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北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (1): 120-125. doi: 10.19723/j.issn.1671-167X.2021.01.018

• 论著 • 上一篇    下一篇

玻璃体和通用型复合树脂耐磨性的临床对照研究

穆海丽1,2,田福聪3,王晓燕1,Δ(),高学军1   

  1. 1.北京大学口腔医学院·口腔医院,牙体牙髓科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081
    2.北京大学口腔医学院·口腔医院第一门诊部综合科,北京 100034
  • 收稿日期:2020-10-09 出版日期:2021-02-18 发布日期:2021-02-07
  • 通讯作者: 王晓燕 E-mail:wangxiaoyan@pkuss.bjmu.edu.cn

Evaluation of wear property of Giomer and universal composite in vivo

MU Hai-li1,2,TIAN Fu-cong3,WANG Xiao-yan1,Δ(),GAO Xue-jun1   

  1. 1. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034, China
  • Received:2020-10-09 Online:2021-02-18 Published:2021-02-07
  • Contact: Xiao-yan WANG E-mail:wangxiaoyan@pkuss.bjmu.edu.cn

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摘要：

目的: 采用激光三维扫描技术评估玻璃体和通用型复合树脂用于后牙充填的耐磨性。方法: 根据纳入标准选取48名患者共108颗患牙(每组各54颗),随机分配用玻璃体(Beautifil Ⅱ,简称BF)或通用型复合树脂(Filtek Z350,简称Z350)进行充填。分别于术后1周、6个月、18个月和4年,采用改良美国公共卫生署(United States Public Health Service,USPHS)标准对充填体进行临床评价并拍照和制取模型。使用激光三维扫描仪扫描模型后,对图像进行配准和计算磨耗深度,使用SPSS 20.0进行统计分析。结果: 术后4年回访43名患者,回访率为89.6%。BF组和Z350组各有4例和3例出现脱落、继发龋、充填体折断和牙髓坏死。两组充填体的4年存留率均为95.8%,符合美国牙医协会(American Dental Association,ADA)标准(3年存留率>90%)。0~6个月两组充填体的磨耗速率最快,随后磨耗速率的下降趋于平缓,BF组4年总磨耗深度为(58±22) μm,Z350组为(54±16) μm(P>0.05), 耐磨性均符合ADA标准(3年磨耗深度<100 μm)。两组充填体均表现为围绕咬合接触区形成凹坑状磨耗(Ⅰ型)和充填体发生均匀磨耗(Ⅱ型)。术后4年,Ⅰ型磨耗充填体中,BF组的磨耗深度大于Z350组(P<0.05),Ⅱ型磨耗充填体中,两组间差异无统计学意义(P>0.05)。结论: 玻璃体的4年存留率和耐磨性均符合ADA标准,用于后牙牙合面重咬合接触区时,玻璃体的耐磨性略逊于复合树脂,用于非重咬合接触区时,二者间无明显差异。

关键词: 复合树脂类, 牙修复磨损, 成像, 三维

Abstract:

Objective: To observe the wear performance of Giomer and universal composite for posterior restorations by 3D laser scan method, in order to guide the material selection in clinic.Methods: In this study,48 patients (108 teeth) were selected according to the inclusion and exclusion criteria. All the patients in need of a minimum of 2 Class Ⅰ and/or Class Ⅱ restorations were invited to join the study. The teeth were restored with Giomer (Beautifil Ⅱ, BF) and universal composite (Filtek Z350, Z350) randomly. The restorations were evaluated at baseline and after 6-, 18-, 48-month using the modified United States Public Health Service (USPHS) criteria for clinical performance. The in vivo images and gypsum replicas were taken at each recall. A 3D-laser scanner and Geomagic Studio 12 were used to analyze the wear depth quantitatively. Statistical analysis was performed with SPSS 20.0.Results: After 4 years, 89.6% patients were recalled. The survival rate of both materials was 95.8% (Kaplan-Meier survival analysis). Seven restorations of the two materials failed due to loss of restoration, bulk fracture, secondary caries and pulp necrosis. The wear patterns of restorations were divided into 2 classes. Pattern Ⅰ: occlusal contact areas showed the deepest and fastest wear depth; pattern Ⅱ: the wear depth was slow and uniform. Both materials showed a rapid wear in the first 6 months. Then the wear rate was decreased. The occlusal wear depth after 4 years were (58±22) μm and (54±16) μm for BF group and Z350 group respectively, which were in accordance with the American Dental Association (ADA) guidelines (wear depth for 3 years <100 μm). No significant differences (P>0.05) were observed between the two groups. Regarding the restorations with wear pattern Ⅰ, the wear depth of BF group was higher than Z350 group at 6- and 48-month (P<0.05), while there was no significant difference between restorations with wear pattern Ⅱ (P>0.05).Conclusion: Within the limitation of the study, after 4 years, the survival rate and wear resistance of Giomer met ADA guidelines for tooth-colored restorative materials for posterior teeth. When the two materials were applied in occlusal contact areas, wear resistance of Giomer was slightly lower than universal composite resin. No significant difference was found when they were applied in none of the occlusal contact areas.

Key words: Composite resins, Dental restoration wear, Imaging, three-dimensional

中图分类号: 

  • R783.1

图1

图像扫描及配准过程"

图2

BF组和Z350组磨耗深度及磨耗速率随时间的变化"

表1

不同牙位和洞型对磨耗深度的影响"

Items Wear depth/μm, x-±s
Tooth type Cavity type
Premolar Molar Class Ⅰ Class Ⅱ
BF group
6 months 40±13 45±16 51±16 40±13
18 months 48±14 53±18 56±16 48±15
48 months 53±17 66±27 64±21 57±23
Mann-Whitney U test P>0.05 P>0.05
Z350 group
6 months 38±16 36±10 39±12 37±14
18 months 50±20 45±10 46±13 47±16
48 months 50±14 58±18 59±18 53±17
Mann-Whitney U test P>0.05 P>0.05

图3

激光三维扫描图像分析充填体的磨耗情况"

表2

BF组和Z350组充填体磨耗类型分布"

Items Pattern Ⅰ Pattern Ⅱ Total
BF group 16 27 43
Z350 group 17 25 42
Total 33 52 85

图4

两组不同磨耗类型的磨耗深度对比"

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ISSN 1671-167X
CN 11-4691/R
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