, con técnica abierta o percutánea dependiendo de las características de cada caso. En términos generales, se presenta consolidación en la gran mayoría de los casos; siendo menor en: aquellas fracturas desplazadas, en fracturas del polo proximal, en fracturas de diagnóstico tardío y en pacientes fumadores. El manejo quirúrgico condiciona mayor tasa de complicaciones, sin embargo las mismas se consideran menores. Se expone el caso de un paciente con antecedente de trauma de muñeca. En la valoración inicial, presentó datos clínicos poco específicos, se realizó una radiografía de muñeca y no se evidenció ninguna lesión ósea. Sin embargo, el paciente persistió con dolor, por lo que se realizó una tomografía axial computarizada, y se diagnosticó una fractura del polo proximal del escafoides. Se procedió con un manejo quirúrgico.

Trophic Ecology of Seahorse Key, Florida: A Unique Bird-Snake Interaction Network Analysis

In 2015 the entire breeding colony of nesting waterbirds on Seahorse Key (Florida, U.S.A.) unexpectedly abandoned the island and have not returned. These birds have a unique trophic relationship with a sympatric cottonmouth snake (Agkistrodon conanti) population, as well as potentially important positions within the entire insular food web. Species-interaction network analysis was used to compare two trophic networks; pre- and post-abandonment. Trophic data were used to create a weighted adjacency matrix for each network and the resulting network metrics were compared using the network analysis software package UCINET and visualized using NetDraw. Results for the pre-abandonment network indicated a large, complex, diffuse network with low centrality and seven sub-networks. Several species of colonial nesting birds were identified as holding important positions within the network for resource transfer from marine and intertidal environments to terrestrial trophic guilds, particularly to the snakes. Post-abandonment analysis showed the network significantly fractured with the terrestrial trophic guild that includes the snakes being smaller, more isolated and potentially less stable.

Functional Outcomes of Clavicular Fractures Fixation in Adolescent Children

Background: Fractures of the clavicle are common in both adults and children. Recent studies in the treatment of adult fractures have indicated that improved outcomes are achieved after open reduction and internal fixation. The aim of this study was to conduct a retrospective study of the functional outcomes after open reduction and internal fixation of displaced clavicle fractures in adolescent children. Material and Methods: We analysed a retrospective case series of 28 adolescent children who had displaced fractures of the clavicle which were treated with open reduction and internal fixation. The rate of healing, radiographic outcomes, functional outcomes, and complications were looked at. Results: There were 28 children with an average age of 13.8 years (range 13-16 years) had their closed unilateral clavicle fractures treated with open reduction and internal fixation. All the patients were boys. The right side was affected in 14 patients and the left in 14. There were 26 mid-shaft fractures and two lateral-end fracture. Patients were followed for an average of 12 months. There were no superficial or deep infections and all cases went on to clinical and radiological union. Twenty-four (86%) of children returned to unrestricted sporting activity. The mean QuickDASH score at 12 months was 3.24. Four patients had scar sensitivity, and four had plate prominence. Ten patients required metalwork removal. Conclusion: Historically, almost all clavicle fractures in children were treated non-operatively regardless of the displacement and the location of fractures, with variable outcomes. We conclude that open reduction and internal fixation of displaced clavicle shaft fractures in older children can be performed safely and gives predictable results especially with healing periods and functional outcomes.

A Study on the Fracture Characteristic According to the Shape of Double Cantilever Beam Specimen for Mode II with Ultra-high Strength Steel and Mg Alloy Steel

A Study on the Fracture Characteristic According to the Shape of Double Cantilever Beam Specimen for Mode II with Ultra-high Strength Steel and Mg Alloy Steel

Effect of bioactive glass pretreatment on the durability of dentin bonding interface

To study the effect of bioactive glass (BG) on the dentin bond strength and the microleakage of hybrid layer. In the study, 30 dentin planes were prepared from the third molars with no caries and equally assigned to the control group, BG group, and sodium trimetaphosphate (STMP)-polyacrylic acid (PAA)-BG group (S-P-BG group), randomly. After etched with 35% phosphoric acid, the dentin planes of BG group were pretreated with 0.5 g/L BG, and the dentin planes of S-P-BG group were pretreated with 5% STMP, 5% PAA and 0.5 g/L BG. No additional pretreatment was done to the dentin planes of control group. Then the dentin planes were bonded using 3M Single Bond 2 adhesive to 3M Z350XT composite resin, and cut into 0.9 mm×0.9 mm column samples, which were stored at 37 ℃ artificial saliva (AS). After 24 hours, 1 month, and 3 months, the microtensile bond strength test was performed. The data were analyzed using one-way ANOVA and LSD method. The morphology of the bond fracture interface was observed with scanning electron microscope. Other 27 teeth were collected and the enamel layer and roots cut off, with the pulp chamber exposed. 0.1% rhodamine B was added to the 3M Single Bond 2 adhesive, and then the adhesive was applied to complete the bonding procedures as above. The teeth were stored in 37 ℃ AS for 24 hours, 1 month, 3 months, and then 0.1% sodium fluorescein solution was placed in the chambers and stained for 1 hour. Confocal laser scanning microscopy was used to observe the interface morphology and microleakage of the hybrid layer. At the end of 24 hours and 1 month, there was no significant difference in the microtensile bond strength among the three groups (P>0.05). After 3 months of soaking, the S-P-BG group [(36.91±7.07) MPa] had significantly higher microtensile bond strength than the control group [(32.73±8.06) MPa] (P=0.026); For the control group and the BG group, the microtensile bond strength significantly decreased at the end of 3 months compared with 24 hours (control group: P=0.017, BG group: P=0.01); The microtensile bond strength of S-P-BG group af the end of 3 months had no significant difference in compared with 24 hours [(37.99±7.98) MPa] (P>0.05). Observation of the fracture surface at the 24 hours showed no obvious mineralization in all the three groups. After 1 and 3 months, mineral formation was observed in BG group and S-P-BG group, and no obvious collagen exposure was observed in S-P-BG group. Confocal laser scanning microscopy revealed no obvious differences in the morphology and quantity of the resin tag in the control group, BG group and S-P-BG group. At the end of 24 hours, leakage was found in all the three groups. The microleakage of the control group increased at the end of 3 months, while the microleakage of the BG and S-P-BG groups decreased. BG pretreatment of dentin bonding interface can induce mineralization at the bonding interface and reduce the microleakage of the hybrid layer; pretreating the dentin bonding interface with STMP, PAA and BG may enhance the maintaining of the dentin bonding durability.