12 年后延长型后牙复合树脂修复体的临床性能和 SEM 边缘质量。

Clinical performance and SEM marginal quality of extended posterior resin composite restorations after 12 years.

机构信息

Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany.

Private Practice, Nuremberg, Germany.

出版信息

Dent Mater. 2020 Jul;36(7):e217-e228. doi: 10.1016/j.dental.2020.03.022. Epub 2020 May 22.

DOI:10.1016/j.dental.2020.03.022

PMID:32451207

Abstract

OBJECTIVE

To investigate the clinical behavior of two different resin-based restorative systems in extended Class II cavities in a controlled prospective split-mouth study over 12 years and to assess marginal quality under a SEM using epoxy replicas.

METHODS

Thirty patients received 68 resin composite restorations (Solobond M+Grandio: n=36; Syntac+Tetric Ceram: n=32) by one dentist in a private practice. 35% of cavities revealed no enamel at the bottom of the proximal box, 48% of cavities provided <0.5mm remaining proximal enamel. Restorations were examined according to modified USPHS criteria at baseline, and after six months, one, two, four, six, eight, 10, and 12 years. Expoxy replicas of 21 restoration pairs were analysed under a SEM at 200× magnification regarding marginal quality.

RESULTS

At the 12-years recall, 59 of the original 68 restorations in 27 of 30 patients were available (drop out 13%). Two restorations failed due to cusp fracture (Tetric Ceram) and marginal fracture (Grandio). The overall success rate of all restorations was 97.1% (Kaplan-Meier survival algorithm) with no differences between the two materials (p=0.923). After 144 months of clinical service, restorations in molars performed worse than in premolars regarding the integrity of restoration and tooth (p<0.05) being detected as wear, chippings, and cracks. Beyond the 4-year recall, marginal staining significantly increased. SEM evaluation of replicas revealed that perfect margin (49% baseline vs. 10% after 12 years), overhang (13% at baseline vs. 3% after 12 years), negative step formation (34% at baseline vs. 75% after 12 years), and marginal fractures (0% at baseline vs. 6% after 12 years) significantly changed during the evaluation period (p<0.001).

SIGNIFICANCE

Extended direct resin composite restorations performed satisfactorily over 12 years of clinical service. SEM analysis delivered qualitative data regarding marginal deterioration over time.

摘要

目的

通过一项为期 12 年的对照前瞻性分口研究，调查两种不同树脂基修复系统在扩展 II 类窝洞中的临床行为，并使用环氧复制技术通过扫描电镜（SEM）评估边缘质量。

方法

由一位私人执业牙医为 30 名患者的 68 个树脂复合修复体（Solobond M+Grandio：n=36；Syntac+Tetric Ceram：n=32）进行治疗。35%的窝洞底部没有釉质，48%的窝洞提供的近中剩余釉质<0.5mm。在基线、6 个月、1、2、4、6、8、10 和 12 年时，根据改良的美国公共卫生服务标准对修复体进行检查。分析 21 对修复体的环氧复制件，在 200×放大倍数下通过 SEM 评估边缘质量。

结果

在 12 年的随访中，30 名患者中的 27 名（脱落 13%）有 68 个原始修复体中的 59 个。有两个修复体因牙尖折裂（Tetric Ceram）和边缘折裂（Grandio）而失败。所有修复体的总体成功率为 97.1%（Kaplan-Meier 生存算法），两种材料之间无差异（p=0.923）。在临床服务 144 个月后，磨牙的修复体完整性和牙齿状况（磨耗、崩瓷和裂纹）比前磨牙差（p<0.05）。超过 4 年的随访后，边缘着色显著增加。对复制件的 SEM 评估显示，完美边缘（49%的基线 vs. 12 年后的 10%）、悬突（13%的基线 vs. 12 年后的 3%）、负台阶形成（34%的基线 vs. 12 年后的 75%）和边缘折裂（0%的基线 vs. 12 年后的 6%）在评估期间显著变化（p<0.001）。