一步法粘结剂治疗非龋性颈部病变的3年临床疗效

3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions.

作者信息

Moretto S G, Russo E M A, Carvalho R C R, De Munck J, Van Landuyt K, Peumans M, Van Meerbeek B, Cardoso M V

机构信息

KU Leuven - BIOMAT, Department of Oral Health Sciences, Catholic University of Leuven, Belgium.

出版信息

J Dent. 2013 Aug;41(8):675-82. doi: 10.1016/j.jdent.2013.05.016. Epub 2013 Jun 6.

DOI:10.1016/j.jdent.2013.05.016

PMID:23747824

Abstract

OBJECTIVES

Despite representing an important component of current dental adhesives, HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel. The aim of this randomised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives.

METHODS

Thirty patients had 175 non-carious cervical lesions restored with composite (Gradia Direct Anterior, GC) using either the HEMA-rich adhesive Clearfil Tri-S Bond (C3S; Kuraray) or the HEMA-free adhesive G-Bond (GB; GC). The restorations were evaluated by two examiners at baseline, 6, 12, 24 and 36 months regarding retention, caries recurrence, marginal integrity and discoloration and post-operative sensitivity. The data were statistically analysed with GEE and McNemar tests (p<0.05).

RESULTS

The recall rate at 6 and 12 months was 100% and decreased to 96.7% at 24 and 36 months. At 3 years, the retention rate was 93.8% for C3S and 98.8% for GB (p=0.14). A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated, irrespective of the recall (p>0.05). After 3 years, both adhesives presented an increase in the percentage of clinically acceptable marginal discoloration (C3S: 32.9% and GB: 26.8%) normally associated to clinically acceptable marginal defects (C3S: 35.8% and GB: 26.5%). Only 1 dentine margin of a GB restoration presented a severe marginal defect (1.2%) and 1 C3S restoration presented caries recurrence. The overall 3-year clinical success rate was 92.6% for C3S and 97.6% for GB (p=0.16).

CONCLUSION

Both one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years.

CLINICAL SIGNIFICANCE

HEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity. However, this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex. In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a HEMA-rich and HEMA-free one-step adhesive.

摘要

目的

尽管甲基丙烯酸羟乙酯（HEMA）是当前牙科粘合剂的重要组成部分，但据说它会对牙本质和牙釉质粘结的长期稳定性产生负面影响。这项随机临床试验的目的是评估两种一步自酸蚀粘合剂的3年临床性能。

方法

30名患者的175处非龋性颈部病变用复合树脂（Gradia Direct Anterior，GC）修复，分别使用富含HEMA的粘合剂Clearfil Tri-S Bond（C3S；可乐丽）或不含HEMA的粘合剂G-Bond（GB；GC）。两名检查者在基线、6个月、12个月、24个月和36个月时对修复体的固位、龋病复发、边缘完整性、变色和术后敏感性进行评估。数据采用广义估计方程（GEE）和麦克尼马尔检验进行统计学分析（p<0.05）。

结果

6个月和12个月时的召回率为100%，24个月和36个月时降至96.7%。3年时，C3S的固位率为93.8%，GB为98.8%（p=0.14）。成对比较显示，对于所有评估参数，两种粘合剂之间均无显著差异，无论召回情况如何（p>0.05）。3年后，两种粘合剂在临床上可接受的边缘变色百分比均有所增加（C3S：32.9%，GB：26.8%），这通常与临床上可接受的边缘缺陷相关（C3S：35.8%，GB：26.5%）。GB修复体只有1个牙本质边缘出现严重边缘缺陷（1.2%），1个C3S修复体出现龋病复发。C3S的3年总体临床成功率为92.6%，GB为97.6%（p=0.16）。