Göehring T N, Peters O A, Lutz F
Department of Preventative Dentistry, Periodontology, and Cariology, University of Zurich, Switzerland.
J Prosthet Dent. 2001 Jul;86(1):81-92. doi: 10.1067/mpr.2001.115072.
There are no studies that analyze the long-term durability of minimally invasive fixed partial dentures (FPDs) by comparing different methods of adhesive bonding.
This in vitro study examined the influence of cavity design and operative technique on the marginal adaptation of resin-bonded composite FPDs.
Slot-inlay tooth preparations with cavity margins located in enamel were prepared in 18 maxillary canines and 18 maxillary first molars designated as abutments. The specimens were divided equally into 3 experimental groups. In all groups, butt joint tooth preparations were created in canines and molars. In group 2, canines were prepared additionally with a 1.5-mm wide palatal bevel in enamel. After pretests with modification spaces of 11 and 17 mm (length), 2 missing premolars were replaced by the ceromer Targis and reinforced with the glass-fiber material Vectris. The prostheses were inserted with Tetric Ceram with use of an ultrasonic-supported, high-viscosity technique. Restorations were selectively bonded to cavity finish lines in groups 1 and 2 ("selective bonding"). In group 3, restorations were bonded totally to the whole cavity surface ("total bonding"). The restorations were stressed in a computer-controlled masticator. Marginal quality was examined with an SEM at x 200.
The percent area of optimal margins after thermomechanical loading between composite and enamel in each group was as follows: group 1, 86.2% +/- 12.3% for canines and 95.5% +/- 3.5% for molars; group 2, 95.3% +/- 2.1% for canines and 96.2% +/- 2.7% for molars; and group 3, 95% +/- 0.9% for canines and 86.4% +/- 3.2% for molars. The marginal quality for molars inserted with total bonding was significantly lower (P< or =.05).
Within the limitations of this study, the selective bonding technique for slot inlay-retained fixed partial dentures resulted in a negligible loss of marginal quality after extensive mechanical and thermal stress. The selective bonding technique is recommended for box-shaped cavity preparations.
目前尚无研究通过比较不同的粘结方法来分析微创固定局部义齿（FPD）的长期耐久性。
本体外研究探讨了洞型设计和操作技术对树脂粘结复合固定局部义齿边缘适合性的影响。
在18颗上颌尖牙和18颗上颌第一磨牙（作为基牙）上制备边缘位于牙釉质的嵌体式牙体预备。将标本平均分为3个实验组。所有组中，尖牙和磨牙均制备对接式牙体预备。在第2组中，尖牙在牙釉质上额外制备一个1.5毫米宽的腭侧斜面。在进行了11毫米和17毫米（长度）的预备空间预测试后，用瓷聚体Targis替换2颗缺失的前磨牙，并用玻璃纤维材料Vectris进行增强。使用超声辅助的高粘度技术，用Tetric Ceram插入修复体。在第1组和第2组中，修复体选择性地粘结到洞型的完成线处（“选择性粘结”）。在第3组中，修复体完全粘结到整个洞型表面（“完全粘结”）。在计算机控制的咀嚼模拟器中对修复体施加应力。用扫描电子显微镜在200倍下检查边缘质量。
每组复合树脂与牙釉质之间经热机械加载后边缘理想的面积百分比分别如下：第1组，尖牙为86.2%±12.3%，磨牙为95.5%±3.5%；第2组，尖牙为95.3%±2.1%，磨牙为96.2%±2.7%；第3组，尖牙为95%±0.9%，磨牙为86.4%±3.2%。完全粘结法插入的磨牙边缘质量显著较低（P≤0.05）。
在本研究的局限性范围内，对于嵌体式固定局部义齿，选择性粘结技术在经过大量机械和热应力后导致边缘质量损失可忽略不计。对于盒状洞型预备，推荐使用选择性粘结技术。
