Palodent在成对后牙邻面成形的临床评价

目的:评价在成对后牙邻牙合面成形时Palodent系统和普通成形系统的临床应用效果。方法:将符合纳入标准的102对成对的后牙邻牙合面洞随机分为试验组和对照组,每组各51对。充填时分别采用Palodent和普通成形系统,由同一名医师完成所有邻牙合面洞的充填工作。在充填后即刻、1周和1年由另一名医师通过临床检查和X线片对患牙充填后的舒适度、食物嵌塞、解剖外形、边缘嵴、邻接关系和牙龈炎症6项指标进行评价,比较2种成形系统的临床效果。结果:充填后即刻,在解剖外形、边缘嵴和邻接关系3个指标上Palodent组满意度为92.2%、88.2%、90.2%,普通成形系统满意度为76.5%、70.6%和74.5%,差异有显著性(P＜0.05); 充填后1周在舒适度、食物嵌塞、解剖外形、边缘嵴和邻接关系5个指标上,差异有显著性(P＜0.05) ;充填后1年在舒适度、食物嵌塞、解剖外形、边缘嵴和邻接关系6个指标上差异亦有显著性(P＜0.05)。结论:Palodent系统在线对后牙邻牙合面成形时比普通成形系统优势明显。     

Palodent后牙邻面成形系统的临床应用

目的建立后牙邻面成形系统的临床评价体系,并用其评价Palodent和环周成形系统对后牙的临床应用效果。方法将符合纳入标准的101个邻面洞按简单随机法分为试验组和对照组,充填时分别采用Palodent和环周成形系统。单个牙充填者79个,成对牙充填者22个。由同一名主治医师完成所有邻面洞的充填工作。由临床医师在充填后即刻用探针检查充填体悬突情况,在备洞后、充填后即刻和术后1周复查时用牙线检查邻接触区恢复情况;由患者在术后即刻和1周复查时填写问卷,了解食物嵌塞、术中舒适度和患牙挤胀感等情况。取充填侧的半口模型,在2名主治医师统一模型评价标准后,由其中1人为所有模型评分。结果建立了一套由问卷调查、临床检查和模型评价组成的评价体系,共计9项指标。应用该体系评价Palodent和环周成形系统,发现2组在问卷调查指标和悬突发生率上无统计学差异;但Palodent成形系统能使后牙邻面洞树脂充填时获得更紧密的邻接触关系。对成对后牙邻面洞进行充填时,Palodent成形系统的边缘嵴成形效果优于环周成形系统。结论对成对后牙的邻面洞进行充填时,Palodent成形系统优于环周成形系统。     

分牙楔钳恢复二类洞邻面接触关系的临床应用

目的 观察分牙楔钳用于Ⅱ类洞复合树脂充填时邻面接触关系的恢复效果。方法 选择227颗后牙Ⅱ类洞,随机分为三组进行树脂充填。A组采用普通成形片加楔子的传统方法充填复合树脂;B组采用分段式成形系统充填复合树脂;C组采用分牙楔钳充填复合树脂。充填完成后采用牙线法测试接触区的松紧度,并拍摄X线片观察邻面成形情况,术后1周复查食物嵌塞情况。结果 A组72颗患牙邻面接触松紧度临床满意率为52.8%,术后复诊69颗食物嵌塞发生率为31.9%;B组76颗患牙邻面接触松紧度临床满意率为82.9%,术后复诊71颗食物嵌塞发生率为5.6%;C组79颗患牙邻面接触松紧度临床满意率为88.6%,术后复诊73颗食物嵌塞发生率为6.8%。A组与B组、A组与C组在邻面接触松紧度的临床满意率、食物嵌塞的发生率上均存在显著差异,而B组与C组之间无差异。A组邻面成形临床满意率为80.6%,B组邻面成形临床满意率为86.8%,C组邻面成形临床满意率为89.9%,各组之间无差异。结论 分牙楔钳用于二类洞复合树脂充填可以获得临床满意的邻面接触关系,从而减少充填术后食物嵌塞的发生。     

