Faculty of Dentistry, Department of Restorative Dentistry, Ondokuz Mayis University, Samsun, Turkey.
Faculty of Dentistry, Department of Endodontics, Ondokuz Mayis University, Samsun, Turkey.
Clin Oral Investig. 2019 May;23(5):2323-2330. doi: 10.1007/s00784-018-2677-6. Epub 2018 Oct 6.
This study compared the 3-year clinical performance of a low-shrinkage silorane-based composite material with that of a methacrylate-based composite material in the restoration of endodontically treated premolar teeth.
A total of 70 patients requiring a Class II composite-resin restoration of a premolar tooth following root-canal treatment participated in the study. Cavities were restored with either a silorane-based restorative (Filtek Silorane + Silorane System Adhesive) or a methacrylate-based restorative (Filtek Z250 + Clearfil SE Bond) system applied according to the manufacturer's instructions. Restorations were evaluated by two blinded observers at five different time intervals (baseline; 6 months; 1, 2, and 3 years) according to modified USPHS criteria. Pearson's chi-square tests were used to examine differences in the clinical performance of the materials (retention, color match, marginal discoloration, secondary caries, anatomical form, marginal adaptation, and surface roughness), and Friedman and Wilcoxon tests were used to compare changes between baseline and each recall time, with a level of 0.05 considered statistically significant.
After 3 years, no statistically significant differences in clinical performance were observed between the two materials (p > 0.05). Intra-system comparisons revealed a statistically significant deterioration in color match, marginal discoloration, anatomical form, marginal adaptation, and surface roughness scores after 3 years for both systems. Although the difference was not significant at 3 years of follow-up, the level of deterioration in marginal adaptation and surface roughness was greater for the Filtek Silorane restoration than for the Filtek Z250 restoration at the 1 year follow-up (p > 0.05).
Restorations of both materials were clinically acceptable after 3 years. The Filtek Silorane system did not appear to offer any clinical advantages over the methacrylate-based system when used in the restoration of Class II cavities in endodontically treated premolars.
The restoration of endodontically treated premolars with minor or moderate loss of tooth structure can be directly performed either with silorane or methacrylate-based composite resins.
本研究比较了 3 年临床性能的低收缩硅烷基复合材料与基于甲基丙烯酸酯复合材料在牙髓治疗前磨牙的修复。
共有 70 名患者需要在根管治疗后对前磨牙进行 II 类复合树脂修复，参与了本研究。使用基于硅烷的修复材料（Filtek Silorane+Silorane 系统胶粘剂）或基于甲基丙烯酸酯的修复材料（Filtek Z250+Clearfil SE Bond）系统，按照制造商的说明进行修复。根据改良美国公共卫生协会标准，在五个不同的时间间隔（基线；6 个月；1、2 和 3 年），由两名盲法观察者对修复体进行评估。使用 Pearson 卡方检验比较两种材料的临床性能差异（保留率、颜色匹配、边缘变色、继发龋、解剖形态、边缘适应性和表面粗糙度），使用 Friedman 和 Wilcoxon 检验比较基线和每次随访时间之间的变化，以 0.05 为统计学显著水平。
3 年后，两种材料的临床性能无统计学差异（p>0.05）。系统内比较显示，两种系统在 3 年后颜色匹配、边缘变色、解剖形态、边缘适应性和表面粗糙度评分均有统计学显著恶化。尽管在 3 年随访时差异不显著，但在 1 年随访时，Filtek Silorane 修复体的边缘适应性和表面粗糙度恶化程度大于 Filtek Z250 修复体（p>0.05）。
两种材料的修复体在 3 年后临床效果均可接受。Filtek Silorane 系统在修复牙髓治疗前磨牙 II 类窝洞时，似乎没有比基于甲基丙烯酸酯的系统提供任何临床优势。
对于牙体结构少量或中度丧失的牙髓治疗前磨牙，可以直接用硅烷或甲基丙烯酸酯基复合树脂进行修复。
