临床和 OCT 评估在一项为期 12 个月 RCT 中通用黏合剂的应用模式。

Clinical and OCT assessment of application modes of a universal adhesive in a 12-month RCT.

机构信息

Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.

出版信息

J Dent. 2022 Apr;119:104068. doi: 10.1016/j.jdent.2022.104068. Epub 2022 Feb 19.

DOI:10.1016/j.jdent.2022.104068

PMID:35192908

Abstract

OBJECTIVES

To evaluate a universal adhesive clinically using FDI criteria and by optical coherence tomography (OCT).

METHODS

In 50 patients, three or four non-carious cervical lesions (NCCL) were restored with composite (Venus® Diamond Flow, Kulzer) using iBond® Universal (iBU, Kulzer) applied in self-etch (iBU-SE, n = 50), selective-enamel-etch (iBU-SEE, n = 29) or etch-and-rinse mode (iBU-ER, n = 50) and the reference OptiBond™ FL (OFL, Kerr, n = 50). Restorations were imaged by SD-OCT. The weighted mean length of interfacial adhesive defects (AD, %) was quantified per restoration immediately after placement (t), simultaneously with clinical assessment (FDI criteria) after 14 days (t), 6 (t) and 12 months (t). Data were statistically analyzed (McNemar-/Wilcoxon-/Mann-Whitney-U test (α = 0.05), Kaplan-Meier survival curves).

RESULTS

After 12 months, cumulative failure rates were lower with iBU-SE (0.0%; p = 0.016), iBU-SEE (0.0%; p = 0.125), and iBU-ER (2.1%; p = 0.070; loss t) compared to OFL (16.7%; losses t, t). Generally, marginal adaptation decreased (p < 0.001) and marginal staining increased (p ≤ 0.031), without significant group differences (p > 0.064). AD increased in all groups (p < 0.001). At enamel, AD appeared more extended with iBU-SE vs. iBU-SEE (t-t; p ≤ 0.005), iBU-ER (t-t; p ≤ 0.051) and OFL (t-t; p ≤ 0.018). At dentin/cement iBU generally caused fewer defects than OFL (t-t; p ≤ 0.010) and with SE vs. ER (t-t; p = 0.010).

CONCLUSIONS

In NCCLs, iBU generally provides a more durable bond than OFL. Recommended mode is SEE. Clinic and OCT provided comparable results. OCT has higher statistical power, shows group differences earlier and specifically for the different hard tooth tissues.

CLINICAL SIGNIFICANCE

The universal adhesive iBU was superior against the reference OFL in NCCLs. It can be recommended with SEE. Evaluation of interfacial adhesive defects by OCT seems to allow early prediction of adhesives' clinical performance.

摘要

目的

使用 FDI 标准和光相干断层扫描（OCT）评估通用胶粘剂的临床效果。

方法

在 50 名患者中，使用 iBond® Universal（iBU，Kulzer）以自酸蚀（iBU-SE，n=50）、选择性釉质酸蚀（iBU-SEE，n=29）或酸蚀-冲洗模式（iBU-ER，n=50）对 3 或 4 个非龋性颈（NCCL）病变进行复合树脂（Venus® Diamond Flow，Kulzer）修复，并使用 OptiBond™ FL（OFL，Kerr，n=50）作为参照。使用 SD-OCT 对修复体进行成像。在放置后即刻（t）、14 天后（t）、6 个月（t）和 12 个月（t）时，同时进行临床评估（FDI 标准），对每个修复体的界面胶粘剂缺陷（AD，%）的加权平均长度进行量化。数据采用（McNemar-/Wilcoxon-/Mann-Whitney-U 检验（α=0.05）和 Kaplan-Meier 生存曲线进行统计学分析。

结果

12 个月时，iBU-SE（0.0%；p=0.016）、iBU-SEE（0.0%；p=0.125）和 iBU-ER（2.1%；p=0.070；丧失 t）的累积失效率低于 OFL（16.7%；丧失 t、t）。总体而言，边缘适应性降低（p<0.001），边缘着色增加（p≤0.031），但各组间无显著差异（p>0.064）。所有组的 AD 均增加（p<0.001）。在牙釉质处，与 iBU-SEE 相比，iBU-SE 的 AD 更为延伸（t-t；p≤0.005），与 iBU-ER 和 OFL 相比（t-t；p≤0.051 和 p≤0.018）。在牙本质/牙骨质中，iBU 引起的缺陷一般少于 OFL（t-t；p≤0.010），与 SE 相比，ER（t-t；p=0.010）。