Molnár Janka, Fráter Márk, Sáry Tekla, Braunitzer Gábor, Vallittu Pekka K, Lassila Lippo, Garoushi Sufyan
Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
dicomLAB Dental Ltd., Szeged, Hungary.
Dent Mater. 2022 Apr;38(4):e83-e93. doi: 10.1016/j.dental.2022.02.007. Epub 2022 Feb 26.
The aim was to investigate the fatigue performance of endodontically treated (ET) molars restored by various dentin-replacing materials and material configurations. Moreover, the impact of additional adhesive treatment with glass-ionomer cement (GIC) was evaluated.
250 intact molars were collected and randomly distributed into ten groups (n = 25). After endodontic procedure standard Class I cavities were prepared and restored with different direct restorative techniques and dentin-replacing materials. Two-group were restored with either packable or flowable short fiber-reinforced composites (SFRCs). Two-group were restored by experimental fiber-reinforced GIC with and without adhesive treatment. Four-group were restored by conventional and resin-modified GICs with or without adhesive treatment. One-group was restored with a dual-cure composite resin and last group was restored with only conventional composite resin (control). Fatigue-survival was measured for all specimens using a cyclic-loading machine until fracture occurred or a number of 40.000 cycles were achieved. Kaplan-Meyer survival analysis was conducted, followed by pairwise log-rank post hoc comparisons. Fracture mode was then examined by means of optical microscopy and SEM.
Group restored with flowable SFRC showed significantly higher survival (p < 0.05) compared to all of the groups, except for group restored with packable SFRC (p > 0.05). Group restored with fiber-reinforced GIC had significantly (p < 0.05) higher survival rates compared to other commercial GICs. SEM demonstrated change of the fracture line when fracture reached the SFRC layer.
Direct restoration of Class I in ET molars with the use of SFRCs as dentin-replacing materials demonstrated its ability to reinforce the dental structures and to increase the fatigue resistance in this specific clinical situation.
本研究旨在调查用各种牙本质替代材料和材料配置修复的根管治疗（ET）磨牙的疲劳性能。此外，还评估了用玻璃离子水门汀（GIC）进行额外粘结处理的影响。
收集250颗完整磨牙并随机分为十组（n = 25）。根管治疗后，制备标准I类洞并用不同的直接修复技术和牙本质替代材料进行修复。两组分别用可压实或可流动的短纤维增强复合材料（SFRC）修复。两组分别用实验性纤维增强GIC修复，一组进行粘结处理，另一组不进行粘结处理。四组分别用传统和树脂改性GIC修复，两组进行粘结处理，两组不进行粘结处理。一组用双固化复合树脂修复，最后一组仅用传统复合树脂修复（对照组）。使用循环加载机测量所有标本的疲劳存活率，直到发生断裂或达到40000次循环。进行Kaplan - Meyer生存分析，然后进行成对对数秩事后比较。然后通过光学显微镜和扫描电子显微镜检查断裂模式。
与所有组相比，用可流动SFRC修复的组显示出显著更高的存活率（p < 0.05），除了用可压实SFRC修复的组（p > 0.05）。与其他商用GIC相比，用纤维增强GIC修复的组具有显著更高的存活率（p < 0.05）。扫描电子显微镜显示，当断裂到达SFRC层时，断裂线发生变化。
在ET磨牙中使用SFRC作为牙本质替代材料直接修复I类洞，证明了其在这种特定临床情况下增强牙齿结构和提高抗疲劳性的能力。
