Department of Restorative Dentistry and Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.
Department of Dentistry, Health Science Institute, Federal University of Juiz de Fora, Governador Valadares, Brazil.
J Mech Behav Biomed Mater. 2018 Jun;82:268-281. doi: 10.1016/j.jmbbm.2018.03.019. Epub 2018 Mar 23.
A systematic review was conducted to determine whether there were composition strategies available to reduce and control polymerization shrinkage stress development in resin-based restorative dental materials.
This report was reported in accordance with the PRISMA Statement. Two reviewers performed a literature search up to December 2016, without restriction of the year of publication, in seven databases: PubMed, Web of Science, Scopus, SciELO, LILACS, IBECS, and BBO.
Only laboratory studies that evaluated polymerization shrinkage stress by direct testing were included. Pilot studies, reviews and in vitro studies that evaluated polymerization shrinkage stress by indirect methods (e.g., microleakage or cuspal deflection measurements), finite elemental analysis, or theoretical and mathematical models were excluded. Of the 6113 eligible articles, 62 studies were included in the qualitative analysis, and the meta-analysis was performed with 58 studies. The composition strategy was subdivided according to the modified part of the material: filler phase, coupling agent, or resin matrix. A global comparison was performed with random-effects models (α = 0.05). The only subgroup that did not show a statistical difference between the alternative strategy and the control was 'the use of alternative photo-initiators' (p = 0.29).
Modification of the resin matrix made the largest contribution to minimizing stress development. The technology used for decreasing stress in the formulation of low-shrinkage and bulk-fill materials was shown to be a promising application for reducing and controlling stress development.
系统评价旨在确定是否存在可用于减少和控制树脂基修复牙科材料聚合收缩应力发展的组成策略。
本报告根据 PRISMA 声明进行报告。两名审查员进行了文献检索，检索时间截至 2016 年 12 月，没有对出版年份进行限制，检索了 7 个数据库：PubMed、Web of Science、Scopus、SciELO、LILACS、IBECS 和 BBO。
仅纳入通过直接测试评估聚合收缩应力的实验室研究。排除了通过间接方法（例如微渗漏或牙尖位移测量）、有限元分析或理论和数学模型评估聚合收缩应力的初步研究、综述和体外研究。在 6113 篇合格文章中，有 62 篇文章被纳入定性分析，58 篇文章进行了荟萃分析。根据材料的改良部分对组成策略进行了细分：填料相、偶联剂或树脂基质。使用随机效应模型（α=0.05）进行了全局比较。唯一没有显示替代策略与对照之间存在统计学差异的亚组是“使用替代光引发剂”（p=0.29）。
树脂基质的改性对最大限度地减少应力发展做出了最大贡献。在低收缩和大体积填充材料配方中用于降低应力的技术已被证明是减少和控制应力发展的有前途的应用。
