Mu H L, Tian F C, Wang X Y, Gao X J
Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Dec 21;53(1):120-125. doi: 10.19723/j.issn.1671-167X.2021.01.018.
To observe the wear performance of Giomer and universal composite for posterior restorations by 3D laser scan method, in order to guide the material selection in clinic.
In this study, 48 patients (108 teeth) were selected according to the inclusion and exclusion criteria. All the patients in need of a minimum of 2 Class Ⅰ and/or Class Ⅱ restorations were invited to join the study. The teeth were restored with Giomer (Beautifil Ⅱ, BF) and universal composite (Filtek Z350, Z350) randomly. The restorations were evaluated at baseline and after 6-, 18-, 48-month using the modified United States Public Health Service (USPHS) criteria for clinical performance. The images and gypsum replicas were taken at each recall. A 3D-laser scanner and Geomagic Studio 12 were used to analyze the wear depth quantitatively. Statistical analysis was performed with SPSS 20.0.
After 4 years, 89.6% patients were recalled. The survival rate of both materials was 95.8% (Kaplan-Meier survival analysis). Seven restorations of the two materials failed due to loss of restoration, bulk fracture, secondary caries and pulp necrosis. The wear patterns of restorations were divided into 2 classes. Pattern Ⅰ: occlusal contact areas showed the deepest and fastest wear depth; pattern Ⅱ: the wear depth was slow and uniform. Both materials showed a rapid wear in the first 6 months. Then the wear rate was decreased. The occlusal wear depth after 4 years were (58±22) μm and (54±16) μm for BF group and Z350 group respectively, which were in accordance with the American Dental Association (ADA) guidelines (wear depth for 3 years < 100 μm). No significant differences (>0.05) were observed between the two groups. Regarding the restorations with wear pattern Ⅰ, the wear depth of BF group was higher than Z350 group at 6- and 48-month ( < 0.05), while there was no significant difference between restorations with wear pattern Ⅱ (>0.05).
Within the limitation of the study, after 4 years, the survival rate and wear resistance of Giomer met ADA guidelines for tooth-colored restorative materials for posterior teeth. When the two materials were applied in occlusal contact areas, wear resistance of Giomer was slightly lower than universal composite resin. No significant difference was found when they were applied in none of the occlusal contact areas.
采用三维激光扫描法观察聚酸改性复合树脂(Giomer)与通用型复合树脂用于后牙修复体的磨损性能,以指导临床材料选择。
本研究根据纳入和排除标准选取48例患者(108颗牙)。所有至少需要2个Ⅰ类和/或Ⅱ类修复体的患者被邀请参加研究。牙齿随机用Giomer(BeautifilⅡ,BF)和通用型复合树脂(Filtek Z350,Z350)修复。使用改良的美国公共卫生服务(USPHS)临床性能标准在基线以及6个月、18个月、48个月后对修复体进行评估。每次复诊时拍摄图像和制作石膏模型。使用三维激光扫描仪和Geomagic Studio 12定量分析磨损深度。采用SPSS 20.0进行统计分析。
4年后,89.6%的患者接受复诊。两种材料的存留率均为95.8%(Kaplan-Meier生存分析)。两种材料的7个修复体因修复体脱落、大块折断、继发龋和牙髓坏死而失败。修复体的磨损模式分为2类。模式Ⅰ:咬合接触区域磨损深度最深且最快;模式Ⅱ:磨损深度缓慢且均匀。两种材料在最初6个月均表现出快速磨损。之后磨损速率降低。4年后BF组和Z350组的咬合面磨损深度分别为(58±22)μm和(54±16)μm,符合美国牙科协会(ADA)指南(3年磨损深度<100μm)。两组之间未观察到显著差异(>0.05)。对于磨损模式Ⅰ的修复体,BF组在6个月和48个月时的磨损深度高于Z350组(<0.05),而磨损模式Ⅱ的修复体之间无显著差异(>0.05)。
在本研究的局限性内,经过4年,聚酸改性复合树脂的存留率和耐磨性符合ADA后牙牙齿颜色修复材料指南。当两种材料应用于咬合接触区域时,聚酸改性复合树脂的耐磨性略低于通用型复合树脂。当它们应用于非咬合接触区域时,未发现显著差异。