インレー修復物の合着に用いる接着性レジンセメントの内部およびマージンへの適合性．In Vitro Micro-CT Study

Internal and Marginal Adaptation of Adhesive Resin Cements Used for Luting Inlay Restorations: An In Vitro Micro-CT Study.

抄録

セメント系セラミックインレーの成功には，レジンルーティングセメントの十分な内部適合とマージナルシール性が特に重要である．本研究の目的は，エナメル質と象牙質表面における歯牙-インレー修復界面の異なるレジンセメントの初期適合を調査することである．32本の抜去臼歯を4群に分けた．各歯にクラスII齲蝕を1本ずつ作製した．各グループにおいて，窩洞の歯肉底の半分はエナメル質上に，残りの半分はセメント質上に存在した．Lava Ultimate CAD/CAMインレーは，以下の接着システムを用いて窩洞に接着された．RelyX Unicem, RelyX Ultimate, Cement, Variolink Esthetic DCを使用した．歯牙を硝酸銀溶液で染色した後，マイクロCT画像を用いてマージナルギャップおよびインターナルギャップのボリュームを測定した．統計解析は，independent test，one-way ANOVA，post hoc Tukey test（<0.05）により実施した．内部およびマージナルギャップボリューム値は，象牙質表面ではバリオリンクエステティックDCが最も高く（0.629±0.363），（2.519±1.007），エナメル質表面ではRelyX Unicemが最も低い（0.005±0.004）および（0.009±0.003）ことが明らかとなった．RelyX UnicemおよびRelyX Ultimateレジンセメントのエナメル質表面における内適応および辺縁適合度は，互いにCementと同等であったが，Variolink Esthetic DCセメントより有意に優れていた．接着性レジン系にかかわらず，エナメル質面への適応は象牙質面への適応より優れていた．

Adequate internal adaptation and marginal sealing of resin luting cements are of particular importance for the success of cemented ceramic inlays. The purpose of this study was to investigate the initial adaptation of different resin cements at the tooth-inlay restoration interface at enamel versus dentin surfaces. Thirty-two extracted human molars were allocated to four groups. One Class II cavity was prepared in each tooth. In each group, half of the cavities' gingival floors were on enamel while the other halves were on cementum. Lava Ultimate CAD/CAM inlays were luted to the cavities using the following adhesive systems: RelyX Unicem, RelyX Ultimate, Cement, and Variolink Esthetic DC. After staining teeth with silver nitrate solution, marginal and internal gap volumes were determined using micro-CT images. Statistical analyses were conducted by independent test and one-way ANOVA followed by post hoc Tukey test ( < 0.05). The internal and marginal gap volume values were the highest for Variolink Esthetic DC at the dentin surface (0.629 ± 0.363) and (2.519 ± 1.007), respectively, and the lowest for RelyX Unicem at the enamel surface (0.005 ± 0.004) and (0.009 ± 0.003), respectively. The internal and marginal adaptation on the enamel surface for RelyX Unicem and RelyX Ultimate resin cements were comparable to each other and to Cement but significantly better than Variolink Esthetic DC cement. Regardless of the adhesive resin system used, adaptation on enamel is superior to that on dentin surfaces.