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不同后牙修复系统颈部边缘微渗漏的评估。

Evaluation of microleakage in cervical margins of various posterior restorative systems.

作者信息

Bedran de Castro Ana Karina Barbieri, Pimenta Luiz André Freire, Amaral Cristiane Mariote, Ambrosano Gláucia Maria Boni

机构信息

Department of Restorative Dentistry, School of Dentistry of Piracicaba, University of Campinas, Brazil.

出版信息

J Esthet Restor Dent. 2002;14(2):107-14. doi: 10.1111/j.1708-8240.2002.tb00159.x.

Abstract

PURPOSE

The purpose of this in vitro study was to evaluate the microleakage and dye penetration patterns of various restorative systems in the cervical margins of Class II cavities using the dye penetration technique.

MATERIALS AND METHODS

Ninety bovine incisors were selected and part of the crown was sectioned producing a standardized occlusogingival margin of 4 mm. Standardized Class II box cavities were designed on the mesial (MO) and distal (OD) surfaces with the gingival margin in dentin. The cavities were randomly divided into six groups (n = 30): group 1 (control), Etch & Prime 3.0 (Degussa AG) + Definite (Degussa AG); group 2, Prime & Bond NT (Dentsply De Trey) + Definite; group 3, Etch & Prime 3.0 + flowable composite resin Wave (SDI) + Definite; group 4 (control), Prime & Bond NT + TPH Spectrum (Denstply De Trey); group 5, Etch & Prime 3.0 + TPH Spectrum; group 6, Prime & Bond NT + Wave + TPH Spectrum. After they were finished and polished, the specimens were subjected to 1500 thermal cycles in baths of 5 degrees+/-2 degrees C and 55 degrees+/-2 degrees C with 60 seconds of dwell time for each bath. After the thermocycling, the specimens were sealed with acid-resistant varnish, leaving a 1-mm window around the cervical margin interface, and immersed in 2% methylene blue buffered solution for 4 hours. Then the specimens were sectioned longitudinally in half and qualitatively evaluated under stereomicroscopy at 45 times magnification, using ranked scores for the dentin cervical margin (0-4). The dye penetration pattern (adhesive or dentinal) was also evaluated. The data were subjected to a reproducibility kappa test, and the mean of the three examiners' scores was analyzed by the Kruskal-Wallis nonparametric test and a multiple comparison nonparametric test. Fisher's exact test was used to evaluate the dye penetration pattern.

RESULTS

The rank sums of the groups were expressed in decreasing order: group 4, 67.23a; group 3, 72.58ab; group 6, 78.43ab; group 5, 93.19bc; group 2, 112.97c; group 1, 113.52c. (Statistically significant differences are expressed by different superscript letters.) The results indicate that none of the systems used in this study was able to impede microleakage, and that the use of a flowable resin decreases the values of leakage only for Definite composite resin. The dye penetration pattern for the groups that used Prime & Bond NT was predominantly dentinal, whereas the pattern for Etch & Prime 3.0 groups was adhesive.

CLINICAL SIGNIFICANCE

An ormocer-based resin that was developed to improve the physical properties of composite resin and a self-etching primer adhesive system obtained higher values of microleakage compared with a one-bottle adhesive system and a microhybrid composite resin. The flowable composite resin decreased the values of microleakage only for the ormocer-based resin.

摘要

目的

本体外研究的目的是使用染料渗透技术评估各类修复系统在Ⅱ类洞颈部边缘的微渗漏及染料渗透模式。

材料与方法

选取90颗牛切牙,将部分牙冠进行切割,形成4mm标准化的咬合龈向边缘。在近中(MO)和远中(OD)面设计标准化的Ⅱ类盒状洞,龈缘位于牙本质。将洞随机分为6组(n = 30):第1组(对照组),酸蚀与底涂剂3.0(德固赛公司)+ Definite(德固赛公司);第2组,Prime & Bond NT(登士柏德瑞公司)+ Definite;第3组,酸蚀与底涂剂3.0 + 流动复合树脂Wave(SDI公司)+ Definite;第4组(对照组),Prime & Bond NT + TPH Spectrum(登士柏德瑞公司);第5组,酸蚀与底涂剂3.0 + TPH Spectrum;第6组,Prime & Bond NT + Wave + TPH Spectrum。完成并抛光后,将标本在5℃±2℃和55℃±2℃的水浴中进行1500次热循环,每个水浴的停留时间为60秒。热循环后,用耐酸清漆密封标本,在颈部边缘界面周围留出1mm的窗口,然后浸入2%亚甲蓝缓冲溶液中4小时。接着将标本纵向切成两半,在体视显微镜下以45倍放大倍数进行定性评估,对牙本质颈部边缘使用等级评分(0 - 4)。还评估了染料渗透模式(粘结性或牙本质性)。数据进行可重复性kappa检验,三位检查者评分的平均值通过Kruskal - Wallis非参数检验和多重比较非参数检验进行分析。采用Fisher确切检验评估染料渗透模式。

结果

各组的秩和按降序排列:第4组,67.23a;第3组,72.58ab;第6组,78.43ab;第5组,93.19bc;第2组,112.97c;第1组,113.52c。(统计学显著差异用不同的上标字母表示。)结果表明,本研究中使用的任何系统均无法阻止微渗漏,且流动树脂的使用仅对Definite复合树脂降低了渗漏值。使用Prime & Bond NT的组的染料渗透模式主要为牙本质性,而酸蚀与底涂剂3.0组的模式为粘结性。

临床意义

一种为改善复合树脂物理性能而开发的基于有机陶瓷的树脂和一种自酸蚀底涂粘结系统与单瓶装粘结系统及微混合复合树脂相比,微渗漏值更高。流动复合树脂仅对基于有机陶瓷的树脂降低了微渗漏值。

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