永久歯のII級修復におけるレジンコンポジットおよびグラスアイオノマー材料の臨床的検討

Clinical study on resin composite and glass ionomer materials in II class restorations in permanent teeth.

抄録

背景:

欠損補綴に用いられるグラスアイオノマーセメント（GIC）は、高い生体親和性と再石灰化能を有する。しかし，機械的耐性が低いため，特に永久歯列の近心面の広範囲な病変の長期修復には使用されていない．GICの粘性を高めたものは，接着性や耐摩耗性などの物性に優れるため，コンポジットレジンの代替材料として検討することが可能である．本研究の目的は，若年者を対象に，高粘度GICであるEquia Fil（Ivoclar Vivadent）とEquia Coat（Ivoclar Vivadent）および複合材料であるTetric EvoCeram（Ivoclar Vivadent）で製作した永久歯の修復物の臨床およびラジオグラフィー評価することである．

Background: Glass ionomer cements (GIC) used for restoration of missing dental structures have high biocompatibility and remineralization potential. However, low mechanical resistance excludes their use for long-term restorations of extensive lesions, particularly on approximal surfaces in permanent dentition. GIC with increased viscosity have much better physical properties, which involves better bonding and wear resistance, so they can be considered as an alternative to composite resin materials. The aim of this study was to perform a clinical and radiological assessment of restorations in permanent teeth, made with an increased viscosity GIC - Equia Fil (Ivoclar Vivadent) with Equia Coat (Ivoclar Vivadent) and composite material - Tetric EvoCeram (Ivoclar Vivadent) in young patients.

材料と方法:

12.08歳から19.58歳までの49名の患者を対象に，100個の近心面窩洞を複合材料またはGICで充填した．充填前、12ヶ月後、24ヶ月後にバイトウイングラジオグラフィーを撮影し、各修復物の状態をHickelらの基準で評価した。

Material and Methods: A total of 100 cavities on approximal surfaces were filled with the composite material or GIC in 49 patients aged from 12.08 to 19.58 years. During control examinations, the condition of each restoration was assessed with criteria acc. to Hickel et al. Bitewing radiographs had been taken before fillings were placed and after 12 and 24 months.

結果:

2年間の観察後、2本のGIC修復物が保持力の低下と着色のため交換された。他の96本の修復物には満足のいく成績が得られた。24ヶ月後の臨床効果は、エクアフィル95.83％、テトリックエボセラム100％と評価された。その差は統計的に有意ではなかった（=0.145）．GICを使用した場合、マージナル適応度の悪化、ステインやエロージョンの発生リスクが高かった。24ヵ月後のX線写真におけるEquia Fil材の窩洞修復効果は93.75%，Tetric EvoCeram材は100%と評価された．その差は統計学的に有意ではなかった（=0.073）．

Results: After two years of observations, two GIC restorations were replaced due to loss of retention and staining. The other 96 restorations were given a satisfactory grade. The clinical efficacy of Equia Fil after 24 months was assessed at 95.83%, the Tetric EvoCeram at 100%. The difference was not statistically significant (=0.145). When GIC was used, there was a higher risk of marginal adaptation deterioration and the occurrence of staining and erosion. Radiographic efficacy of the Equia Fil material for cavity restoration after 24 months was assessed at 93.75%, for the Tetric EvoCeram material at 100%. Differences were not significant statistically (=0.073).

結論:

小臼歯および永久歯の近心病変の修復に用いたテトリックエボセラムとエクシアフィルは，2年間の観察で同程度の有効性を示した．歯科修復物，永久歯，コンポジットレジン，グラスアイオノマーセメント，臨床試験．

Conclusions: Tetric EvoCeram and Equia Fil used for the restoration of approximal lesions in premolars and permanent molars have similar efficacy in a 2-year period of observation. Dental restoration, permanent, composite resins, glass ionomer cements, clinical study.