Yüksek viskoziteli cam iyonomer ile kompozit rezinin lastik örtü kullanılmayan oklüzal restorasyonlardaki klinik performansları: 1 yıllık randomize kontrollü bölünmüş ağız çalışması

Amaç: Bu randomize, kontrollü, tek kör, bölünmüş ağız (split-mouth), tek merkezli klinik çalışmanın amacı, lastik örtü kullanılamayan alt ikinci büyük azı dişlerin oklüzal restorasyonlarında yüksek viskoziteli cam iyonomer ile nanohibrit kompozit rezinin bir yıllık klinik performanslarının karşılaştırılmasıdır. Gereç ve Yöntem: Bu çalışmada 56 hastanın (26 kadın, 30 erkek) sağ ve sol alt ikinci büyük azı dişlerindeki oklüzal çürükleri bölünmüş ağız tasarımına uygun olarak restore edildi. Yüksek viskoziteli cam iyonomer (EQA; Equia Fil, GC) ve nanohibrit kompozit rezin (GSO; GrandioSo, Voco) üretici firma önerileri doğrultusunda kavitelere uygulandı. Restorasyonların değerlendirilmesi bir hafta, altı ay ve bir yıl sonra FDI kriterlerine göre yapıldı. Verilerin analizi Friedman’s ANOVA ve Mann-Whitney U testleri ile gerçekleştirildi (α=0.05). Bulgular: Bir yıl sonundaki değerlendirmede, fonksiyonel, estetik ve biyolojik değerlendirme kriterleri göz önüne alındığında 1, 2 ve 3 skoru alan ve başarılı olarak değerlendirilen restorasyonların oranı EQA grubunda %96 ve GSO grubunda %100 idi. Altıncı ay ve bir yıldaki değerlendirmelerde GSO grubunun EQA grubuna göre anlamlı derecede daha iyi yüzey parlaklığına sahip olduğu belirlendi (p<0.05). Materyallerin bir yıl içerisindeki değişimleri değerlendirildiğinde ise, GSO grubunda yüzey parlaklığı, yüzey renklenmesi ve kenar uyumu açısından anlamlı ölçüde değişim olduğu (p<0.017; Bonferroni düzeltmeli Wilcoxon işaretli sıralar testi), EQA grubunda ise yüzey parlaklığı ve kenar uyumu açısından anlamlı değişim olduğu görüldü (p<0.017). Sonuç: Lastik örtü kullanılmayan alt ikinci büyük azı dişlerine uygulanan oklüzal restorasyonlarda yüksek viskoziteli cam iyonomer ile nanohibrit kompozit rezin bir yıl sonunda kabul edilebilir klinik başarı gösterdi.

Clinical performance of high-viscosity glass ionomer and resin composite on occlusal restorations performed without rubber-dam isolation: a one-year randomized controlled split-mouth study

Objective: The aim of this randomized, controlled, single-blind, split-mouth and single-center clinical trial was to compare the one-year clinical performances of a high viscosity glass ionomer and a nano-hybrid composite resin on occlusal restorations of mandibular second molar teeth performed without rubber dam isolation. Materials and Method: Occlusal carious lesions on right and left mandibular second molars of 56 patients (26 female, 30 male) were restored according to a split-mouth design in this study. A high viscosity glass ionomer (EQA; Equia Fil, GC) and a nano-hybrid composite resin (GSO; GrandioSo, Voco) were applied according to the manufacturers’ instructions. Clinical evaluation of the restorations was performed according to the FDI criteria at one-week, six-month, and one-year follow-ups. The data were statistically analyzed using Friedman’s ANOVA and Mann-Whitney U tests (α=0.05). Results: After one year, considering functional, esthetic, and biological criteria, the rate of restorations scored with 1, 2, and 3, and were evaluated as successful was 96% in the EQA group, and 100% in the GSO group. GSO showed significantly better surface luster than EQA at both six-month and one-year follow-ups (p<0.05). When one-year alterations within the materials were considered; surface luster, surface discoloration, and marginal adaptation scores significantly increased in the GSO group (p<0.017; Wilcoxon signed-rank test with Bonferroni correction). On the other hand, the scores of surface luster and marginal adaptation significantly increased in the EQA group (p<0.017). Conclusion: One-year performance of high viscosity glass ionomer and nano-hybrid composite on occlusal restorations of mandibular second molars were considered acceptable without rubber-dam isolation.

