Christgau M, Friedl K H, Schmalz G, Edelmann K
University of Regensburg, Dental School, Department of Operative Dentistry and Periodontology, Germany.
Oper Dent. 1999 Jul-Aug;24(4):233-44.
The aim of the present in vitro study was to compare the marginal adaptation and integrity of heat-pressed glass-ceramic veneers to adjacent class 3 composite restorations and to enamel using four dual-curing composite resin cements of different viscosity with their corresponding dentin bonding agents. Thirty-six caries-free human maxillary incisors were first restored with mesial and distal class 3 composite restorations and then prepared for facial ceramic veneers. The cavity margins of the veneers were located either in the class 3 composite restorations or in the residual enamel. Heat-pressed glass-ceramic veneers (IPS Empress) were inserted adhesively using one of the following four luting systems in nine teeth: SonoCem (SC) with EBS; Variolink Ultra (VU), Variolink High-Viscosity (VHV), and Variolink Low-Viscosity (VLV) with Syntac. The veneer margins in the region of the composite restoration and in the region apical to the composite restoration (ceramic/composite resin cement interfaces, composite resin cement/composite restoration interface, and composite resin cement/enamel interface) were evaluated before and after thermo-cycling and mechanical loading (TCML) by quantitative margin analysis under a scanning electron microscope (SEM) using an image analysis system. Furthermore, microleakage was assessed in each tooth by dye penetration after TCML. For all luting systems, SEM analysis revealed excellent marginal adaptation of the ceramic veneers to the composite restorations as well as to enamel. The median percentages of marginal gap formation were 1.1% and less before TCML and 5.1% and less after TCML. The error-rates method revealed no statistical influence of the interface or of the viscosity of the luting material. Maximal values of dye penetration showed a significantly higher microleakage at veneers cemented with VU (median: 86.4%) compared to SC (median: 13.3%). In conclusion, the present data demonstrated that existing clinically acceptable class 3 composite restorations have no negative influence on the marginal adaptation of ceramic veneers. This was valid independent of the viscosity of the dual-curing composite resin cement when SC, VHV, or VLV was used.
本体外研究的目的是使用四种不同粘度的双固化复合树脂粘结剂及其相应的牙本质粘结剂，比较热压玻璃陶瓷贴面与相邻Ⅲ类复合树脂修复体及牙釉质之间的边缘适应性和完整性。三十六颗无龋的人上颌中切牙首先进行近中和远中Ⅲ类复合树脂修复，然后制备唇面陶瓷贴面。贴面的洞缘位于Ⅲ类复合树脂修复体或剩余牙釉质中。使用以下四种粘结系统之一，在九颗牙齿中粘结插入热压玻璃陶瓷贴面（IPS Empress）：SonoCem（SC）与EBS；Variolink Ultra（VU）、Variolink高粘度（VHV）和Variolink低粘度（VLV）与Syntac。在热循环和机械加载（TCML）前后，通过扫描电子显微镜（SEM）下的定量边缘分析和图像分析系统，评估复合树脂修复体区域及复合树脂修复体根尖区域（陶瓷/复合树脂粘结剂界面、复合树脂粘结剂/复合树脂修复体界面和复合树脂粘结剂/牙釉质界面）的贴面边缘。此外，在TCML后通过染料渗透评估每颗牙齿的微渗漏情况。对于所有粘结系统，SEM分析显示陶瓷贴面与复合树脂修复体以及牙釉质之间具有良好的边缘适应性。热循环和机械加载前边缘间隙形成的中位数百分比为1.1%及以下，热循环和机械加载后为5.1%及以下。误差率方法显示界面或粘结材料的粘度没有统计学影响。与SC（中位数：13.3%）相比，VU粘结的贴面染料渗透最大值显示出明显更高的微渗漏（中位数：86.4%）。总之，目前的数据表明，现有的临床可接受的Ⅲ类复合树脂修复体对陶瓷贴面的边缘适应性没有负面影响。当使用SC、VHV或VLV时，这与双固化复合树脂粘结剂粘度无关。
