纳米复合树脂与精细混合复合树脂在 6 年后用于扩展 II 类窝洞的比较

Nanohybrid vs. fine hybrid composite in extended Class II cavities after six years.

机构信息

Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, D-35392 Giessen, Germany.

出版信息

Dent Mater. 2011 May;27(5):455-64. doi: 10.1016/j.dental.2011.01.004.

DOI:10.1016/j.dental.2011.01.004

PMID:21397316

Abstract

OBJECTIVES

In a controlled prospective split-mouth study, clinical behavior of two different resin composites in extended Class II cavities was observed over six years.

METHODS

Thirty patients received 68 direct resin composite restorations (Solobond M + Grandio: n=36; Syntac + Tetric Ceram: n=32) by one dentist in a private practice. All restorations were replacement fillings, 35% of cavities revealed no enamel at the bottom of the proximal box, in 48% of cavities remaining proximal enamel width was <0.5mm. Restorations were examined according to modified USPHS criteria at baseline, and after six months, one, two, four, and six years.

RESULTS

Success rate was 100% after six years of clinical service, while the drop out of patients was 0%. Neither materials nor localization of the restoration (upper vs. lower jaw) had a significant influence on clinical outcome in any criterion after six years (p>0.05; Mann-Whitney U-test). Molar restorations performed worse regarding marginal integrity (4 years), filling integrity (6, 12, 24, 48 months), and tooth integrity (4 and 6 years). Irrespective of the resin composite used, significant changes over time were found for all criteria recorded (Friedman test; p<0.05). Marginal quality revealed a major portion of overhangs having been clearly reduced after the one year recall (baseline: 44%; 6 months: 65%; 1 year: 47%; 2 years: 6%; 4 years: 4%; and 6 years: 3%). Beyond the 1 year recall, negative step formations significantly increased due to wear (p<0.05), having been more pronounced in molars (87% bravo after 4 years) than in premolars (51% bravo after 4 years). Tooth integrity significantly deteriorated due to enamel cracks, which increased over time (p<0.05). Enamel chippings and cracks were significantly more frequent in molars (26% bravo after 4 years to 35% after six years) than in premolars (9% bravo after 4 years, 11% after six years). Restoration integrity over time mainly suffered surface roughness and wear (28% after one year, 75% after two years, 84% after four years, 91% after six years).

SIGNIFICANCES

Both materials performed satisfactorily over the 6-year observation period. Due to the extension of the restorations, wear was clearly visible after six years of clinical service with 91% bravo ratings.

摘要

目的

在一项对照前瞻性分口研究中，观察了两种不同树脂复合材料在扩展 II 类窝洞中的临床行为，时间长达六年。

方法

一位私人执业牙医为 30 名患者共进行了 68 次直接树脂复合材料修复（Solobond M + Grandio：n=36；Syntac + Tetric Ceram：n=32）。所有修复均为替换填充物，35%的窝洞底部无釉质，48%的窝洞剩余近中釉质宽度<0.5mm。根据改良 USPHS 标准，在基线、六个月、一年、两年、四年和六年时对修复体进行检查。

结果

六年临床服务后，成功率为 100%，而患者脱落率为 0%。两种材料和修复体的定位（上颌与下颌）在六年时的任何标准中均无显著影响（p>0.05；Mann-Whitney U 检验）。磨牙修复体在边缘完整性（4 年）、填充完整性（6、12、24、48 个月）和牙齿完整性（4 和 6 年）方面表现较差。无论使用何种树脂复合材料，所有记录的标准在时间上均有显著变化（Friedman 检验；p<0.05）。边缘质量显示，在一年随访时，明显减少了大部分悬突（基线：44%；6 个月：65%；1 年：47%；2 年：6%；4 年：4%；6 年：3%）。在一年随访后，由于磨损，明显增加了负台阶形成（p<0.05），磨牙中更为明显（4 年后 87% Bravo），而前磨牙中则不明显（4 年后 51% Bravo）。由于釉质裂纹，牙齿完整性显著恶化，且随时间推移而增加（p<0.05）。磨牙中的釉质剥落和裂纹明显比前磨牙更频繁（4 年后 26% Bravo，6 年后 35% Bravo），而前磨牙中则较少（4 年后 9% Bravo，6 年后 11% Bravo）。修复体完整性随时间推移主要受表面粗糙度和磨损影响（1 年后 28%，2 年后 75%，4 年后 84%，6 年后 91%）。