Oper Dent. 2020 Sep 1;45(5):E227-E236. doi: 10.2341/19-161-L.
Using a material that optimizes marginal seal when using a margin elevation technique to manage deep class II cavities should enhance clinical outcomes.
Objectives: The purpose of this laboratory study was to perform a tridimensional interfacial gap evaluation of class II cavities with enamel and dentin cervical margins, before and after cyclic fatigue, restored with different nanohybrid resin composites.Methods and Materials: Standardized class II cavities were performed on 48 intact maxillary premolars, placing the mesial cervical margin 1 mm above the cement-enamel junction (CEJ) and the distal cervical margin 1 mm below the CEJ. Specimens were treated with two-step self-etch adhesive (Clearfil SE Bond2) and divided into six groups according to the restoration technique. Microcomputed Tomography imaging was executed before and after 1,000,000 cycles of chewing simulation at 50 N. Tridimensional interfacial gaps, expressed as cubic millimeters, were analyzed through a standardized software flowchart (Mimics). Data were analyzed with a two-way analysis of variance and Tukey post hoc tests (α=0.05).Results: Restoration technique (p=0.001) and chewing simulation (p=0.00001) significantly influenced interfacial gap on dentin but not on enamel. The post hoc test showed that, on dentin margins, flowable resins had a lower gap at baseline but a higher gap after chewing simulation, especially when a 2-mm-thick layer was applied, compared with nanohybrid and bulk-fill composites.Conclusions: Based on the obtained results, no differences in interfacial gap volume were found on enamel margins. On dentin margins, flowable resins showed better marginal seal at baseline, but they seem to be more prone to interfacial degradation during chewing simulation than traditional composites.
在使用边缘提升技术处理深 II 类窝洞时,使用能优化边缘封闭的材料,应该可以改善临床效果。
目的:本实验室研究的目的是在循环疲劳前后,对具有牙釉质和牙本质颈缘的 II 类窝洞进行三维界面间隙评估,并用不同的纳米复合树脂复合材料进行修复。
在 48 个完整的上颌前磨牙上制备标准 II 类窝洞,将近中颈缘置于牙釉质牙骨质界(CEJ)上方 1mm,远中颈缘置于 CEJ 下方 1mm。标本用两步自酸蚀粘结剂(Clearfil SE Bond2)处理,根据修复技术分为六组。在 50N 下进行 100 万次咀嚼模拟后,进行微计算机断层扫描成像。通过标准化软件流程图(Mimics)分析三维界面间隙,以立方毫米表示。数据采用双向方差分析和 Tukey 事后检验(α=0.05)进行分析。
修复技术(p=0.001)和咀嚼模拟(p=0.00001)显著影响牙本质的界面间隙,但不影响牙釉质。事后检验表明,在牙本质边缘,流动树脂在基线时具有较小的间隙,但在咀嚼模拟后间隙较大,尤其是当应用 2mm 厚的层时,与纳米复合树脂和块状填充复合材料相比。
根据所得结果,在牙釉质边缘未发现界面间隙体积的差异。在牙本质边缘,流动树脂在基线时具有更好的边缘封闭性,但在咀嚼模拟过程中似乎比传统复合材料更容易发生界面降解。