4种印章材料行后牙Ⅰ类洞复合树脂直接修复的体外对比研究

doi:10.13701/j.cnki.kqyxyj.2025.10.011

摘要/Abstract

摘要： 目的: 比较4种材料制作的印章,并评价不同印章用于后牙Ⅰ类洞复合树脂直接充填修复后的效果。方法: 体外实验分两部分进行。第一部分:选择同一批次制作的右下第一磨牙树脂牙40颗,随机分为4组,分别为牙龈保护剂印章充填组(A组)、流动树脂印章充填组(B组)、硅橡胶印章充填组(C组)、透明硅橡胶印章充填组(D组),分别用这4种印章材料进行印章制备,记录每个印章制备所需时长,检查印章气泡产生数量。扫描各组充填前牙齿牙合面形态,制备相同大小的Ⅰ类洞,用4种印章行复合树脂直接修复,再次扫描充填后牙合面形态,与充填前牙合面形态进行3D比较,计算均方根值(root mean square,RMS)进行分析。第二部分:选择新鲜拔除的第三磨牙25颗并随机分为5组,除设立上述4组外,增加常规树脂充填组为E组,制备4 mm深的Ⅰ类洞并充填,经冷热循环老化技术后行扫描电镜(scanning electron microscope,SEM)观察微渗漏情况,记录裂隙宽度并定量分析。结果: 第一部分4组印章制备时长、气泡数量、RMS值比较均存在统计学差异(P<0.05),其中,C、D组耗时较长,产生气泡数量较多,RMS值较大,均与A、B两组比较有统计学差异(P<0.05),A、B组之间比较无统计学差异(P＞0.05);第二部分5组微渗漏裂隙宽度和树脂上半段气泡数相比较,差异无统计学意义(P＞0.05)。结论: 高流动性的光固化树脂材料能精确恢复后牙Ⅰ类洞的牙合面形态,且制备时长短,产生气泡量少,是用于印章法补牙的优选。

关键词: 复合树脂直接修复, 印章材料, 牙合面复制精确性, 微渗漏

Abstract: Objective: To compare four types of matrices fabricated from different materials and evaluate the effects of different matrices on the clinical outcomes of direct composite resin restorations in posterior teeth with Class Ⅰ cavities. Methods: The in vitro experiment was conducted in two parts. Part Ⅰ: Forty resin-made right mandibular first molars from the same production batch were randomly divided into 4 groups: gingival protector stamp filling group (Group A), flowable resin stamp filling group (Group B), silicone rubber stamp filling group (Group C), and transparent silicone rubber stamp filling group (Group D). Stamp preparations were fabricated using four materials, and the time required for each stamp preparation was recorded. The number of bubbles generated in the stamps was examined. The occlusal morphology of the teeth in each group was scanned before filling. Class Ⅰ cavities of identical size were prepared, and direct composite resin restorations were performed using the four types of stamps. The post-filling occlusal morphology was scanned and compared three-dimensionally with the pre-filling morphology. The root mean square (RMS) values were calculated and analyzed. Part Ⅱ: Twenty-five freshly extracted third molars were randomly divided into 5 groups. In addition to the aforementioned four groups (A-D), a conventional resin filling group (Group E) was included. Class Ⅰ cavities with a depth of 4 mm were prepared and filled. After the cycle of heating and cooling, scanning electron microscopy (SEM) was used to observe the microleakage. Gap widths were recorded and quantitatively analyzed. Results: Part Ⅰ: The four groups showed statistically significant differences in preparation time, number of bubbles, and RMS values (P<0.05). Groups C and D required longer preparation times, produced more bubbles, and demonstrated higher RMS values, all showing statistically significant differences compared to Groups A and B (P<0.05). No statistically significant differences were observed between Groups A and B in any parameters (P>0.05). Part Ⅱ: No statistically significant differences were found among the five groups in terms of microleakage gap width and number of bubbles in the upper half of the resin (P>0.05). Conclusion: The high-flow light-curing resin material demonstrated excellent efficacy in precisely restoring the occlusal morphology of posterior Class Ⅰ cavities, exhibiting shorter preparation time and fewer air bubbles generated during fabrication. It represents a promising choice for the stamp technique in dental restorations.

Key words: composite resin direct restoration, stamp material, occlusal surface replication accuracy, microleakage

王豪杰, 张运祥, 李敏, 张览锐, 潘红, 楚媛媛. 4种印章材料行后牙Ⅰ类洞复合树脂直接修复的体外对比研究[J]. 口腔医学研究, 2025, 41(10): 901-906.

WANG Haojie, ZHANG Yunxiang, LI Min, ZHANG Lanrui, PAN Hong, CHU Yuanyuan. In Vitro Comparative Study of Four Stamp Materials for Direct Composite Resin Restoration of Class Ⅰ Cavities in Posterior Teeth[J]. Journal of Oral Science Research, 2025, 41(10): 901-906.

