School of Dentistry, Indiana University, Indianapolis, IN 46202, USA. hnassar @ iupui.edu
Caries Res. 2011;45(4):346-52. doi: 10.1159/000329384. Epub 2011 Jul 20.
To investigate how the size of the space between restoration and dentinal wall of the tooth affects the development of secondary caries lesions, especially wall lesions.
Tooth-resin composite specimens were mounted on custom-made gap model stages and divided into 4 groups (n = 10): group 1 with a 30-μm gap throughout both enamel and dentin, group 2 with a 30-μm enamel gap and 530-μm dentinal gap, group 3 with 525-μm gaps in both enamel and dentin, and group 4 with 525-μm and 1,025-μm gaps in enamel and dentin, respectively. Specimens were gas sterilized and incubated in a cycling microbial caries model for 8 days and analyzed with confocal microscopy for lesion size at the enamel outer lesion (EOL), enamel wall lesion (EWL), dentin wall lesion A (DWL-A) next to the dentin-enamel junction (DEJ) and dentin wall lesion B (DWL-B) at 750 μm from the DEJ.
No difference in EOL or EWL size was found between the groups. DWL-A and DWL-B were larger in group 3 than groups 1 and 2. A larger DWL-B was found in group 3 than group 4.
The presence of additional space at the dentinal wall area did not affect secondary caries development as long as the enamel gap was small. However, with enamel gaps of approximately 500 μm, the presence of the additional gap space at the dentinal wall led to the development of smaller dentinal wall lesions at the deeper parts of the simulated cavity. In uniform gaps, the size of the interface was positively correlated with the size of the dentinal wall lesions.
研究牙修复体和牙本质壁之间的间隙大小如何影响继发龋病的发展,尤其是侧壁病变。
将牙-树脂复合材料标本安装在定制的间隙模型台上,并分为 4 组(n = 10):组 1 在牙釉质和牙本质中均有 30μm 的间隙,组 2 在牙釉质中有 30μm 的间隙,而在牙本质中有 530μm 的间隙,组 3 在牙釉质和牙本质中均有 525μm 的间隙,组 4 在牙釉质和牙本质中分别有 525μm 和 1025μm 的间隙。标本经气体消毒后,在循环微生物龋病模型中孵育 8 天,并用共聚焦显微镜分析牙釉质外病变(EOL)、牙釉质侧壁病变(EWL)、牙本质-釉质交界处(DEJ)旁牙本质侧壁病变 A(DWL-A)和距离 DEJ 750μm 处牙本质侧壁病变 B(DWL-B)的病变大小。
各组 EOL 或 EWL 的大小无差异。与组 1 和组 2 相比,组 3 的 DWL-A 和 DWL-B 更大。组 3 的 DWL-B 大于组 4。
只要牙釉质间隙较小,牙本质壁区域存在额外的间隙并不影响继发龋的发展。然而,当牙釉质间隙约为 500μm 时,牙本质壁上存在额外的间隙会导致模拟腔更深部位的牙本质侧壁病变更小。在均匀的间隙中,界面的大小与牙本质侧壁病变的大小呈正相关。