Thonemann B, Federlin M, Schmalz G, Grundler W
University of Regensburg, Dental School, Department of Operative Dentistry and Periodontology, Germany.
Oper Dent. 1999 Sep-Oct;24(5):261-71.
For improving the marginal integrity of composite restorations, a total bonding method has been advocated besides the conventional selective bonding method. Total bonding avoids the placement of a base. The entire internal cavity surface is available for the adhesive bond. Selective bonding involves the placement of a base covering the pulpal floor as well as the pulpoaxial wall. In this study, five dentin/enamel bonding system/composite combinations were used to restore 60 class 2 cavities with their cervical margins below the cementoenamel junction (CEJ); six teeth per material were restored according to the total bonding and the selective bonding methods. Before and after simultaneous thermo-cycling and mechanical loading (TCML) marginal adaptation was evaluated on replicas in the SEM. Microleakage was determined by dye penetration on the original samples after TCML. The data were statistically evaluated with the Mann-Whitney U-test and the Wilcoxon test. The error rates method was applied. In SEM analysis the error rates method indicated a significant difference between the two restoration methods in general. In the pairwise comparisons, no significant differences between the selective bonding and total bonding methods were found for Syntac/Tetric, Gluma 2000/Pekafill, and Gluma/Pekafill. With Scotchbond Multi-Purpose (SBMP) and All-Bond 2 (AB2), total bonding revealed significantly (P < or = 0.01) less gap formation before and after TCML than selective bonding. Accordingly, total bonding showed significantly less (P < or = 0.01) dye penetration with Scotch-bond Multi-Purpose and All-Bond 2 compared to selective bonding. In conclusion, the reduction of microleakage by application of the total bonding method depended upon the bonding system used. Total bonding could be an alternative procedure for the adhesive restoration of class 2 cavities when their gingival margins are apical to the cementoenamel junction, provided the proper system is used and pulp damage is prevented.
为提高复合树脂修复体的边缘完整性，除传统的选择性粘结方法外，还提倡采用全粘结方法。全粘结无需放置基底。整个窝洞内壁表面均可用于粘结。选择性粘结则需放置覆盖髓室底和髓轴壁的基底。本研究采用五种牙本质/牙釉质粘结系统/复合树脂组合修复60个二类洞，其颈部边缘位于釉牙骨质界（CEJ）下方；每种材料的六个牙齿分别按照全粘结和选择性粘结方法进行修复。在进行热循环和机械加载（TCML）前后，通过扫描电子显微镜（SEM）对复制模型的边缘适应性进行评估。热循环和机械加载后，通过染料渗透法测定原始样本的微渗漏情况。数据采用Mann-Whitney U检验和Wilcoxon检验进行统计学评估。应用误差率方法。在SEM分析中，误差率方法表明两种修复方法总体上存在显著差异。在两两比较中，对于Syntac/Tetric、Gluma 2000/Pekafill和Gluma/Pekafill，选择性粘结和全粘结方法之间未发现显著差异。对于Scotchbond Multi-Purpose（SBMP）和All-Bond 2（AB2），全粘结在热循环和机械加载前后显示出的间隙形成明显少于选择性粘结（P≤0.01）。因此，与选择性粘结相比，使用Scotchbond Multi-Purpose和All-Bond 2时，全粘结显示出显著更少的染料渗透（P≤0.01）。总之，应用全粘结方法减少微渗漏取决于所使用的粘结系统。当二类洞的牙龈边缘位于釉牙骨质界上方时，若使用合适的系统并防止牙髓损伤，全粘结可作为二类洞粘结修复的替代方法。
