Tomaszewska Iwona M, Kearns Jennifer O, Ilie Nicoleta, Fleming Garry J P
Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland.
Materials Science Unit, Dublin Dental University Hospital, School of Dental Science Trinity College Dublin, Dublin 2, Ireland.
J Dent. 2015 Mar;43(3):309-16. doi: 10.1016/j.jdent.2015.01.010. Epub 2015 Jan 24.
To assess the cuspal deflection and cervical microleakage scores of standardised large mesio-occlusal-distal (MOD) cavities filled with different restoration protocols: (1) conventional resin restoratives, (2) bulk fill flowable base materials 'capped' with a conventional dimethacrylate resin-based composite (RBC) or (3) bulk fill resin restorative materials.
Standardised MOD cavities were prepared in sixty-four sound maxillary premolar teeth and randomly allocated to eight groups. Restorations were placed in conjunction with a universal bonding system and resin restorative materials were irradiated with a quartz-tungsten-halogen light-curing-unit. Restoration protocol (eight oblique increments of conventional resin restorative, bulk fill flowable base and two occlusal 'capping' RBC increments (three increments in total) or bulk fill resin restorative (two increments)) was the dependent variable. A twin channel deflection measuring gauge measured the buccal and palatal cuspal deflections. Teeth were thermally fatigued, immersed in a 0.2% basic fuchsin dye for 24h, sectioned and examined for cervical microleakage score.
Post hoc Tukey's tests highlighted significant differences in the mean total cuspal deflection values between resin restoratives (p < 0.0001) and restoration protocol (p < 0.005). In general (albeit product dependently), an increase in mean total cuspal deflection and concomitant decrease in cervical microleakage score was evident for bulk fill flowable base materials with occlusal 'capping' RBC increments (restoration protocol 2) compared with bulk fill resin restoratives (restoration protocol 3).
Not all bulk fill flowable materials or bulk fill resin restoratives behave in a similar fashion when used to restore standardised MOD cavities in maxillary premolar teeth and material selection is vital in the absence of clinical data.
Poorly performing bulk fill flowable materials or bulk fill restoratives can be identified using the cuspal deflection and cervical microleakage protocol which could save the complications encountered clinically when restoring Class II restorations.
评估采用不同修复方案填充的标准化大近中-牙合-远中（MOD）洞型的牙尖偏斜度和颈部微渗漏评分：（1）传统树脂修复材料；（2）用传统双甲基丙烯酸酯树脂基复合材料（RBC）“覆盖”的大块充填可流动基底材料；（3）大块充填树脂修复材料。
在64颗完好的上颌前磨牙上制备标准化MOD洞型，并随机分为8组。修复时使用通用粘结系统，树脂修复材料用石英-钨-卤素光固化灯照射。修复方案（传统树脂修复材料分8个斜向增量、大块充填可流动基底材料及2个牙合面“覆盖”RBC增量（共3个增量）或大块充填树脂修复材料（2个增量））为因变量。使用双通道偏斜度测量仪测量颊尖和腭尖的偏斜度。对牙齿进行热疲劳处理，浸入0.2%碱性品红染料中24小时，切片并检查颈部微渗漏评分。
事后Tukey检验突出显示了树脂修复材料之间（p < 0.0001）以及修复方案之间（p < 0.005）平均总牙尖偏斜度值的显著差异。总体而言（尽管取决于产品），与大块充填树脂修复材料（修复方案3）相比，对于采用牙合面“覆盖”RBC增量的大块充填可流动基底材料（修复方案2），平均总牙尖偏斜度增加，同时颈部微渗漏评分降低。
当用于修复上颌前磨牙的标准化MOD洞型时，并非所有大块充填可流动材料或大块充填树脂修复材料的表现都相似，在缺乏临床数据的情况下，材料选择至关重要。
使用牙尖偏斜度和颈部微渗漏方案可以识别性能不佳的大块充填可流动材料或大块充填修复材料，这可以避免在修复Ⅱ类洞时临床上遇到的并发症。
