复合树脂修复体的射线不透性对影像学诊断及决策的影响。

Canto Joseane Delfino de Albuquerque, de Mendonça Luciana Sarmento, de Arruda José Alcides Almeida, Alvares Pamella Recco, Moreno Amália, Pontual Maria Luiza Anjos, da Silveira Marcia Maria Fonesca

Gen Dent. 2019 Sep-Oct;67(5):72-76.

The objective of this study was to evaluate the influence of the radiopacity of composite resin restorations on the interpretation of phantom radiographic images and to correlate the diagnosis with clinical management. Eighty healthy extracted human third molars were divided into 4 groups (n = 20 each): 3 restorative groups and 1 group of untreated teeth. The radiopacity of the materials was evaluated objectively using 10-mm discs of the composite resins SureFil SDR Flow (SDR), Filtek Bulk Fill Flowable Restorative (Filtek Bulk), and Filtek Z250 XT (Z250). Standard Class II cavities were prepared in the teeth. In the SDR and Filtek Bulk groups, the respective material was placed as a 2-mm base, and the remainder of the cavity was restored with Z250. In the Z250 group, the entire preparation was filled with Z250 composite resin. Ten phantoms of 6 teeth each were created; each phantom included 1 molar selected randomly from each of the 4 groups and 2 healthy premolars. Bitewing radiographs of the phantoms were obtained with a digital phosphor plate system and stored. For the subjective analysis, 5 examiners evaluated each of the molars on the radiographs and established the diagnosis and treatment plan. The radiopacity of the materials was statistically similar (P = 0.413), and there was no statistically significant difference between groups in the interpretation of the images. The radiopacity of the materials met ISO standard 4049/2009. Diagnosis and decision-making were influenced by the radiopacity of the materials. Filtek Z250, which had the lowest radiopacity, was diagnosed correctly more often than SDR, which had higher radiopacity. Filtek Bulk had the highest opacity and the highest percentage of correct diagnoses. In clinical practice, radiographic visualization of restorations and dental structures is essential for establishing a correct diagnosis and treatment plan. A restorative material may be within the established requirements for radiopacity, but on radiographic evaluation it might not be differentiated from mineralized dental tissues.

本研究的目的是评估复合树脂修复体的不透射线性对体模X线影像判读的影响，并将诊断结果与临床处理相关联。80颗健康拔除的人类第三磨牙被分为4组（每组n = 20）：3个修复组和1个未处理牙齿组。使用SureFil SDR Flow（SDR）复合树脂、Filtek Bulk Fill Flowable Restorative（Filtek Bulk）和Filtek Z250 XT（Z250）的10毫米圆盘客观评估材料的不透射线性。在牙齿上制备标准II类洞。在SDR组和Filtek Bulk组中，分别用各自的材料作为2毫米的基底，洞的其余部分用Z250修复。在Z250组中，整个窝洞用Z250复合树脂充填。制作了10个每个包含6颗牙齿的体模；每个体模包括从4组中每组随机选择的1颗磨牙和2颗健康前磨牙。使用数字磷光板系统获取体模的咬合翼片X线片并储存。对于主观分析，5名检查者评估X线片上的每颗磨牙并确定诊断和治疗计划。材料的不透射线性在统计学上相似（P = 0.413），并且在影像判读方面各组之间没有统计学上的显著差异。材料的不透射线性符合ISO标准4049/2009。诊断和决策受到材料不透射线性的影响。不透射线性最低的Filtek Z250比不透射线性较高的SDR更常被正确诊断。Filtek Bulk的不透射线性最高且正确诊断的百分比最高。在临床实践中，修复体和牙齿结构的X线显影对于确立正确的诊断和治疗计划至关重要。一种修复材料可能在既定的不透射线性要求范围内，但在X线评估中可能无法与矿化的牙体组织区分开来。