Mitchell Christina A, Pintado Maria R, Douglas William H
The Oral Healthcare Research Centre, School of Clinical Dentistry, Queen's University, Royal Victoria Hospital, Belfast, United Kingdom.
J Prosthet Dent. 2002 Sep;88(3):320-8. doi: 10.1067/mpr.2002.128150.
Many different rotary instruments are available for shaping composite restorations. Whether use of these instruments causes undesirable iatrogenic abrasion of either the tooth surface or the composite restorative material is unknown. Assuming that damage occurs, which technique is least damaging is unknown.
This in vitro study quantified the loss of surface enamel and dentin surrounding Class V preparations during composite shaping and finishing procedures. The susceptibility of 2 types of composites to tooth abrasion was also examined.
Standardized Class V cavities were prepared at the amelodentinal junction of 36 human molar teeth. The teeth were randomly assigned to 6 groups of 6 teeth each. They were restored with either a low- or high-viscosity composite (Revolution or Prodigy Condensable, respectively) and finished with aluminum oxide disks, tungsten carbide burs, or ultrafine finishing diamond burs. The preparations were profiled before and after restoration. After each finishing procedure, morphological measurements of surface changes in the dentin and enamel were made and reported as volume (in cubic millimeters); maximum depth, mean maximum depth, and mean depth (in micrometers); and surface area (in square millimeters). The results were subjected to a 2-way analysis of variance for restorative material and finishing technique (P<.05).
Aluminum oxide disks removed significantly less enamel than tungsten carbide burs or ultrafine finishing diamond burs, as measured by volume, maximum depth, mean maximum depth, mean depth, and surface area (P<.05). Conversely, aluminum oxide disks removed significantly greater dentin than either tungsten carbide burs or ultrafine finishing burs as measured by loss of volume, mean depth, and surface area (P<.05). There was no significant difference in the loss of surrounding tooth substance based on resin type (low or high viscosity).
Within the limitations of this study, the 3 finishing systems tested resulted in varying degrees of iatrogenic abrasion of enamel and dentin. The composite material used had no significant effect on abrasion of the surrounding enamel or dentin.
有许多不同的旋转器械可用于复合树脂修复体的塑形。使用这些器械是否会对牙齿表面或复合树脂修复材料造成不良医源性磨损尚不清楚。假设发生了损伤，哪种技术造成的损害最小也不清楚。
本体外研究量化了Ⅴ类洞预备周围的釉质和牙本质在复合树脂塑形和修整过程中的损失。还检查了2种类型的复合树脂对牙齿磨损的敏感性。
在36颗人磨牙的釉牙本质界制备标准化的Ⅴ类洞。将牙齿随机分为6组，每组6颗。分别用低粘度或高粘度复合树脂（分别为Revolution或Prodigy Condensable）进行修复，并用氧化铝盘、碳化钨车针或超细修整金刚石车针进行修整。修复前后对预备体进行轮廓测量。每次修整操作后，对牙本质和釉质表面变化进行形态学测量，并以体积（立方毫米）、最大深度、平均最大深度和平均深度（微米）以及表面积（平方毫米）报告。结果进行了修复材料和修整技术的双向方差分析（P<0.05）。
通过体积、最大深度、平均最大深度、平均深度和表面积测量，氧化铝盘去除的釉质明显少于碳化钨车针或超细修整金刚石车针（P<0.05）。相反，通过体积损失、平均深度和表面积测量，氧化铝盘去除的牙本质明显多于碳化钨车针或超细修整车针（P<0.05）。基于树脂类型（低粘度或高粘度），周围牙齿物质的损失没有显著差异。
在本研究的局限性内，所测试的3种修整系统导致了不同程度的釉质和牙本质医源性磨损。所用的复合树脂材料对周围釉质或牙本质的磨损没有显著影响。
