State University of Campinas, Brazil.
Oper Dent. 2012 Mar-Apr;37(2):195-204. doi: 10.2341/11-184L. Epub 2012 Feb 7.
The aim of this study was to evaluate the influence of previous enamel etch and light emitting diode (LED) curing on gap formation of self-etch adhesive systems in Class I composite restorations after thermomechanical aging (TMA). Thus, on 192 human molars, a box-shaped Class I cavity was prepared maintaining enamel margins. Self-etch adhesives (Clearfil SE and Clearfil S3) were used to restore the preparation with a microhybrid composite. Before application of the adhesives, half of the teeth were enamel etched for 15 seconds with 37% phosphoric acid; the other half were not etched. For the photoactivation of the adhesives and composite, three light-curing units (LCUs) were used: one polywave (Ultra-Lume LED 5, UL) and two single-peak (FlashLite 1401, FL and Radii-cal, RD) LEDs. After this, epoxy resin replicas of the occlusal surface were made, and the specimens were submitted to TMA. New replicas were made from the aged specimens for marginal adaptation analysis by scanning electron microscopy. Data were submitted to Kruskal-Wallis and Wilcoxon tests (α=0.05). Before TMA, when enamel was etched before the application of S3, no gap formation was observed; however, there were gaps at the interface for the other tested conditions, with a statistical difference (p≤0.05). After TMA, the selective enamel etching previous to the S3 application, regardless of the LCU, promoted higher marginal adaptation compared to the other tested groups (p≤0.05). Prior to TMA, higher marginal integrity was observed, in comparison with specimens after TMA (p≤0.05). With regard to Clearfil SE and Clearfil Tri-S cured with FL, no differences of gap formation were found between before and after aging (5.3 ± 3.8 and 7.4 ± 7.5, respectively), especially when the Clearfil Tri-S was used in the conventional protocol. When cured with RD or UL and not etched, Clearfil Tri-S presented the higher gap formation. In conclusion, additional enamel etching promoted better marginal integrity for Clearfil Tri-S, showing it to be an efficient technique for Class I composite restorations. The two-step self-etch adhesive was not influenced by selective enamel etching or by the LED-curing unit.
本研究旨在评估在热机械老化(TMA)后,自酸蚀粘结剂系统在 I 类复合修复体中形成间隙的影响,以及先前的釉质酸蚀和发光二极管(LED)固化的影响。因此,在 192 个人类磨牙上,制备了一个保持釉质边缘的盒状 I 类腔。使用自酸蚀粘结剂(Clearfil SE 和 Clearfil S3)用微混合复合材料修复预备体。在应用粘结剂之前,一半的牙齿用 37%磷酸酸蚀 15 秒;另一半未酸蚀。对于粘结剂和复合树脂的光激活,使用了三种光固化单元(LCU):一个多波长(Ultra-Lume LED 5,UL)和两个单峰(FlashLite 1401,FL 和 Radii-cal,RD)LED。之后,制作了咬合面的环氧树脂复制品,并对标本进行 TMA。从老化的标本中制作新的复制品,通过扫描电子显微镜进行边缘适应性分析。数据采用 Kruskal-Wallis 和 Wilcoxon 检验(α=0.05)。在 TMA 之前,当 S3 应用前进行选择性釉质酸蚀时,未观察到间隙形成;然而,对于其他测试条件,在界面处存在间隙,具有统计学差异(p≤0.05)。在 TMA 之后,S3 应用前选择性釉质酸蚀,无论使用哪种 LCU,与其他测试组相比,都能提高更高的边缘适应性(p≤0.05)。在 TMA 之前,与 TMA 后相比,观察到更高的边缘完整性(p≤0.05)。关于 Clearfil SE 和用 FL 固化的 Clearfil Tri-S,在老化前后未发现间隙形成的差异(分别为 5.3±3.8 和 7.4±7.5),尤其是当 Clearfil Tri-S 按常规方案使用时。当用 RD 或 UL 固化且不酸蚀时,Clearfil Tri-S 表现出更高的间隙形成。总之,额外的釉质酸蚀提高了 Clearfil Tri-S 的边缘完整性,表明这是一种有效的 I 类复合修复技术。两步自酸蚀粘结剂不受选择性釉质酸蚀或 LED 固化单元的影响。