___

  • Nair P, Hickel R, Ilie N. Adverse effects of salivary contamination for adhesives in restorative dentistry. A literature review. Am J Dent 2017;30:156-64.
  • Van Meerbeek B, Van Landuyt K, De Munck J, Inoue S, Yoshida Y, Perdigao J, et al. Bonding to enamel and dentin. In: Summitt JB, Robbins JW, Hilton TJ, Schwartz RS, editors. Fundamentals of Operative Dentistry: A Contemporary Approach. 3rd ed. Chicago: Quintessence; 2006. p.183-260.
  • Kulczyk K, Sidhu S, McCabe J. Salivary contamination and bond strength of glass-ionomers to dentin. Oper Dent 2005;30:676-83.
  • Shimazu K, Karibe H, Ogata K. Effect of artificial saliva contamination on adhesion of dental restorative materials. Dent Mater J 2014;33:545-50.
  • Pereira T. Silver amalgam: A clinician's perspective. J Res Dent 2016;4:25-30.
  • Lohbauer U, Krämer N, Siedschlag G, Schubert EW, Lauerer B, Mueller FA, et al. Strength and wear resistance of a dental glass-ionomer cement with a novel nanofilled resin coating. Am J Dent 2011;24:124-8.
  • Wang XY, Yap AU, Ngo HC. Effect of early water exposure on the strength of glass ionomer restoratives. Oper Dent 2006;31:584-9.
  • Donovan TE, Eidson S. Instruments and equipment for tooth preparation. In: Roberson T, Heymann HO, Swift Jr EJ, editors. Sturdevant's Art and Science of Operative Dentistry. 6th ed. St. Louis: Mosby; 2006. p.164-85.
  • Affoo RH, Foley N, Garrick R, Siqueira WL, Martin RE. Meta-Analysis of Salivary Flow Rates in Young and Older Adults. J Am Geriatr Soc 2015;63:2142-51.
  • Hickel R, Peschke A, Tyas M, Mjör I, Bayne S, Peters M, et al. FDI World Dental Federation: clinical criteria for the evaluation of direct and indirect restorations—update and clinical examples. Clin Oral Investig 2010;14:349-66.
  • Turkun LS, Kanik O. A Prospective Six-Year Clinical Study Evaluating Reinforced Glass Ionomer Cements with Resin Coating on Posterior Teeth: Quo Vadis? Oper Dent 2016;41:587-98.
  • Gurgan S, Kutuk ZB, Ergin E, Oztas SS, Cakir FY. Clinical performance of a glass ionomer restorative system: a 6-year evaluation. Clin Oral Investig 2017;21:2335-43.
  • Lohbauer U, Kramer N, Siedschlag G, Schubert EW, Lauerer B, Muller FA, et al. Strength and wear resistance of a dental glass-ionomer cement with a novel nanofilled resin coating. Am J Dent 2011;24:124-8.
  • Ulrich L. Dental Glass Ionomer Cements as Permanent Filling Materials. Properties, Limitations and Future Trends. Materials 2010;3:76-96.
  • Scholtanus JD, Huysmans MC. Clinical failure of class-II restorations of a highly viscous glass-ionomer material over a 6-year period: a retrospective study. J Dent 2007;35:156-62.
  • Celik EU, Tunac AT, Yilmaz F. Three-year clinical evaluation of high-viscosity glass ionomer restorations in non-carious cervical lesions: a randomised controlled split-mouth clinical trial. Clin Oral Investig 2019;23:1473-80.
  • Jung M, Eichelberger K, Klimek J. Surface geometry of four nanofiller and one hybrid composite after one-step and multiple-step polishing. Oper Dent 2007;32:347-55.
  • Yazici AR, Tuncer D, Antonson S, Onen A, Kilinc E. Effects of delayed finishing/polishing on surface roughness, hardness and gloss of tooth-coloured restorative materials. Eur J Dent 2010;4:50-6.
  • Letzel H. Survival rates and reasons for failure of posterior composite restorations in multicentre clinical trial. J Dent 1989;17:10-7.
  • Arhun N, Celik C, Yamanel K. Clinical evaluation of resin-based composites in posterior restorations: two-year results. Oper Dent 2010;35:397-404.