Einfluss unterschiedlicher Inkrementstärken auf die Stabilität des adhäsiven Verbundes zwischen Bulk-Fill-Kompositen und Dentin

Ziel der Studie Das Ziel dieser Studie war, zu untersuchen, wie sich die Kombination unterschiedlicher Inkrementstärken von Bulk-Fill-Kompositen (3M Filtek Bulk Fill / 3M Filtek Bulk Fill Flowable) auf den Haftverbund zwischen Dentin und Komposit auswirken. Als Adhäsivsystem kamen dabei Universalad...

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Bibliographic Details
Main Author: Hoffmann, Alexander
Contributors: Frankenberger, Roland (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2019
Online Access:PDF Full Text
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Objectives The aim of this study was to determine how increment thickness of bulk-fill composites (3M Filtek Bulk Fill / 3M Filtek Bulk Fill Flowable) effects the resin-dentin bonding strength. Two universal adhesive systems (Adhese Universal / Scotchbond Universal) were used in this study to examine their behavior in combination with the bulk-fill composites. In addition, in another test group it was examined which results show up for the combination of 3M Filtek Bulk Fill material and Syntac Classic as a bonding agent. Material and methods Occlusal class I cavities (4 x 4 x 4 mm) were preparated in 51 caries-free, extracted human third molars. Afterwards the teeth were randomly divided in 15 groups. Following the adhesive process according to the manufacturer instruction manual, the cavities were filled with the composite material 3M Filtek Bulk Fill und 3M Filtek Bulk Fill Flowable in different incremental thickness. Syntac Classic, Adhese Universal und Scotchbond Universal were used as adhesive systems in five groups each. After thermocycling the specimen (2500 cycles) for aging simulation the teeth were cut in 0,8 mm x 0,8 mm sticks with a microsaw. Afterwards the resin-dentin bonding strength was measured in a microtensile bond strength test. Finally, the dentin parts of the broken specimens were examined under scanning electron microscopy to determine the type of failure.   Results The combination of universal adhesive systems and bulk-fill composite materials results in a much more efficient filling process. On one hand, it is time saving because of less intermediate steps and on the other hand it also leads to a less technique sensitive process because of less error possibilities. The best results regarding the microtensile bond strength were reached in the test groups with 3M Filtek Bulk Fill Flowable as a bottom increment followed by an increment of 3M Filtek Bulk Fill. Both Adhese Universal and Scotchbond Universal reached sufficient bond strength in this study for clinical usage. Statistically significant worse results for bonding strength showed up for the Scotchbond Universal group, when only the packable bulk-fill-material was used. The Adhese Universal group showed higher pretest failures of the specimen during sawing process with this filling method, too. The combination of the Syntac Classic adhesive system and the 3M Filtek Bulk Fill material could not reach sufficient bonding strength in this study. Practical Conclusion In order to reach a highly efficient filling process, universal adhesive systems can be used in combination with bulk-fill composite materials. For optimal bonding strength and marginal quality, a flowable material should be used as bottom layer. Subsequently a higher filled, packable material should be used for the top layer to reach a better stability and less abrasion. Because of the translucency of bulk-fill composite materials and thereby less aesthetical results, this method should only be used in posterior regions and on teeth with bright color. Important for clinical success is the only use of specially developed bulk-fill-materials when thicker increments have to be hardened. Standard composite materials are not reaching sufficient bonding strengths if used in thicker increments than described in the manufacturer instruction manual.