Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
Department of Fixed Prosthodontics, Faculty of Dentistry, British University in Egypt, Cairo, Egypt.
J Prosthodont. 2024 Apr;33(4):374-381. doi: 10.1111/jopr.13696. Epub 2023 May 6.
This study evaluated the effect of cervical margin relocation (CMR) with two different materials and contamination with hemostatic agents on the margin adaptation and microleakage of ceramic restorations.
Mesial-occlusal-distal cavities were prepared in 60 human first molars and distributed to 3 groups (n = 20) according to the margin relocation procedure. The groups were: group F; flowable composite applied in two 2 mm increments, group B; bulk-fill flowable composite applied as a bulk increment of 4 mm thickness and group C (control); no CMR was done. Each group was subdivided into two subgroups (subgroup N; no hemostatic agent applied and subgroup H; hemostatic agent was applied). In all groups, ceramic inlays were prepared and cemented. The samples were subjected to thermocycling (10,000 cycles). The adaptation of the cervical margin was evaluated with scanning electron microscopy (200×). Samples were then assessed for microleakage analysis with the dye penetration method. Marginal adaptation data were normally distributed and analyzed using two-way ANOVA followed by Tukey's post hoc test. Ordinal microleakage score data were analyzed using cumulative link models followed by the analysis of deviance using Wald chi-square tests.
Both CMR and contamination with a hemostatic agent had significant effects on the margin adaptation of the cervical margin. Group C showed the highest adaptation with no significant difference from group F. The lowest adaptation was revealed in group B with a significant difference from group C. Subgroup N (in all groups) showed a statistically higher adaptation than subgroup H. Regarding microleakage assessment, CMR had no significant effect but hemostatic agent application showed a significantly higher microleakage score for all groups.
Both the CMR procedure and contamination with AlCl hemostatic agent had a negative effect on marginal adaptation. For microleakage assessment, only contamination with hemostatic agent negatively affected the microleakage with no effect on the margin relocation procedure.
本研究评估了两种不同材料的宫颈缘移位（CMR）和止血剂污染对陶瓷修复体边缘适应性和微渗漏的影响。
在 60 个人工第一磨牙的近中-颊侧-远中制备腔，并根据边缘迁移程序将其分为 3 组（n=20）。这 3 组分别为：F 组，应用 2 毫米厚的流动复合树脂分两次应用；B 组，应用 4 毫米厚的块状流动复合树脂；C 组（对照组），未进行 CMR。每组又分为两个亚组（N 亚组，未应用止血剂；H 亚组，应用止血剂）。在所有组中，制备陶瓷嵌体并粘结。将样本进行热循环（10000 次）。用扫描电子显微镜（200×）评估颈缘的适应性。然后，用染料渗透法评估微渗漏分析。边缘适应性数据呈正态分布，采用双因素方差分析，再用 Tukey 事后检验。有序微渗漏评分数据采用累积链接模型分析，然后用 Wald chi-square 检验进行方差分析。
CMR 和止血剂污染均对颈缘边缘的适应性有显著影响。C 组的适应性最高，与 F 组无显著差异。B 组的适应性最低，与 C 组有显著差异。N 亚组（所有组）的适应性均高于 H 亚组。关于微渗漏评估，CMR 无显著影响，但止血剂应用使所有组的微渗漏评分显著升高。
CMR 程序和止血剂污染对边缘适应性均有负面影响。对于微渗漏评估，只有止血剂污染对微渗漏有负面影响，对边缘迁移程序无影响。
