Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany.
Odontology. 2019 Jul;107(3):374-382. doi: 10.1007/s10266-018-0402-1. Epub 2018 Dec 19.
The aim of this study was to evaluate internal and marginal adaptation of high-viscosity bulk-fill composites to enamel and dentin with a self-etch (SE) and an etch-and-rinse adhesive (ER) without and with artificial aging. 128 MOD cavities in extracted human molars were prepared, randomly assigned to 8 groups (n = 16), bonded with either OptiBond FL (OFL, ER) or Xeno V+ (X, SE), and restored in 4 mm horizontal bulk layers with SonicFill (SF), Tetric EvoCeram Bulk fill (TEC), and x-tra fil (XF). Incremental layering technique with Premise (P) served as control. Half of the specimens each (n = 8) were subjected either to water storage (1 day, 37 °C) or prolonged storage (180 days) and thereafter thermocycling. Replicas were analyzed for marginal gap formation. After sectioning, interfacial adhesive defects were assessed. Results were statistical analyzed. (1) Internal adaptation: Except for TEC/OFL at enamel without artificial aging, no significant differences between bulk-fill composites and the control were observed. All groups at dentin with OFL showed less internal adhesive defects than that with X (p < 0.05). (2) Marginal adaptation: No significant differences were observed between bulk-fill composites and control except for P after artificial aging (p > 0.05). All other composites, regardless of artificial aging, formed significantly more marginal gaps at enamel with X compared to with OFL (p ≤ 0.05). Simplified restorations with high-viscosity bulk-fill composite showed comparable internal and marginal adaptation to incrementally placed fillings. A superiority of the 3-step ER approach was seen compared to the 1-step SE adhesive irrespective of the bulk-fill composite used.
本研究旨在评估自酸蚀（SE）和酸蚀-冲洗（ER）两种粘接剂在不进行和进行人工老化的情况下，对牙釉质和牙本质用高粘度的大体积充填复合材料的内部和边缘适应性。在 128 个从人磨牙中制备的 MOD 窝洞中，随机分为 8 组（n = 16），用 OptiBond FL（OFL，ER）或 Xeno V+（X，SE）粘接，用 SonicFill（SF）、Tetric EvoCeram Bulk fill（TEC）和 x-tra fil（XF）以 4mm 水平的大块层充填。用 Premise（P）的增量分层技术作为对照。每组一半（n = 8）的样本分别在水中储存（1 天，37°C）或延长储存（180 天）后进行冷热循环。复制件用于分析边缘间隙形成情况。经过切片后，评估界面粘接缺陷。结果进行了统计分析。（1）内部适应性：除了牙釉质未经过人工老化的 TEC/OFL 组外，大体积充填复合材料与对照组之间没有明显差异。在牙本质上用 OFL 的所有组都显示出比用 X 更少的内部粘接缺陷（p<0.05）。（2）边缘适应性：除了人工老化后的 P 组外（p>0.05），大体积充填复合材料与对照组之间没有显著差异。所有其他复合材料，无论是否经过人工老化，在用 X 时在牙釉质上形成的边缘间隙明显大于用 OFL（p≤0.05）。用高粘度的大体积充填复合材料进行简化修复，其内部和边缘适应性与增量放置的填充物相当。与使用的大体积充填复合材料无关，3 步 ER 法比 1 步 SE 法具有优势。