树脂球法恢复二类洞邻面接触关系的临床研究

目的 观察树脂球法用于二类洞复合树脂充填时邻面接触关系的恢复效果.方法 选择130颗后牙邻(牙合)面洞,根据患牙缺损颊舌连线的切面与邻牙接触区的问距将窝洞分为A、B、C三型,所有窝洞随机分为两组进行树脂充填.对照组使用传统方法,实验组使用树脂球法.充填完成后采用牙线法测试接触区的松紧度.术后一周复查食物嵌塞情况.结果 实验组64颗患牙邻面接触关系临床满意率为89%,术后食物嵌塞发生率为3.1%;对照组66颗患牙邻面接触关系临床满意率为19.7%;术后食物嵌塞发生率为27.3%;经统计学χ2检验,实验组与对照组在接触关系的临床满意率、食物嵌塞的发生率上均存在极显著差异(P<0.01).A型洞接触关系临床满意率实验组为100%,对照组为100%.无显著差异(P>0.05);B型洞临床满意率实验组为95.6%.对照组为O,差异有极显著性(P<0.01);C型洞接触关系临床满意率实验组为27.3%,对照组为O%,差异无显著性(P>O.05).结论 树脂球法用于二类洞复合树脂充填可以获得临床满意的邻面接触关系.从而减少充填术后食物嵌塞的发生.     

邻牙邻面修整对重建Ⅱ类洞充填后邻接关系的效果研究

目的观察邻牙邻面去釉对树脂充填重建Ⅱ类洞邻接关系的临床效果。方法在选取的274颗邻牙邻面形态异常的Ⅱ类洞树脂充填修复患牙中,充填前应用邻面去釉技术对邻牙形态异常的邻面进行修整的邻牙邻面去釉组105颗,未进行邻牙修整的常规组169颗。充填后2周、12个月,对2组邻面形态和食物嵌塞的2项指标进行评价,并进行统计学分析。结果术后2周、12个月复查,邻牙邻面去釉组邻面形态评价满意率均为94.3%,常规组均为80.5%,差异有统计学意义（P〈0.05）;邻牙邻面去釉组食物嵌塞满意率分别为89.5%和88.6%,常规组分别为79.9%、78.1%,差异有统计学意义（P〈0.05）。结论对伴有邻牙邻面形态异常的后牙Ⅱ类洞,充填时配合邻牙邻面去釉修整,可以提高治疗的满意率。     

银汞合金嵌体与银汞合金充填体修复后牙邻牙合Ⅱ类洞的临床对照研究

目的比较银汞合金嵌体与银汞合金充填体修复后牙邻牙合Ⅱ类洞的疗效。方法选取200例后牙邻牙合Ⅱ类洞的中龋患者,分为银汞合金嵌体组和银汞合金充填体组,各100例,观察修复体折断、修复体松动脱落、食物嵌塞、龈炎、继发龋等5个指标。结果在继发龋、食物嵌塞、龈炎3方面银汞合金嵌体组优于银汞合金充填体组(P<0.05),其它两个指标组间无显著性差异。结论银汞合金嵌体是提高后牙邻牙合Ⅱ类洞修复效果的有效可行方法。     

银汞合金嵌体与银汞合金充填体修复后牙邻Ⅱ类洞的临床对照研究

目的比较银汞合金嵌体与银汞合金充填体修复后牙邻Ⅱ类洞的疗效。方法选取200例后牙邻Ⅱ类洞的中龋患者,分为银汞合金嵌体组和银汞合金充填体组,各100例,观察修复体折断、修复体松动脱落、食物嵌塞、龈炎、继发龋等5个指标。结果在继发龋、食物嵌塞、龈炎3方面银汞合金嵌体组优于银汞合金充填体组(P<0.05),其它两个指标组间无显著性差异。结论银汞合金嵌体是提高后牙邻Ⅱ类洞修复效果的有效可行方法。     

游离端后牙远中邻牙合洞银汞合金湿性粘接修复的疗效观察

目的　观察银汞合金湿性粘接术修复游离端后牙远中邻牙合洞的疗效。方法　将 190颗患牙 ,随机分为两组 ,实验组用银汞合金粘接修复 ,对照组用传统银汞合金充填。结果　追踪观察 2年 ,两组成功率分别为 96 8%和 85 2 % ,P <0 0 1,有显著性差异 ,实验组疗效明显优于对照组。结论　银汞合金湿性粘接修复游离端后牙远中邻牙合洞 ,是一种较好的修复方法。?     

