釉质预酸蚀对自酸蚀粘结剂XenoⅢ临床疗效的影响

Effect of beforehand selective enamel etching on the clinical performance of a self-etch adhesive Xeno Ⅲ

目的:研究釉质预酸蚀对一步法自酸蚀粘结剂Xeno Ⅲ应用于楔状缺损充填治疗疗效的影响。方法:采用半口对照设计对我科32例患者(124颗前磨牙)唇颊侧楔状缺损进行粘结修复治疗,试验组在使用Xeno Ⅲ前用35%磷酸酸蚀缺损边缘釉质30s,对照组直接常规粘结树脂充填治疗。修复后1周(基线)、3个月、6个月、1年时按照改良美国公共卫生署(USPHS)标准对两组修复体的固位、釉质边缘着色、边缘适合度、术后敏感、继发龋进行临床评价。结果:在各时间点两组修复体脱落率比较,差异无统计学意义(P>0.05),1年时,试验组的边缘着色及边缘适合度的A级率均优于对照组,且差异均具有统计学意义(P<0.05)。对照组的边缘着色及边缘适合度的A级率在6个月与1年的比较,差异均具有统计学意义(P<0.05);而试验组在这两个时间点的边缘着色及边缘适合度比较,差异无统计学意义(P>0.05)。结论:预酸蚀釉质能改善Xeno Ⅲ粘结修复楔状缺损时的边缘封闭,从而改善临床疗效。

Objective To evaluate the clinical performance of a one-step,self-etch adhesive Xenolll combined with a composite Z350 to restore wedge-shaped defect with or without beforehand selective etching of enamel. Methods Totally 32 clients 124 teeth with wedge-shaped defect from our department were selected and randomly divided into 2 groups according to half-mouth control design. In the control group,the adhesive（Xenolll）was applied without beforehand enamel phosphoric-acid- etching,whereas the latter was applied first in the experimental group.The restorative composites used for all restorations were Z350,The clinical performance was assessed at one week（baseline）,3,6months, 1 year in terms of retention,marginal staining and adapability at the enamel, post-operative sensitivity and secondary caries. Results The retention rates showed no significant differences between the two groups at all the recall times（P〉0,05）.At the one-year recall, marginal staining and adapability at the enamel showed significant differences between groups（P〈0.05）：the percentages of restorations that have no marginal staining（got A critieria）and have perfect marginal adapability（got A critieria）are higher in experimental group.Only in control group,there were significant differences between the one- year recall and 6-months recall in terms of marginal staining and marginal adapability（P〈0.05）. Conclusion Selective enamel acid-etching might enhance the adhesive marginal seal ability of this one-step self-etch adhesive（Xenolll）,then improve the clinical performance.