Sousa R P, Zanin I C J, Lima J P M, Vasconcelos S M L C, Melo M A S, Beltrão H C P, Rodrigues L K A
Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, CE, Brazil.
J Dent. 2009 Jan;37(1):44-51. doi: 10.1016/j.jdent.2008.08.009. Epub 2008 Nov 20.
Since secondary caries is one of the main reasons for replacing restorations, this study assessed the effects of different restorative materials on the microbiological composition of dental biofilm and on enamel demineralisation around the restoration.
A randomized, double-blind, split-mouth in situ design was conducted in one phase of 14 days, during which, 20 volunteers wore palatal devices containing five human dental enamel slabs. Each slab was randomly restored with one of the following materials: Filtek-Z-250/Single Bond, control group (composite resin), Permite (amalgam), Fuji II (encapsulated resin-modified glass ionomer), Vitremer (resin-modified glass ionomer) and Ketac Molar (conventional glass ionomer). The volunteers used fluoride dentifrice, 3x/day and a 20% sucrose solution was dripped onto the slabs 8x/day. The biofilm formed on the slabs was analyzed to determine the counts of total streptococci, mutans streptococci and lactobacilli. Enamel demineralisation was determined by cross-sectional microhardness (CSMH) at 20 and 70 microm from the margin of the restoration. Kruskal-Wallis and analysis of variance, followed by least mean squares (LMS) test, were used to evaluate microbiota and CSMH among the groups. The significance level used was 5%.
No statistically significant differences were found in the cariogenic microbiota grown on the slabs. At a 20-mum distance, only Fuji II statistically differed from the other groups, showing the lowest demineralisation. At 70 microm, Fuji II significantly inhibited demineralisation when compared to Permite, Filtek-Z-250 and Ketac Molar.
In the context of fluoride dentifrice and under the cariogenic exposure conditions of this study, only the encapsulated resin-modified glass ionomer material provided additional protection against secondary caries.
继发龋是修复体更换的主要原因之一,本研究评估了不同修复材料对牙生物膜微生物组成以及修复体周围牙釉质脱矿的影响。
采用随机、双盲、口内分侧原位设计,为期14天,在此期间,20名志愿者佩戴含有五块人牙釉质块的腭部装置。每块牙釉质块随机用以下材料之一修复:Filtek-Z-250/单键合剂,对照组(复合树脂),Permite(银汞合金),Fuji II(胶囊装树脂改性玻璃离子体),Vitremer(树脂改性玻璃离子体)和Ketac Molar(传统玻璃离子体)。志愿者每天使用含氟牙膏3次,每天8次将20%的蔗糖溶液滴在牙釉质块上。分析牙釉质块上形成的生物膜,以确定总链球菌、变形链球菌和乳酸杆菌的数量。通过在距修复边缘20和70微米处的横断面显微硬度(CSMH)测定牙釉质脱矿情况。使用Kruskal-Wallis检验和方差分析,随后进行最小二乘均值(LMS)检验,以评估各组之间的微生物群和CSMH。使用的显著性水平为5%。
在牙釉质块上生长的致龋微生物群中未发现统计学上的显著差异。在距离20微米处,只有Fuji II与其他组在统计学上有差异,显示出最低的脱矿程度。在70微米处,与Permite、Filtek-Z-250和Ketac Molar相比,Fuji II显著抑制了脱矿。
在本研究的含氟牙膏环境和致龋暴露条件下,只有胶囊装树脂改性玻璃离子体材料对继发龋提供了额外的保护。