Uludag Bulent, Ozturk Ozge, Ozturk A Nilgun
Department of Prosthodontics, University of Ankara, Faculty of Dentistry, Gazi University, Ankara, Turkey.
J Prosthet Dent. 2009 Oct;102(4):235-41. doi: 10.1016/S0022-3913(09)60161-X.
Despite recent advances in adhesive dentistry, resin cement/dentin adhesive combinations are not able to prevent microleakage in ceramic inlays. Marginal quality of tooth-colored restorations in large Class II cavities is satisfactory in enamel margins, but microleakage in dentin margins remains a concern.
The purpose of this study was to evaluate the microleakage of all-ceramic inlays luted with 2 dual-polymerizing resin cements or 1 autopolymerizing resin cement in combination with different dentin adhesives.
One hundred and twenty extracted human mandibular third molars were used in this study. Teeth were prepared to receive Class II MOD inlays with enamel gingival margins on 1 proximal surface and dentin gingival margins on the other surface. One hundred and twenty prepared teeth were divided into 3 groups of 40; 1 group for each resin cement: RelyX ARC, Variolink II, or Panavia 21. Each of the 3 groups were further divided into 4 dentin adhesive groups; Single Bond, ExciTE DSC, ED Primer, or Admira Bond. Each of the resin cements were used in combination with the 4 dentin adhesives, and IPS Empress ceramic inlays were placed with 12 different cement/adhesive combinations. After 1000 thermal cycles in a 5 degrees -55 degrees C water bath with a dwell time of 30 seconds, all specimens were subjected to cyclic axial mechanical loading. Then the restored teeth were stored in 0.5% basic fuchsin solution for 24 hours. The extent of dye penetration along the margins was measured with a stereomicroscope at x40 magnification. The data were evaluated statistically using repeated-measures ANOVA and Duncan tests (alpha=.05).
Microleakage at dentin margins was greater than that at enamel margins (P<.05) for all groups. Variolink II and RelyX ARC resin cements showed significantly lower microleakage results than Panavia 21 with all dentin adhesives in enamel margins. For dentin margins, Variolink II/Admira Bond combination showed the lowest microleakage value in dentin (P<.05).
The overall microleakage at the enamel margins was significantly less than at the dentin margins (P<.05). Panavia 21 showed higher microleakage values than Variolink II and RelyX ARC in enamel margins.
尽管牙体粘接修复技术近来有所进展，但树脂水门汀/牙本质粘接剂组合仍无法防止陶瓷嵌体出现微渗漏。大的Ⅱ类洞型中牙齿颜色修复体的边缘质量在釉质边缘令人满意，但牙本质边缘的微渗漏仍是一个问题。
本研究的目的是评估用两种双重固化树脂水门汀或一种自凝树脂水门汀与不同牙本质粘接剂联合使用时全瓷嵌体的微渗漏情况。
本研究使用了120颗拔除的人类下颌第三磨牙。制备牙齿以容纳Ⅱ类MOD嵌体，一个近中面有釉质牙龈边缘，另一个面有牙本质牙龈边缘。120颗制备好的牙齿被分为3组，每组40颗；每种树脂水门汀一组：RelyX ARC、Variolink II或Panavia 21。3组中的每一组又进一步分为4个牙本质粘接剂组；Single Bond、ExciTE DSC、ED Primer或Admira Bond。每种树脂水门汀与4种牙本质粘接剂联合使用，并用12种不同的水门汀/粘接剂组合放置IPS Empress陶瓷嵌体。在5℃-55℃水浴中进行1000次热循环，保压时间为30秒后，所有标本均承受循环轴向机械加载。然后将修复后的牙齿储存在0.5%碱性品红溶液中24小时。用体视显微镜在40倍放大倍数下测量染料沿边缘的渗透程度。使用重复测量方差分析和邓肯检验（α=0.05）对数据进行统计学评估。
所有组在牙本质边缘的微渗漏均大于釉质边缘（P＜.05）。在釉质边缘，Variolink II和RelyX ARC树脂水门汀与所有牙本质粘接剂联合使用时的微渗漏结果均显著低于Panavia 21。对于牙本质边缘，Variolink II/Admira Bond组合在牙本质中的微渗漏值最低（P＜.05）。
釉质边缘的总体微渗漏明显少于牙本质边缘（P＜.05）。在釉质边缘，Panavia 21的微渗漏值高于Variolink II和RelyX ARC。
