Ilie Nicoleta, Kunzelmann Karl-Heinz, Hickel Reinhard
Department of Restorative Dentistry, Dental School of the Ludwig-Maximilians-University, Goethestr. 70 80336 Munich, Germany.
Dent Mater. 2006 Jul;22(7):593-601. doi: 10.1016/j.dental.2005.05.014. Epub 2005 Nov 14.
The present study determined the influence of polymerization shrinkage of eight commercially available hybrid, micro-filled and nano composites (Z100 and Filtek Supreme, 3M-ESPE; Charisma and Durafill, Heraeus Kulzer; Tetric and InTen-S, Ivoclar Vivadent; Enamel plus HFO, GDF; Palfique Estelite Low Flow, Tokuyama) placed in large class 1 cavities on the bond strength to dentin.
Polymerization shrinkage was recorded for 300 s at room temperature with a Stress-Strain-Analyzer (C(FACTOR)=0.3). The maximum contraction stresses after 300 s, the time until gelation (t(0.5 N)) and the coefficient of near linear fit of contraction force/time (gradient) were analysed. For the evaluation of the micro-tensile-bond-strength (micro-TBS), hourglass shape samples obtained from a total of 32 no carious extracted human third and second molars, randomly divided into 8 groups, were used. Micro tensile bond strengths were determined by computing the ratio of maximum load by the adhesion area of the hourglass shape. In order to analyze the quality of the polymerization within fillings, hardness profiles of a surface cut thought the middle of the restored tooth and along the tooth axis were made. Further, the modulus of elasticity, determined in a three-point-bending test, as well as the variation of the modulus of elasticity and of the hardness within a filling were considered. The statistical analyses were conducted by ANOVA (alpha=0.05) and post-hoc Tukey's test.
A significant correlation between polymerization shrinkage and micro-TBS was found (Pearson; -0.44). The correlation between modulus of elasticity in bending test and shrinkage stress (Pearson; 0.77), coefficient of near linear fit m (Pearson; 0.72), time until gelation (Pearson; -0.52) and micro-tensile-bond-strength (Pearson; -0.45) was also significant. A high polymerization tension and modulus of elasticity negatively affected the adhesion of the composite to the tooth hard substance. Further, the number of samples lost during the slice cutting and the hourglass shape preparation was found to correlate highly significantly with the shrinkage stress (Pearson; 0.97), coefficient of near linear fit m (Pearson; 0.94) and modulus of elasticity (Pearson; 0.82). All materials showed sufficient polymerization within the filling in comparison to the filling surface, the hardness at the bottom of the filling was greater than 80% of the maximum hardness value. The modulus of elasticity was not considerably reduced within the filling.
High contraction stress and modulus of elasticity, fast development of contraction force and an early start of stress build-up of materials placed in restrictive cavities cause tension in the material with a possible subsequent distortion of the bond to the tooth structure. A low modulus of elasticity is not necessarily associated with high bond strength. However, it causes a more uniform stress distribution at the restorative composite-tooth interface. This is also evident in a reduced sample loss during the different stages of sample preparation.
本研究确定了8种市售混合、微填料和纳米复合材料(3M-ESPE公司的Z100和Filtek Supreme;贺利氏古莎公司的Charisma和Durafill;义获嘉伟瓦登特公司的Tetric和InTen-S;GDF公司的Enamel plus HFO;德山公司的Palfique Estelite Low Flow)聚合收缩对其与大的Ⅰ类洞型牙本质粘结强度的影响。
使用应力应变分析仪(C(因子)=0.3)在室温下记录300秒的聚合收缩情况。分析300秒后的最大收缩应力、凝胶化时间(t(0.5N))以及收缩力/时间的近似线性拟合系数(梯度)。为评估微拉伸粘结强度(微TBS),使用从总共32颗无龋的拔除人第三磨牙和第二磨牙中获取的沙漏形样本,随机分为8组。通过计算沙漏形样本的最大载荷与粘结面积之比来确定微拉伸粘结强度。为分析充填物内部的聚合质量,制作了沿修复牙中部并沿牙轴方向的表面切割硬度剖面图。此外,还考虑了在三点弯曲试验中测定的弹性模量以及充填物内部弹性模量和硬度的变化。采用方差分析(α=0.05)和事后Tukey检验进行统计分析。
发现聚合收缩与微TBS之间存在显著相关性(Pearson相关系数;-0.44)。弯曲试验中的弹性模量与收缩应力(Pearson相关系数;0.77)、近似线性拟合系数m(Pearson相关系数;0.72)、凝胶化时间(Pearson相关系数;-0.52)和微拉伸粘结强度(Pearson相关系数;-0.45)之间的相关性也很显著。高聚合张力和弹性模量对复合材料与牙齿硬组织的粘结有负面影响。此外,发现在切片切割和沙漏形制备过程中丢失的样本数量与收缩应力(Pearson相关系数;0.97)、近似线性拟合系数m(Pearson相关系数;0.94)和弹性模量(Pearson相关系数;0.82)高度显著相关。与充填表面相比,所有材料在充填物内部均显示出足够的聚合,充填物底部的硬度大于最大硬度值的80%。充填物内部的弹性模量没有显著降低。
高收缩应力和弹性模量、收缩力的快速发展以及放置在受限洞型中的材料应力积累过早会导致材料内部产生张力,可能随后使与牙齿结构的粘结发生变形。低弹性模量不一定与高粘结强度相关。然而,它会使修复复合材料与牙齿界面处的应力分布更均匀。这在样本制备的不同阶段样本丢失减少方面也很明显。