Stappert Christian F J, Chitmongkolsuk Somsak, Silva Nelson R F A, Att Wael, Strub Joerg R
Department of Prosthodontics, Albert-Ludwigs-University, Faculty of Dentistry, Freiburg, Germany.
Dent Mater. 2008 Sep;24(9):1248-57. doi: 10.1016/j.dental.2008.02.005. Epub 2008 Apr 18.
To investigate the influence of mouth-motion fatigue on marginal-accuracy of partial-coverage-restorations-(PCRs) of various dental materials.
Eighty molars were prepared equally and divided into five groups (n=16). PCRs were fabricated of following dental materials: Group-GO=Gold-Pontor-MPF(double dagger), Group-TA=Targis*, Group-EX=IPS-e.max-Press*, Group-EM=IPS-Empress*, Group-PC=ProCAD*/Cerec 3(dagger) ((double dagger)Metalor/*Ivoclar-Vivadent/(dagger)Sirona-Dental-System). Gold-PCRs were cemented conventionally. Residual 64 PCRs were adhesively luted and subjected to masticatory loading (1.2million-cycles, 1.6Hz, 49N) and thermal cycling (5 degrees C/55 degrees C, 60s, dwell-time, 5500cycles). Discrepancies in marginal-accuracy were examined on epoxy replicas (200 x magnification). Statistical analysis was performed by unpaired and paired t-tests (alpha=0.05).
After cementing, marginal-accuracy (geometrical mean)[95% confidence limits] was recorded: GO-47[43-51]microm, TA-42[38-45]microm, EX-60[52-67]microm, EM-52[45-60]microm and PC-75[59-94]microm. No significant differences were found between groups GO, TA and EM. Values of Group-EX were significantly higher compared to Group-TA (p=0.04). Group-PC demonstrated significantly decreased marginal-accuracy towards groups GO (p=0.03) and TA (p=0.02). Except for Group-GO (p=0.01), no significant changes in marginal-accuracy were observed after mouth-motion fatigue and thermal cycling (GO-42[38-45]microm, TA-42[38-47]microm, EX-56[49-65]microm, EM-54[46-64]microm and PC-71[59-84]microm). However, Group-GO and Group-EM showed significant deviations in marginal-accuracy after aging (p=0.04). Marginal discrepancies of groups EX and EM were similar (p=1.0). Values of Group-PC were significantly higher when compared to groups GO (p=0.01) and TA (p=0.02). Buccal-lingual marginal discrepancies were significantly higher than mesial-distal in all groups and stages.
Cast-gold-PCRs demonstrated superior marginal-accuracy, followed by indirect ceromer PCRs. All-ceramic PCRs showed in vitro clinical acceptable marginal widths, even though CAD/CAM fabrication slightly compromised marginal-accuracy. Since preparation margins were not exposed to occlusal loading directly, increased marginal discrepancies due to marginal chipping during mouth-motion fatigue were not experienced.
研究口腔运动疲劳对各种牙科材料制作的部分覆盖修复体(PCR)边缘精度的影响。
将80颗磨牙平均预备后分为五组(n = 16)。用以下牙科材料制作PCR:GO组 = 金合金 - 桥体 - MPF(双剑号),TA组 = Targis*,EX组 = IPS - e.max - Press*,EM组 = IPS - Empress*,PC组 = ProCAD*/Cerec 3(剑号)(双剑号为Metalor/*Ivoclar - Vivadent/(剑号)Sirona - Dental - System)。金合金PCR采用传统方法粘结。其余64个PCR采用粘结固位,并进行咀嚼加载(120万次循环,1.6Hz,49N)和热循环(5℃/55℃,60秒停留时间,5500次循环)。在环氧树脂复制品上(200倍放大)检查边缘精度的差异。采用非配对和配对t检验进行统计分析(α = 0.05)。
粘结后,记录边缘精度(几何平均值)[95%置信区间]:GO组 - 47[43 - 51]微米,TA组 - 42[38 - 45]微米,EX组 - 60[52 - 67]微米,EM组 - 52[45 - 60]微米,PC组 - 75[59 - 94]微米。GO组、TA组和EM组之间未发现显著差异。EX组的值与TA组相比显著更高(p = 0.04)。PC组与GO组(p = 0.03)和TA组(p = 0.02)相比,边缘精度显著降低。除GO组(p = 0.01)外,口腔运动疲劳和热循环后边缘精度未观察到显著变化(GO组 - 42[38 - 45]微米,TA组 - 42[38 - 47]微米,EX组 - 56[49 - 65]微米,EM组 - 54[46 - 64]微米,PC组 - 71[59 - 84]微米)。然而,GO组和EM组在老化后边缘精度出现显著偏差(p = 0.04)。EX组和EM组的边缘差异相似(p = 1.0)。PC组的值与GO组(p = 0.01)和TA组(p = 0.02)相比显著更高。在所有组和阶段,颊舌侧边缘差异均显著高于近远中边缘差异。
铸造金合金PCR显示出卓越的边缘精度,其次是间接陶瓷聚合物PCR。全陶瓷PCR在体外显示出临床可接受的边缘宽度,尽管CAD/CAM制作略微损害了边缘精度。由于预备边缘未直接承受咬合负荷,因此未出现因口腔运动疲劳期间边缘崩裂导致的边缘差异增加。