Department of Conservative Dentistry and Periodontology, University Hospital, Jena, Germany.
Department of Fundamental Science, University of Applied Sciences, Jena, Germany.
PLoS One. 2022 Jun 23;17(6):e0270312. doi: 10.1371/journal.pone.0270312. eCollection 2022.
The aim of the present clinically controlled two-year study was to investigate the influence of laser-based cavity preparation on the long-term performance of Class V resin-composite fillings. Class V non-carious lesions (n = 75) were randomly assigned to two test and one control group. Cavities in both test groups were prepared using an Er,Cr:YSGG laser (Waterlase MD, Biolase, Irvine, California, USA). The device was operated at 3 W (150 mJ, 30 J/cm2), 50% water, 60% air, 30 Hz in H mode. Subsequently, laser-prepared tooth surfaces in test group I (n = 21) were additionally conditioned by acid etching (etch-and-rinse). Laser-prepared cavities of test group II (n = 21) received no additional acid conditioning. After application of an adhesive, all cavities were restored using the resin-composite Venus®. For cavities in the control group (n = 33) conventional diamond burs were used for preparation which was followed by an etch-and-rinse step, too. The fillings were evaluated immediately (baseline) and after 6, 12 and 24 months of wear according to the C-criteria of the USPHS-compatible CPM-index. The results showed that after 24 month of wear, laser-preparation was associated with fillings of high clinical acceptability. Compared to conventional bur-based treatment, laser-based cavity preparation resulted in fillings with high marginal integrity and superior marginal ledge configurations (p = 0.003). Furthermore, laser-preparation combined with additional acid-conditioning (test group I) resulted in fillings with the best marginal integrity and the lowest number in marginal discoloration, especially at the enamel-composite margins (p = 0.044). In addition, total loss of fillings was also less frequently observed in both laser groups as compared to the control. The results clearly demonstrate that laser-based cavity preparation will benefit the clinical long-time performance of Class V resin-composite fillings. Furthermore, additional acid-conditioning after laser preparation is of advantage.
本临床对照研究的目的是研究基于激光的窝洞预备对 V 类复合树脂充填体长期性能的影响。将 75 例非龋性 V 类病变随机分为两组实验组和一组对照组。两组实验组均采用 Er,Cr:YSGG 激光（Waterlase MD，Biolase，加利福尼亚州欧文市）进行窝洞预备。设备以 H 模式、3 W（150 mJ，30 J/cm2）、50%水、60%空气、30 Hz 运行。随后，对实验组 I（n = 21）的激光预备牙面进行酸蚀处理（酸蚀-冲洗）。实验组 II（n = 21）的激光预备窝洞未接受额外的酸处理。应用黏结剂后，使用复合树脂 Venus®充填所有窝洞。对于对照组（n = 33）的窝洞，使用传统的钻石磨头进行预备，然后进行酸蚀冲洗步骤。使用 USPHS 兼容的 CPM 指数的 C 标准，在即刻（基线）和 6、12 和 24 个月的磨损后对充填物进行评估。结果显示，在 24 个月的磨损后，激光预备与高临床可接受性的充填物相关。与传统的牙钻预备相比，激光预备导致边缘完整性高和边缘肩台形态好（p = 0.003）。此外，激光预备结合额外的酸处理（实验组 I）可获得边缘完整性最佳和边缘变色最少的充填物，尤其是在牙釉质-复合树脂交界处（p = 0.044）。此外，与对照组相比，两组激光组的充填物完全脱落的情况也较少。结果清楚地表明，基于激光的窝洞预备将有利于 V 类复合树脂充填体的临床长期性能。此外，激光预备后进行额外的酸处理是有益的。