富士IX玻璃离子与光敏瓷化树脂充填后牙邻(牙合)洞的临床疗效比较

目的:比较富士IX玻璃离子和光敏瓷化树脂充填后牙邻牙合洞的临床疗效。方法:随机选择需要充填的后牙邻牙合面洞型836个牙,常规制备窝洞,分别采用富士IX玻璃离子或光敏瓷化树脂充填窝洞。结果:富士IX玻璃离子和光敏瓷化树脂充填成功率分别为93.6%、96.6%,两组比较无显著性差异(P<0.05)。结论:富士IX玻璃离子和光敏瓷化树脂修复后牙邻牙合面洞效果无显著差异。     

FUJIⅡ玻璃离子水门汀用于后牙邻面洞龈壁充填的临床评价

目的 评价FUJI Ⅱ化学固化型玻璃离子水门汀用于后牙邻面洞龈壁充填的临床疗效。方法 选择后牙邻面龋患者107名,共156颗患牙,按照要求预备窝洞,邻面洞的龈壁均位于龈下 ≥ 1mm处,将患牙随机平分为两组,实验组先用FUJI Ⅱ化学固化型玻璃离子水门汀充填邻面洞达距离面洞缘至少2mm处,然后用3M复合树脂充填余留窝洞;对照组中邻、面洞均采用复合树脂充填(深窝洞先用玻璃离子常规垫底)。术后6、12个月进行复查,分别对充填物洞缘裂隙、充填物龈方继发龋及充填物完整性等情况进行评价。结果 两组患牙充填物在术后6个月后的脱落率、边缘裂隙率以及龈方继发龋的发生率均无显著差异; 12月后对照组充填物的脱落率、边缘裂隙率、龈方继发龋的发生率均显著高于实验组(P<0.05); 6个月及12个月时,实验组充填物的失败率均明显低于对照组(P<0.05)。结论 而至FUJI Ⅱ化学固化型玻璃离子水门汀用于邻面洞龈壁充填有利于增加充填物的密合性,减少继发龋的发生,降低充填物的脱落率,从而改善其临床疗效。     

Morphological analysis of proximal contacts in class II direct restorations with 3D image reconstruction

Objectives

To evaluate the proximal contact on class II composite restorations constructed using various restorative approaches by a morphological analysis.

Methods

Sixty plastic premolar teeth were prepared for class II cavities. These teeth were divided into six groups and restored using different materials and matrix systems. Two composite materials used were a microhybrid composite Filtek Z100 (3M/ESPE) and a packable composite P60 (3M/ESPE). Three interproximal matrix systems were two circumferential metal matrices (0.05 mm and 0.03 mm thin, respectively) combined with a Tofflemire retainer, and a pre-contoured sectional matrix system (Palodent). The contact morphologies of the restorations were visually inspected with regard to their buccolinugal and mesiodistal aspects. The contact tightness was measured by inserting different amounts of metal strips. For quantitatively morphologic analysis, three-dimensional (3D) scans of proximal contacts were performed. The results were analysed with two-way ANOVA and the Tukey test.

Results

Under visual observation, contact surfaces in sectional matrix groups showed anatomic profile but concave in the centre, whilst the circumferential matrix groups showed flat profiles. The sectional matrix improved the contact tightness. The 3D analysis revealed that the matrix system was correlated with the contact morphology, since the sectional matrix generated significantly deeper and wider surface concavity.

Conclusions

All the interproximal matrix systems presented some deficiency in either the contact tightness or contours. Although the sectional matrix system enhanced contact tightness, it caused contact concavity by formation of interproximal marginal overhang. The quantitative morphologic analysis helps to examine improper proximal contact and the associated problems.     

Influence of matrix systems on proximal contact tightness of 2- and 3-surface posterior composite restorations in vivo

Objectives

To investigate the influence of cavity preparation (MO/DO/MOD) and type of matrix system on proximal contact tightness of direct posterior composite restorations.

