Tardem Chane, Albuquerque Elisa Gomes, Lopes Letícia de Souza, Marins Stella Soares, Calazans Fernanda Signorelli, Poubel Luiz Augusto, Barcelos Roberta, Barceleiro Marcos de Oliveira
Universidade Federal Fluminense - UFF, Instituto de Saúde de Nova Friburgo, Departamento de Formação Específica, Nova Friburgo, RJ, Brasil.
Universidade do Estado do Rio de Janeiro - UERJ, Departamento de Dentística, Rio de Janeiro, RJ, Brasil.
Braz Oral Res. 2019 Sep 16;33(0):e089. doi: 10.1590/1807-3107bor-2019.vol33.0089.
The objectives of this double-blind randomized clinical trial were to compare (a) the clinical times and (b) the occurrence and severity of postoperative sensitivity, of posterior restoration that used a universal adhesive, in a self-etch or selective enamel-etching technique, along with incremental or bulk-fill composites (presented in syringes or capsules). A total of 295 posterior restorations were placed according to the following groups: SETB - self-etch/bulk-fill in syringe; SETC - self-etch/bulk-fill in capsules; SETI - self-etch/incremental; SEEB - selective enamel-etching/bulk-fill in syringe; SEEC - selective enamel-etching/bulk-fill in capsules; and SEEI - selective enamel-etching/incremental. Clinical time was assessed by a reason (s/mm3) between the total volume of resin inserted and the total time required to perform the restorations. Postoperative sensitivity was evaluated using two scales (Numeric Rating Scale and Visual Analogue Scale). Mean clinical time results, analyzed by Wald's Chi-square, showed significant statistical differences among all groups (p<0.001), indicating that the restorative strategy affected the time required for the restoration. A generalized estimating equation model statistical analysis, performed to compare postoperative sensitivity, showed that neither the restorative technique, the adhesive strategy nor the presentation mode of the bulk-fill composite affected the overall risk of postoperative sensitivity (4.06 [2.22-6.81]). The use of bulk-fill composite, presented in capsules or syringes, is less time consuming and does not increase the risk or intensity of postoperative sensitivity relative to the traditional incremental technique.
(a)使用通用粘结剂,采用自酸蚀或选择性釉质酸蚀技术,以及使用增量或大体积充填复合树脂(以注射器或胶囊形式提供)进行后牙修复的临床操作时间;(b)术后敏感的发生率和严重程度。根据以下分组共进行了295颗后牙修复:SETB - 自酸蚀/注射器装大体积充填;SETC - 自酸蚀/胶囊装大体积充填;SETI - 自酸蚀/增量充填;SEEB - 选择性釉质酸蚀/注射器装大体积充填;SEEC - 选择性釉质酸蚀/胶囊装大体积充填;SEEI - 选择性釉质酸蚀/增量充填。临床操作时间通过树脂插入总体积与完成修复所需总时间之间的比率(s/mm³)进行评估。术后敏感性使用两种量表(数字评定量表和视觉模拟量表)进行评估。通过Wald卡方分析的平均临床操作时间结果显示,所有组之间存在显著统计学差异(p<0.001),表明修复策略会影响修复所需时间。为比较术后敏感性而进行的广义估计方程模型统计分析表明,修复技术、粘结策略或大体积充填复合树脂的呈现方式均未影响术后敏感的总体风险(4.06 [2.22 - 6.81])。相对于传统的增量技术,使用胶囊或注射器形式提供的大体积充填复合树脂耗时更少,且不会增加术后敏感的风险或强度。