Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Avenida General Carlos Cavalcanti, Ponta Grossa, PR 4748, Brazil.
Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, R. Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR, Brazil.
Dent Mater. 2024 Nov;40(11):1798-1807. doi: 10.1016/j.dental.2024.07.034. Epub 2024 Aug 14.
To evaluate the clinical performance of two flowable composites based on methacrylate and one based on ormocer in treating non-carious cervical lesions (NCCLs) after 48-month evaluation in a split-mouth double-blind clinical study design.
A total of 183 restorations were performed on NCCLs using a universal adhesive system (Futurabond U, Voco GmbH) with selective enamel etching on 27 participants: two participants received twelve restorations each, three received nine restorations each, and 22 participants received six restorations each. Three different flowable composites were employed (n = 61): a low-viscosity methacrylate-based composite (GrandioSO Flow, LVM), a high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HVM), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 48 months. Statistical analysis was conducted using Kaplan-Meier Survival analysis and Kruskal-Wallis analysis of variance rank (α = 0.05).
After 48 months, 17 restorations were lost: LVM 6, HVM 9, ORM 2. The retention rates (95 % confidence interval) were 89.4 % for LVM, 80.4 % for HVM, and 95.6 % for ORM, with a significant difference between HVM vs. LVM and HVM vs. ORM (p < 0.05). Minor defects were observed in 30 restorations for marginal staining criteria (LVM 12, HVM 10, ORM 8) and in 71 restorations for marginal adaptation criteria (LVM 24, HVM 20, ORM 27) without significant difference between groups (p > 0.05). No restorations showed postoperative sensitivity or recurrence of caries.
The increased viscosity of flowable composites could reduce the clinical longevity in NCCLs after 48 months. Ormocer-based and low-viscosity methacrylate-based flowable composites showed a successful clinical performance in NCCLs after 48 months.
在一项为期 48 个月的 split-mouth 双盲临床研究设计中，评估两种基于甲基丙烯酸酯的流动性复合材料和一种基于有机硅氧烷的流动性复合材料在治疗非龋性颈（NCCL）方面的临床性能。
在 27 名参与者中，使用通用粘结系统（Futurabond U，Voco GmbH）进行选择性牙釉质酸蚀，对 183 个 NCCL 进行修复：两名参与者各接受 12 个修复体，三名参与者各接受 9 个修复体，22 名参与者各接受 6 个修复体。使用三种不同的流动性复合材料（n=61）：一种低粘度甲基丙烯酸酯基复合材料（GrandioSO Flow，LVM）、一种高粘度甲基丙烯酸酯基复合材料（GrandioSO Heavy Flow，HVM）和一种基于有机硅氧烷的流动性复合材料（Admira Fusion Flow，ORM）。所有修复体在 48 个月后均使用 FDI 和 USPHS 标准进行评估。统计分析采用 Kaplan-Meier 生存分析和 Kruskal-Wallis 方差秩分析（α=0.05）。
48 个月后，有 17 个修复体丢失：LVM 6 个，HVM 9 个，ORM 2 个。LVM 的保留率（95%置信区间）为 89.4%，HVM 为 80.4%，ORM 为 95.6%，HVM 与 LVM 之间以及 HVM 与 ORM 之间有显著差异（p<0.05）。Marginal staining criteria 有 30 个修复体出现 Minor 缺陷（LVM 12，HVM 10，ORM 8），Marginal adaptation criteria 有 71 个修复体出现 Minor 缺陷（LVM 24，HVM 20，ORM 27），各组间无显著差异（p>0.05）。没有修复体出现术后敏感或龋齿复发。
流动性复合材料的粘度增加可能会降低 NCCL 48 个月后的临床寿命。在 48 个月后，基于有机硅氧烷和低粘度甲基丙烯酸酯的流动性复合材料在 NCCL 中表现出了成功的临床性能。