Materials and methods

85 patients in need of a two- or three surface Class II direct composite restoration were randomly divided into two treatment groups. Group 1 was treated with a sectional matrix system combined with a separation ring (Palodent); Group 2 was treated with a circumferential matrix system in combination with a retainer (Tofflemire). Proximal contact tightness was recorded before treatment and directly after finishing the restoration.

Results

For the two-surface cavities use of the separation ring resulted in a statistically significantly tighter proximal contacts at both the mesial and distal site (MO: 2.51 ± 0.81 N; DO: 2.82 ± 1.14 N) compared to the use of the circumferential (MO: −1.08 ± 1.04 N; DO: −0.22 ± 0.87 N) (p = 0.01). Regarding the three-surface (MOD) cavities no statistically significant differences were found between the mesial and distal site, nor was there an effect of the used matrix system. No statistically significant influence of cavity design (mesially/distally) was recorded for all cavities (MO, DO and MOD).

Conclusions

Use of the sectional matrix system in two-surface Class II cavities resulted in statistically significantly tighter proximal contacts than the use of the circumferential matrix system.For the three-surface no statistically significant differences in contact tightness were found between the different matrix systems.Location of the cavity (mesially or distally) did not show to have any statistically significant effect on the obtained proximal contact tightness.     

Comparison of proximal contacts of Class II resin composite restorations in vitro

This study investigated the tightness of the proximal contact when placing posterior resin composite restorations with circumferential and sectional matrix systems in an in vitro model using a special measuring device (Tooth Pressure Meter). A manikin model was used with an artificial first molar in which an MO-preparation was ground, simulating the clinical situation of an amalgam replacement. This preparation was duplicated, resulting in 160 identically prepared teeth. These teeth were divided into 8 groups (n=20). In 2 groups, circumferential matrix bands (flat or contoured) in a Tofflemire retainer were applied. In the remaining 6 groups, 3 different separation rings were combined with 2 types of sectional matrix bands. All the cavities were restored using Clearfil Photo Bond and Clearfil AP-X. The tightness of the proximal contact was measured using the Tooth Pressure Meter. Data were statistically analyzed using SPSS 12. ANOVA was used to find differences in proximal contact tightness between the groups. Tukey tests were used to find differences between the homogeneous subgroups. The use of sectional matrices combined with separation rings resulted in tighter proximal contacts compared to when circumferential systems were used (p<0.001). The use of these devices is therefore recommended when posterior resin composite restorations are placed.     

A randomized clinical trial on proximal contacts of posterior composites

OBJECTIVE: The objective of this study was to investigate clinical changes in proximal contact strength inserting Class II composite resin restorations according to one of three randomly assigned protocols. MATERIALS AND METHODS: Seventy-one Class II restorations (MO/DO) were placed by two calibrated operators. Restorations were randomly assigned to one of three groups: one using a circumferential and two a sectional matrix system with separation rings. Proximal contacts were measured by one independent observer with a Tooth Pressure Meter immediately before treatment, and directly after finishing the restoration. RESULTS: Compared to the situation before treatment groups with a sectional matrix system resulted in a statistical significant stronger mean proximal contact strengths (p<0.05), whereas the use of a circumferential matrix system with hand-instrument resulted in a lower proximal contact strength (p<0.05). CONCLUSION: Class II posterior composite resin restorations placed with a combination of sectional matrices and separation rings resulted in a stronger proximal contact than when a circumferential matrix system was used.     

双步成形树脂充填重建后牙邻接关系2年随访研究

目的评价双步成形法树脂直接充填重建大面积后牙邻缺损的邻接关系临床效果。方法332例大面积邻缺损患牙由同一术者采用Ivory型成形系统成形龈向1/3区＋Palodent成形系统成形向2/3区的双步成形技术,直接树脂充填修复。术后由第三方即时检查并记录牙邻接紧密度和充填物悬突情况,术后1、12、24个月复查牙邻接紧密度、树脂修复体边缘密合度和边缘染色、修复区及毗邻牙间乳头出血指数并作牙线作用习惯问卷调查。结果所有患例术后均重建临床可接受邻接紧密度,未发现悬突形成,2年内所有患例均保持临床可接受邻接紧密度,树脂修复体边缘密合度和边缘染色评分均保持Ryge′s A级。术后1、12、24个月,常用和非常用牙线人群组内,修复区与毗邻牙间乳头出血指数差异无统计学意义（P〉0.05）。结论采用双步成形技术树脂直接充填可有效重建大面积缺损后牙的符合生理功能性邻接关系。     

Handling protocol of posterior composites--part 3: matrix systems.

