Klíniskt mat á tannlituðum jaxlafyllingarefnum eftir tvö ár

Abstract

Polymerization contraction has been a clinical problem for resin based composites. Manufacturers have attempted to develop materials that have less contraction. The aim of this clinical investigation was to evaluate the performance of Hermes Posterior Restorative (3M ESPE), a new low shrink silorane composite, used in conjunction with its dedicated Hermes adhesive system and compare to Tetric Ceram bonded with AdheSE (Vivadent). The materials were placed in teeth in individuals that needed at least two box shape class II restorations of similar size. The restorations were placed by one operator in private practice. A total of 53 restoration pairs were placed in 31 patients. The restorations were evaluated by two trained examiners using USPHS criteria. After one year all 53 restoration pairs were available for re-evaluation and 52 restoration pairs in 30 patients at two years. One Tetric restoration was rermoved because of tooth sensitivity after one year, excluding one patient. At two years all proximal contacts scored normal, colour match and gingival status unchanged and no secondary caries detected. No sensitivity, except the one tooth at one year, was reported. Slight chipping (Beta) was reported in three Tetric restorations while one Hermes restoration scored Beta for surface roughness. Three restorations of each material scored Beta for anatomic form. When marginal integrity was evaluated, 83% scored Alfa for both materials. 40 Tetric (77%) and 34 Hermes (65%) restorations scored Alfa when interfacial staining was evaluated. There was no statistical difference between the materials for any of the criteria evaluated (p<0.05). After two years both materials were clinically acceptable as a posterior restorative. High incidence of marginal discoloration suggests that improved adhesives are needed.

Framleiðendur hafa leitast við að minnka hvörfunarsamdrátt í plastblendi sem er þekkt vandamál. Tilgangur rannsóknarinnar var að bera saman gæði og endingu Hermes Posterior Restorative (3M ESPE) plastblendi ásamt Hermes bindiefni við Tetric Ceram plastblendi og AdheSE bindiefni (Vivadent). Bæði bindiefnin eru sjálfætandi. Efnin voru sett í tennur fullorðinna einstaklinga sem þurftu a.m.k. tvær boxlaga II. klassa fyllingar af svipaðri stærð. Öll efni voru meðhöndluð samkvæmt fyrirmælum framleiðenda. Samtals voru sett 53 fyllingapör sem voru metnar af tveimur sérþjálfuðum skoðunarmönnum eftir einfölduðu USPHS skráningakerfi. Eftir eitt ár voru öll 53 fyllingarpörin skoðuð og 52 pör í 30 einstaklingum eftir tvö ár. Ein Tetric fylling hafði verið fjarlægð vegna viðkvæmni eftir eitt ár, sem útilokaði viðkomandi frá rannsókninni. Við tveggja ára skoðun voru allir snertipunktar innan eðlilegra marka, litur fyllinga og tannholdsástand óbreytt og engin tannáta fannst meðfram brúnum fyllinga. Einungis voru skráð eymsli eða viðkvæmni í einni tönn. Kvarnast hafði úr þremur Tetric fyllingum (Beta) en allar Hermes fyllingar fengu Alfa. Þrjár fyllingar af hvorri tegund höfðu slitnað og fengu Beta. Þegar niðurbrot brúna fyllinga var metið, fengu 43 fyllingar af hvorri tegund Alfa. 40 Tetric (77%) og 34 Hermes (65%) fyllingar voru metnar Alfa þegar mislitun í samskeytum fyllingar/tannar var skoðuð. Ekki var tölfræðilegur munur milli efnanna fyrir neitt atriðið sem metin voru (p<0.05). Við tveggja ára skoðun virðast bæði efnin hæf til að nota í jaxlafyllingar. Há tíðni mislitana á brúnum fyllinga bendir til að bæta þurfi eða breyta um bindiefni.