Yamada Yoshihiro, Tsubota Yuji, Fukushima Shunji
Department of Fixed Prosthodontics, Tsurumi University School of Dental Medicine, Yokohama, Japan.
Int J Prosthodont. 2004 Jan-Feb;17(1):94-8.
The aim of the present study was to compare the fracture resistance of endodontically treated maxillary premolars with mesio-occlusodistal (MOD) cavities restored using various restorative materials and luting agents.
Eighty extracted human maxillary premolars satisfying certain predetermined criteria were subjected to seven different restoration methods (10 premolars per method). After endodontic treatment, an MOD cavity was prepared in each specimen, and restoration was carried out by one of the following methods: group 1 = control (intact premolars); groups 2 and 3 = restoration using a photo-cure resin composite with and without bonding, respectively; groups 4 and 5 = restoration using a cast-metal inlay with zinc phosphate and adhesive resin cements, respectively; groups 6 and 7 = restoration using a cast-metal onlay with zinc phosphate and adhesive resin cements, respectively; and group 8 = restoration using a hybrid resin onlay. A fracture test was conducted to determine the fracture resistance and fracture mode of each specimen.
Fracture resistance was greatest for teeth restored using a cast-metal onlay cemented with adhesive resin cement, but those fractures that did occur were generally unrestorable. Fracture resistance of teeth restored using a cast-metal inlay was also high. Fracture resistance for teeth restored using a resin composite was significantly lower, but the majority of these fractures were restorable.
Endodontically treated maxillary premolars with MOD cavities could be successfully restored by cast onlay and inlay restorations luted with adhesive resin cement, but their failure mode was often unfavorable.
本研究的目的是比较使用不同修复材料和粘结剂修复近中-咬合-远中（MOD）洞形的根管治疗上颌前磨牙的抗折性。
选取80颗符合特定预定标准的拔除人类上颌前磨牙，采用七种不同的修复方法（每种方法10颗前磨牙）。根管治疗后，在每个标本上制备一个MOD洞形，并通过以下方法之一进行修复：第1组=对照组（完整前磨牙）；第2组和第3组分别=使用光固化树脂复合材料修复，有无粘结；第4组和第5组分别=使用铸造金属嵌体，分别用磷酸锌和粘结树脂粘结剂修复；第6组和第7组分别=使用铸造金属高嵌体，分别用磷酸锌和粘结树脂粘结剂修复；第8组=使用混合树脂高嵌体修复。进行抗折试验以确定每个标本的抗折性和折裂模式。
使用粘结树脂粘结的铸造金属高嵌体修复的牙齿抗折性最强，但发生的那些折裂通常无法修复。使用铸造金属嵌体修复的牙齿抗折性也很高。使用树脂复合材料修复的牙齿抗折性明显较低，但这些折裂中的大多数是可修复的。
根管治疗的有MOD洞形的上颌前磨牙，采用粘结树脂粘结的铸造高嵌体和嵌体修复可成功修复，但它们的失败模式往往不理想。