参考文献

[1] Sonkar M, Mahapatra J, Patel A, et al. Perfecting posterior dental simulacrum: Unveiling the stamp technique for tooth restoration [J]. Cureus, 2024, 16(6):e62640.
[2] Gupta R, Thakur S, Goud KM, et al. A biomimetic approach for class 1 restorations using stamp technique: A case report [J]. Int J Appl Dent Sci, 2021, 7:161-163.
[3] Schwendicke F, Göstemeyer G, Blunck U, et al. Directly placed restorative materials: Review and network meta-analysis [J]. J Dent Res, 2016, 95(6):613-622.
[4] Karunakar P, Ranga Reddy MS, Kumar BS, et al. Direct and indirect stamp techniques for composite restorations-Sealing the uniqueness of a tooth: A case series [J]. J Conserv Dent, 2022, 25(3):327-331.
[5] Saoji SS, Ikhar A, Manik K, et al. Elevating restorative dentistry: Use of the art of stamp techniques in mandibular posterior regions [J]. Cureus, 2024, 16(7):e64014.
[6] Leon A, Ungureanu L, Caraiane A, et al. Transfer of occlusal morphology from dental laboratory to dental office through the stamp technique [J]. Int J Appl Dent Sci, 2018, 22:161-163.
[7] Klein C, von Ohle C, Wolff D, et al. A quantitative assessment of silicone and PTFE-based stamp techniques for restoring occlusal anatomy using resin-based composites [J]. Clin Oral Investig, 2022, 26(1):207-215.
[8] Vertuan M, Mosquim V, Guimarães GMF, et al. The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4-year follow-up [J]. J Esthet Restor Dent, 2023, 35(3):442-448.
[9] Ramseyer ST, Helbling C, Lussi A. Posterior vertical bite reconstructions of erosively worn dentitions and the "stamp technique" - A case series with a mean observation time of 40 months [J]. J Adhes Dent, 2015, 17(3):283-289.
[10] 杨洋,浦婷婷,陈立,等.比较两种改良式印章法辅助后牙树脂牙合贴面修复的形态准确性[J].北京大学学报(医学版),2021,53(5):977-982.
[11] 谢淑娟,潘卫红.后牙印章法美学树脂修复的实验研究[J].临床口腔医学杂志,2021,37(2):83-85.
[12] Li L, Chen H, Zhao Y, et al. Design of occlusal wear facets of fixed dental prostheses driven by personalized mandibular movement [J]. J Prosthet Dent, 2022, 128(1):33-41.
[13] Zhu J, Fu C, Deng X, et al. Effects of stamp material and restoration depth on the accuracy of direct composite resin restorations using stamp technique [J]. J Dent, 2024, 150:105369.
[14] 朱光宇,苫君玲.印章法行后牙树脂美学修复的疗效观察[J].全科口腔医学杂志(电子版),2018,5(36):6-8.
[15] Klein C, von Ohle C, Wolff D, et al. A quantitative assessment of silicone and PTFE-based stamp techniques for restoring occlusal anatomy using resin-based composites [J]. Clin Oral Investig, 2022, 26(1):207-215.
[16] Zhu J, Zhu L, Deng X, et al. Evaluation of direct restorations for pit-and-fissure caries using stamp combined with single-shade composite resin technique: A 12-month follow-up in vivo study [J]. J Dent, 2024, 149:105277.
[17] Albeshir EG, Alsahafi R, Albluwi R, et al. Low-shrinkage resin matrices in restorative dentistry-narrative review [J]. Materials (Basel), 2022, 15(8):2951.
[18] Atilan Yavuz S, Erturk Avunduk AT, Karatas O, et al. Impact of acid and laser etching of enamel on microleakage in different adhesive systems [J]. Lasers Med Sci, 2024, 39(1):181.
[19] De Munck J, Van Landuyt K, Peumans M, et al. A critical review of the durability of adhesion to tooth tissue: methods and results [J]. J Dent Res, 2005, 84(2):118-132.
[20] Nawrocka A, Łukomska-Szymaska M. Extracted human teeth and their utility in dental research. Recommendations on proper preservation: A literature review [J]. Dent Med Probl, 2019, 56(2):185-190.
[21] Ertürk Avunduk AT, Bağlar S. Evaluation of microleakage in class Ⅴ cavities prepared by different caries removal methods [J]. Microsc Res Tech, 2019, 82(9):1566-1574.
[22] Zotti F, Vincenzi S, Zangani A, et al. Stamp technique: An explorative SEM analysis [J]. Dent J (Basel), 2023, 11(3):77.
[23] Alexey M. Direct posterior composite restorations using stamp technique-conventional and modified: A case series [J]. Int J Dent, 2017, 2(1): 3-7.
[24] Zhu J, Zhu L, Deng X, et al. Evaluation of direct restorations for pit-and-fissure caries using stamp combined with single-shade composite resin technique: A 12-month follow-up in vivo study [J]. J Dent, 2024, 149:105277.
[25] Loumprinis N, Maier E, Belli R, et al. Viscosity and stickiness of dental resin composites at elevated temperatures [J]. Dent Mater, 2021, 37(3):413-422.
[26] Comba A, Baldi A, Saratti CM, et al. Could different direct restoration techniques affect interfacial gap and fracture resistance of endodontically treated anterior teeth? [J]. Clin Oral Investig, 2021, 25(10):5967-5975.
[27] Qian K, Wang QL, Pan J. 3D digital evaluation for direct composite restoration using the modified stamp technique [J]. Chin J Dent Res, 2021, 24(3):185-189.
[28] Saoji SS, Ikhar A, Manik K, et al. Elevating restorative dentistry: Use of the art of stamp techniques in mandibular posterior regions [J]. Cureus, 2024, 16(7):e64014.