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在根管治疗后的后牙修复中,研磨树脂复合材料与直接纳米混合大块充填树脂复合材料的临床性能和耐磨性对比:一项为期1年的随机临床试验。

Clinical performance and wear resistance of milled resin composite material versus direct nanohybrid bulk-fill resin composite in the restoration of endodontically treated posterior teeth over 1 year: Randomized clinical trial.

作者信息

Elhaddad Esraa Esmeail H, Mohsen Mohamed M A, Mohamed Dina Ezz Eldin

机构信息

Conservative Dentistry Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.

Conservative Dentistry Department, Faculty of Dentistry, Misr University for Science and Technology, Cairo, Egypt.

出版信息

J Conserv Dent Endod. 2024 Apr;27(4):400-407. doi: 10.4103/JCDE.JCDE_46_24. Epub 2024 Apr 5.

Abstract

CONTEXT

The restorative complexities associated with endodontically treated teeth surpass those encountered with vital ones. The field of adhesive dentistry experienced a significant advancement that led to a shift in treatment approach toward bonded restorations.

AIM

The aim of the study was to assess the clinical performance of using indirect Milled composite or direct bulk-fill resin composite restorations for endo-treated teeth, as well as to measure the amount of wear on the occlusal tables of both restorations using a digital scanner.

SUBJECTS AND METHODS

Participants were divided into two groups, where R1 represents the endodontically treated teeth restored with Milled composite, R2 represents the endodontically treated teeth restored with direct bulk-fill composite where 13 patients in each group were treated with a total number of 26 restorations in all patients. Where each restoration was assessed immediately at baseline (T0), 6 months (T6), and 12 months (T12) using the modified United States Public Health Service criteria. Moreover, wear was measured immediately at (T0) and (T12) intraorally and extraorally using intraoral scanners and three-dimensional surface-based superimposition software.

STATISTICAL ANALYSIS USED

Chi-squared test, Mann-Whitney -test, Friedman's test, Nemenyi test, Shapiro-Wilk test, paired -tests, intraclass correlation coefficient.

RESULTS

At all intervals, the majority of the cases in both groups had an alpha score. Some cases exhibited bravo scores in both groups at T6 and T12 regarding the color match, marginal adaptation, marginal discoloration, and marginal integrity without statistically significant difference ( > 0.05). Direct nanohybrid bulk-fill resin composite showed a greater amount of wear without a statistically significant difference ( > 0.05). Extraoral measurement was significantly higher than intraoral measurement ( < 0.001). There was no significant reliability/agreement between both methods.

CONCLUSIONS

Both milled composite and direct bulk-fill resin composite restorations in endodontically treated teeth demonstrated appropriate clinical performance and minimal wear over an 1-year follow-up period.

摘要

背景

根管治疗牙齿的修复复杂性超过活髓牙。牙体粘结修复领域取得了重大进展,导致治疗方法转向粘结修复。

目的

本研究的目的是评估使用间接铣削复合树脂或直接大块充填树脂复合材料修复根管治疗牙齿的临床性能,并使用数字扫描仪测量两种修复体咬合面的磨损量。

受试者和方法

参与者分为两组,其中R1代表用铣削复合树脂修复的根管治疗牙齿,R2代表用直接大块充填复合树脂修复的根管治疗牙齿,每组13例患者,所有患者共治疗26颗修复体。使用改良的美国公共卫生服务标准在基线(T0)、6个月(T6)和12个月(T12)时对每个修复体进行评估。此外,使用口腔内扫描仪和基于三维表面的叠加软件在口腔内和口腔外立即在(T0)和(T12)测量磨损情况。

使用的统计分析

卡方检验、曼-惠特尼检验、弗里德曼检验、内曼尼检验、夏皮罗-威尔克检验、配对检验、组内相关系数。

结果

在所有时间间隔,两组中的大多数病例均为α级评分。在T6和T12时,两组中一些病例在颜色匹配、边缘适应性、边缘变色和边缘完整性方面表现为优级评分,无统计学显著差异(P>0.05)。直接纳米混合大块充填树脂复合材料显示出更大的磨损量,但无统计学显著差异(P>0.05)。口腔外测量显著高于口腔内测量(P<0.001)。两种方法之间没有显著的可靠性/一致性。

结论

在1年的随访期内,根管治疗牙齿中的铣削复合树脂和直接大块充填树脂复合材料修复体均表现出适当的临床性能和最小的磨损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9266/11108410/fe1748447dfe/JCDE-27-400-g001.jpg

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