Usumez Aslihan, Cobankara Funda Kont, Ozturk Nilgun, Eskitascioglu Gurcan, Belli Sema
Department of Prosthodontics, Faculty of Dentistry, University of Selcuk, Konya, Turkey.
J Prosthet Dent. 2004 Aug;92(2):163-9. doi: 10.1016/j.prosdent.2004.05.004.
Several new esthetic dowel systems are available for the restoration of endodontically treated teeth, but little is known about how effectively these dowels seal the restored teeth.
The purpose of this in vitro study was to compare microleakage of 3 esthetic, adhesively luted dowel systems with a conventional dowel system.
The root canals of 41 human intact single-rooted extracted teeth were prepared using a step-back technique. The teeth were randomly divided into 4 experimental groups (n=10), and 1 tooth served as a positive control. The decoronated roots were obturated with gutta-percha using lateral condensation. Roots were restored with 1 of the following dowel systems according to the manufacturer's instructions: (1) stainless steel dowels (ParaPost), (2) glass fiber dowels (Snowpost), (3) resin-supported polyethylene fiber (Ribbond) dowels, or (4) zirconia dowels (Cosmopost). Using a fluid filtration method, coronal leakage of the specimens along the dowel space and root canal restorative material was measured. Fluid movement measurements were made at 2-minute intervals for 8 minutes to measure the presence of voids existing in the obturated canals, at 1 week, 3 months, and 6 months following dowel insertion. A repeated-measures analysis of variance (ANOVA) was used to analyze logarithmic transformations of data (time and dowel material) for significant differences. The Tukey HSD test and paired 2-tailed tests were used to perform multiple comparisons (alpha=.05).
The data indicated that the leakage values varied according to the dowel system used (P<.01). There was significant interaction between dowel systems and time of testing (P<.01). The sealing ability of zirconia dowels decreased over time (P<.01), but sealing abilities of stainless steel and resin-supported polyethylene fiber dowels remained constant (P>.05). The sealing ability of glass fiber dowels increased at 3 months (P=.032) and remained constant over the next 3 months (P=.758). Statistically, resin-supported polyethylene fiber and glass fiber dowels showed the lowest coronal leakage when compared with stainless steel and zirconia dowels at all time periods (P<.01). There were no significant differences between resin-supported polyethylene fiber and glass fiber dowels at any time period. The initial leakage measurement in zirconia dowel and stainless steel dowels were similar (P=.914), but became significantly different at 3 and 6 months (P<.01).
Resin-supported polyethylene fiber dowels and glass fiber dowels tested exhibited less microleakage compared to zirconia dowel systems. The latter system should be further evaluated because of its unacceptable level of leakage.
有几种新型美观桩钉系统可用于根管治疗后牙齿的修复,但对于这些桩钉密封修复牙齿的效果了解甚少。
本体外研究的目的是比较3种美观的、粘结固定桩钉系统与传统桩钉系统的微渗漏情况。
采用逐步后退技术预备41颗完整的人单根离体牙的根管。将牙齿随机分为4个试验组(每组n = 10),1颗牙作为阳性对照。去冠后的牙根采用侧向加压法用牙胶尖充填。根据制造商的说明,用以下桩钉系统之一修复牙根:(1)不锈钢桩钉(ParaPost),(2)玻璃纤维桩钉(Snowpost),(3)树脂支持的聚乙烯纤维(Ribbond)桩钉,或(4)氧化锆桩钉(Cosmopost)。采用流体过滤法,测量标本沿桩钉间隙和根管修复材料的冠部渗漏情况。在桩钉插入后1周、3个月和6个月,每隔2分钟进行一次流体移动测量,持续8分钟,以测量充填根管中存在的空隙。采用重复测量方差分析(ANOVA)分析数据(时间和桩钉材料)的对数转换值,以确定是否存在显著差异。使用Tukey HSD检验和配对双尾检验进行多重比较(α = 0.05)。
数据表明,渗漏值因所使用的桩钉系统而异(P < 0.01)。桩钉系统与测试时间之间存在显著交互作用(P < 0.01)。氧化锆桩钉的密封能力随时间下降(P < 0.01),但不锈钢和树脂支持的聚乙烯纤维桩钉的密封能力保持不变(P > 0.05)。玻璃纤维桩钉的密封能力在3个月时增加(P = 0.032),并在接下来的3个月内保持不变(P = 0.758)。从统计学角度看,在所有时间段内,与不锈钢和氧化锆桩钉相比,树脂支持的聚乙烯纤维和玻璃纤维桩钉的冠部渗漏最低(P < 0.01)。在任何时间段内,树脂支持的聚乙烯纤维和玻璃纤维桩钉之间均无显著差异。氧化锆桩钉和不锈钢桩钉的初始渗漏测量结果相似(P = 0.914),但在3个月和6个月时差异显著(P < 0.01)。
与氧化锆桩钉系统相比,所测试的树脂支持的聚乙烯纤维桩钉和玻璃纤维桩钉表现出较少的微渗漏。由于氧化锆桩钉系统的渗漏水平不可接受,应进一步对其进行评估。