Two of the major clinical problems related to direct posterior composite restorations are the clinician's inability to establish an ideal proximal contour and interproximal contact, which, in turn, can lead to continual food impaction and periodontal disease. The reason for this is that composites provide little internal force to counteract the force from the matrix. Therefore, unlike amalgams, which possess a very high resistance to deformation, composites are easily forced back into their original position by a tight circumferential matrix band. Thus, although tight contacts in small-moderate sized cavities may be possible for posterior composites using circumferential matrices, special matrix systems and wedging techniques are being required to establish a proper contact, especially when cavities with a wide buccolingual width are being restored.     

3M流动树脂与3M玻璃离子修复乳磨牙Ⅱ类洞的临床疗效比较

目的:探索儿童口腔科2种常用充填材料用于乳磨牙邻牙合面龋洞(Ⅱ类洞)充填治疗的临床疗效。方法:将178名4~6岁儿童266颗乳磨牙Ⅱ类洞随机分为2组,即3M流动树脂组(实验A组)、3M玻璃离子组(对照B组),对乳磨牙进行充填治疗后1、2年复查比较2种材料治疗的临床疗效。结果:采用3M流动树脂和3M玻璃离子对Ⅱ类洞进行充填治疗后1年成功率分别为96.00%和87.80%,充填治疗后2年成功率分别为95.76%和86.61%,差异有统计学意义(P<0.05)。结论:3M流动树脂用于乳磨牙邻牙合面龋洞充填治疗的临床效果优于3M玻璃离子。     

Influence of composite resin consistency and placement technique on proximal contact tightness of Class II restorations

PURPOSE: To investigate the influence of composite resin consistency and placement technique on proximal contact tightness of Class II composite resin restorations. MATERIALS AND METHODS: A manikin model (KaVo Dental) was used with an artificial first molar in which a standardized MO preparation was ground. This preparation was duplicated 360 times. Cavities were restored using Clearfil Photo Bond (Kuraray) combined with one of three composite resins of different consistencies: a low-viscosity (X-Flow, Dentsply), a medium-viscosity (Clearfil AP-X, Kuraray) and a high-viscosity composite (Tetric Ceram HB, Ivoclar Vivadent). Each composite was combined with 6 different matrix systems and separation techniques (n = 20). Groups 1 and 2: precontoured metal circumferential matrix (KerrHawe 1101-c) in a Tofflemire retainer combined either with hand instrument (OptraContact, Ivoclar Vivadent) or separation ring (Composi-Tight Gold, Garrison Dental Solutions). Group 3: pre-contoured metal sectional matrix (Lite-Flex, Danville Materials) with separation ring. Groups 4 and 5: pre-contoured metal circumferential dead-soft matrix (Adapt SuperCap, KerrHawe) with or without separation ring. Group 6: flat metal circumferential matrix (OptraMatrix, Ivoclar Vivadent) in a Tofflemire-retainer with hand instrument (OptraContact). Proximal contact tightness was measured using the Tooth Pressure Meter (University of Technology, Delft). To determine the effect of experimental variables on the proximal contact tightness, a multiple linear regression model was constructed. RESULTS: Measurements in group 6 were not possible; therefore, this group was excluded. The use of medium- or high-viscosity instead of a low-viscosity composite resin resulted in statistically significantly tighter proximal contacts (p < 0.01). The use of a separation ring resulted in a large, statistically significant increase (p < 0.001) in contact tightness, while the use of a hand instrument resulted in a small, statistically significant increase of contact tightness (p = 0.017). No statistically significant differences were found when a dead-soft matrix or a sectional matrix was used instead of a Tofflemire (p = 0.159, p = 0.261, resp.). CONCLUSION: Use of a separation ring when restoring a Class II composite resin restoration has a greater influence on the obtained proximal contact tightness compared to the influence of the consistency of the composite resin.