Publication: Open Sandwich tekniği ile farklı restoratif malzemeler kullanılarak restore edilmiş dişlerdeki mikrosızıntı değerlerinin in-vitro koşullarda incelenmesi
Abstract
Mine-sement sınırının altında hazırlanan kavitelerde mikrosızıntı ile mücadele edebilmek oldukça güçtür. Bu nedenle bu çalışmanın amacı: derin class II kavitelerdeki stres ve marginal bölgedeki kapanma problemlerinin çözümüne yönelik birçok alternatif klinik teknikten biri olan açık sandviç yönteminin farklı restoratif materyaller kullanarak etkinliğinin incelenmesidir. 100 adet dişe standart MO (meziyo-okluzal), aproksimal kutu (box) şeklinde kaviteler açıldı. Kaviteler, oklüzo-gingival derinliği mine-sement sınırının 1 mm altında olacak şekilde ve aproksimal kutunun ebatları 2X4X6 mm olacak şekilde açılmıştır. Restorasyonları bitirilen dişler rastgele seçilerek 5 ana gruba ayrıldı. (n = 20) Her ana grup termal siklüs ve termo-mekanik yükleme işlemleri için kendi aralarında tekrar 2 gruba ayrılmıştır. (n = 10) Grup 1 kontrol grubudur ve kaviteler direkt kompozit (Filtek Z250) uygulaması ile bitirilmiştir. Grup 2 de basamakta Filtek Flow, Grup 3 te basamakta Grandio Flow, Grup 4 te basamakta Supreme XT Flow, Grup 5 te basamakta Vitremer kullanılmış olup, Grup 2,3,4 ve 5’ in üst yapıları mikrohibrit kompozit rezin (Filtek Z250) ile restore edilmiştir. Her grubu oluşturan örneklerin yarısı sadece termal siklus ile, diğer yarısı oklüzal yük+termal siklus işlemleri ile yaşlandırılmıştır. Mikrosızıntı tayini bazik fuksin boyasının penetrasyon miktarının stereomikroskop (X40) altında incelenmesi ile yapılarak istatistiksel analize tabi tutulmuştur. Çalışmamızda, Vitremer (RMCİS) ve Filtek Flow (mikrohibrit akışkan kompozit) ile yapılan açık sandviç restorasyonlar diğer gruplara oranla mikrosızıntı açısından üstünlük sağlamışlardır. Nanohibrit akışkan kompozitler kendilerinden beklenen üstün mekanik özellikleri sergilememişlerdir. Mikrosızıntı değerleri Grup 2 ve 5 ten ileri düzeyde anlamlı yüksek bulunmuştur. Grup 1,3 ve 4 arasında istatistiksel olarak anlamlı farklılık tespit edilmemiştir. Genel olarak oklüzal yük uygulaması mikrosızıntı miktarlarını arttırmış olmakla birlikte bu farklılık anlamlılığa yakın ancak istatistiksel olarak anlamlı bulunmamıştır. Ancak Grup 3 ve 4 te oklüzal yük uygulaması mikrosızıntı değerleri açısından ileri düzeyde anlamlı artışa neden olmuştur.
In-Vitro Evaluation of Microleakage in Open Sandwich Technique Restored with Different Restorative Materials. It’s difficult to cope with the microleakage in the cavities prepared below the cemento-enamel junction. Therefore the aim of this study is to evaluate the efficiency of the open sandwich technique by using different restorative materials proposed for the solution of the stress and marginal seal problems as an alternative clinical technique in deep class II cavities. Standart MO (mesio-occlusal) box shaped cavities were prepared in 100 teeth. The occluso-gingival depth of the cavities were prepared 1 mm below the cemento-enamel junction and the dimensions of the approximal box is arranged to be 2X4X6 mm in depth. After finishing the restorations, the teeth were randomly selected to form 5 main groups (n=20). Each of the 5 main groups then divided into 2 sub-groups for the thermocycling and thermo-mechanical loading procedures (n=10). Group 1 was the control and the cavities were restored with direct composite resin (Filtek Z250). The gingival increment was Filtek Flow for Group 2, Grandio Flow for Group 3, Supreme XT Flow for Group 4 and Vitremer for Group 5. The remaining parts of the cavities were restored with the microhybrid composite resin (Filtek Z250) for Groups 2,3,4 and 5. The half of the specimens forming each group were aged only by thermocycle. The other half of the specimens aged by both occlusal loading and thermocycle. The evaluation of microleakage is performed by the determination of the amount of the penetration of basic fuchsin dye under stereomicroscope (X40) and the data was statistically analyzed. In this study, the open sandwich technique with using Vitremer (RMGIC) and Filtek Flow (microhybrid flowable composite) as a gingival increment performed far better than the other groups for the microleakage scores. Nanohybrid flowable composite resins did not perform superior mechanical properties. The microleakage scores were found statistically higher than Groups 2 and 5. No statistically significant differences were observed between Groups 1,3 and 4 with respect to marginal microleakage. Overall, aging by occlusal loading increased the microleakage scores but this difference is found to be close to significance but statistically not significant. But statistically higher significant values were obtained in Groups 3 and 4 after occlusal loading with respect to microleakage.
In-Vitro Evaluation of Microleakage in Open Sandwich Technique Restored with Different Restorative Materials. It’s difficult to cope with the microleakage in the cavities prepared below the cemento-enamel junction. Therefore the aim of this study is to evaluate the efficiency of the open sandwich technique by using different restorative materials proposed for the solution of the stress and marginal seal problems as an alternative clinical technique in deep class II cavities. Standart MO (mesio-occlusal) box shaped cavities were prepared in 100 teeth. The occluso-gingival depth of the cavities were prepared 1 mm below the cemento-enamel junction and the dimensions of the approximal box is arranged to be 2X4X6 mm in depth. After finishing the restorations, the teeth were randomly selected to form 5 main groups (n=20). Each of the 5 main groups then divided into 2 sub-groups for the thermocycling and thermo-mechanical loading procedures (n=10). Group 1 was the control and the cavities were restored with direct composite resin (Filtek Z250). The gingival increment was Filtek Flow for Group 2, Grandio Flow for Group 3, Supreme XT Flow for Group 4 and Vitremer for Group 5. The remaining parts of the cavities were restored with the microhybrid composite resin (Filtek Z250) for Groups 2,3,4 and 5. The half of the specimens forming each group were aged only by thermocycle. The other half of the specimens aged by both occlusal loading and thermocycle. The evaluation of microleakage is performed by the determination of the amount of the penetration of basic fuchsin dye under stereomicroscope (X40) and the data was statistically analyzed. In this study, the open sandwich technique with using Vitremer (RMGIC) and Filtek Flow (microhybrid flowable composite) as a gingival increment performed far better than the other groups for the microleakage scores. Nanohybrid flowable composite resins did not perform superior mechanical properties. The microleakage scores were found statistically higher than Groups 2 and 5. No statistically significant differences were observed between Groups 1,3 and 4 with respect to marginal microleakage. Overall, aging by occlusal loading increased the microleakage scores but this difference is found to be close to significance but statistically not significant. But statistically higher significant values were obtained in Groups 3 and 4 after occlusal loading with respect to microleakage.