Van Meerbeek B, Braem M, Lambrechts P, Vanherle G
Department of Operative Dentistry and Dental Materials, Katholieke Universiteit te Leuven, Belgium.
J Dent. 1993 Aug;21(4):195-202. doi: 10.1016/0300-5712(93)90126-b.
Two commercially available dentine-adhesive systems, Tenure and Tripton, were tested in two different cavity designs by placing 132 Class V composite restorations in cervical lesions of 35 patients. In Group A, the cervical restorations were placed totally in dentine without any intentional enamel involvement. In Group B, they were placed in dentine with adjacent enamel margins bevelled and acid etched. The retention rate, the evidence of clinical microleakage, and the marginal integrity were monitored over a 2-year period. The results of this clinical investigation indicate a high failure rate when only dentinal bonding was involved. A loss rate of 30% for Tenure and 55% for Tripton was noted in Group A after 2 years of clinical service. However, both adhesive systems used in combination with micromechanical retention on the enamel border (Group B) performed extremely well with only one restoration each having debonded over the 2-year period. Identically, marginal integrity and evidence of clinical microleakage more severely deteriorated with time for the Group A restorations in comparison with their Group B counterparts. In summary, the overall results were more positive for Tenure than for Tripton. It is concluded that micromechanical retention by acid etching of the enamel margin is still indispensable for the clinical success of cervical Class V composite restorations, primarily for retention and clinical microleakage and also, but to a lesser degree, for marginal adaptation.
通过在35例患者的颈部病变中放置132个V类复合树脂修复体，对两种市售牙本质粘结系统Tenure和Tripton在两种不同的窝洞设计中进行了测试。在A组中，颈部修复体完全置于牙本质内，未故意涉及任何釉质。在B组中，修复体置于牙本质内，相邻釉质边缘进行了斜面制备和酸蚀处理。在2年的时间里监测了保留率、临床微渗漏证据和边缘完整性。这项临床研究的结果表明，仅涉及牙本质粘结时失败率较高。在临床使用2年后，A组中Tenure的脱落率为30%，Tripton为55%。然而，两种粘结系统与釉质边缘的微机械固位相结合使用（B组）时表现极佳，在2年期间每种仅有一个修复体脱粘。同样，与B组修复体相比，A组修复体的边缘完整性和临床微渗漏证据随时间恶化得更严重。总之，Tenure的总体结果比Tripton更积极。得出的结论是，对于颈部V类复合树脂修复体的临床成功，通过酸蚀釉质边缘进行微机械固位仍然是不可或缺的，主要用于固位和临床微渗漏，在较小程度上也用于边缘适应性。
