Die Schmelzrandabschrägung – notwendig oder überholt?

In der vorliegenden Studie konnte in vitro nachgewiesen werden, dass das Brechen scharfer Kanten im Schmelz ausreicht, um die Randständigkeit von approximalen Füllungen im Seitenzahngebiet zu verbessern. Eine Abschrägung im klassischen Sinne bewirkt dem gegenüber keinerlei signifikante Verbesserung. Das Unterlassen würde aufgrund von Spannung durch die Polymerisationsschrumpfung paramarginale Schmelzfrakturen verursachen. Eine Abschrägung im Dentin sollte unterbleiben.

Enamel Bevels – Necessary or obsolete?

In this in vitro study it could be shown, that stripping sharp enamel edges in class II cavities is enough, to increase marginal integrity. Classical enamel bevels do not provoke significantly better results. Desisting any kind of bevel causes polymerisation shrinkage induced paramarginal enamel cracks. Bevelling in dentin should be avoided in general.

Schlüsselwörter

Schmelzrandabschrägung - Schmelzhaftung - paramarginale Schmelzfrakturen

Key words

enamel bevel - enamel adhesion - paramarginal enamel cracks

• Literatur

• 1 Buonocore MG. A Simple Method of Increasing the Adhesion of Acrylic Filling Materials to Enamel Surfaces. J Dent Res 1955; 34: 849-853
• 2 Steiniger B, Schwarzbach H, Stachniss V. Mikroskopische Anatomie der Zähne und des Parodonts. 1. Auflage Stuttgart: Thieme Verlag; 2010
• 3 Lehmann KM, Hellwig E. Zahnärztliche Propädeutik. 10. Auflage München: Elsevier Urban und Fischer; 2005
• 4 Hellwig E, Klimek J, Attin T. Einführung in die Zahnerhaltung. 4. Auflage München: Elsevier Urban und Fischer; 2006
• 5 Frankenberger R. Adhäsiv-Fibel. 1. Auflage Balingen: Spitta-Verlag; 2008
• 6 Wilson NHF, Wilson MA, Wastell IDG et al. Performance of Occlusinin butt-joint and bevel-edged preparations: Five-year results. Dent Mater 1991; 7: 92-98
• 7 Holan G, Eidelman E, Wright GZ. The effect of internal bevel on marginal leakage at the approximal surface of Class 2 composite restorations. Oper Dent 1997; 22: 217-221
• 8 Opdam NJ, Roeters JJ, Kuijs R et al. Necessity of bevels for box only Class II composite restorations. J Prosthet Dent 1998; 80: 274-279
• 9 Swanson TK, Feigal RJ, Tantbirojn D et al. Effect of adhesive systems and bevel on enamel margin integrity in primary and permanent teeth. Pediatr Dent 2008; 30: 134-140
• 10 Crim GA, Mattingly S. Evaluation of two methods for assessing marginal leakage. J Prosthet Dent 1981; 45: 160-163
• 11 Frankenberger R, Krämer N, Lohbauer U et al. Marginal integrity: is the clinical performance of bonded restorations predictable in vitro?. J Adhes Dent 2007; 9: 107-116
• 12 Frankenberger R, Krämer N, Petschelt A. Long-term effect of dentin primers on enamel bond strength and marginal adaptation. Oper Dent 2000; 25: 11-19
• 13 Frankenberger R, Krämer N, Petschelt A. Fatigue behaviour of different dentin adhesives. Clin Oral Investig 1999; 3: 11-17
• 14 Frankenberger R, Lohbauer U, Roggendorf MJ et al. Selective enamel etching reconsidered: better than etch-and-rinse and self-etch?. J Adhes Dent 2008; 10: 339-344
• 15 Frankenberger R, Strobel WO, Krämer N et al. Evaluation of the fatigue behavior of the resin-dentin bond with the use of different methods. J Biomed Mater Res B Appl Biomater 2003; 67: 712-721
• 16 Frankenberger R, Strobel WO, Lohbauer U et al. The effect of six years of water storage on resin composite bonding to human dentin. J Biomed Mater Res B Appl Biomater 2004; 69: 25-32
• 17 Frankenberger R, Tay FR. Self-etch vs. etch-and-rinse adhesives: effect of thermo-mechanical fatigue loading on marginal quality of bonded resin composite restorations. Dent Mater 2005; 21: 397-412
• 18 Holan G, Eidelman E, Wright GZ. The effect of internal bevel on marginal leakage at the approximal surface of Class 2 composite restorations. Oper Dent 1997; 22: 217-221
• 19 Kalra S, Singh A, Gupta M et al. Ormocer: An aesthetic direct restorative material; An in vitro study comparing the marginal sealing ability of organically modified ceramics and a hybrid composite using an ormocer-based bonding agent and a conventional fifth-generation bonding agent. Contemp Clin Dent 2012; 3: 48-53
• 20 Lutz F, Krejci I, Barbakow F. Quality and durability of marginal adaptation in bonded composite restorations. Dent Mat 1991; 7: 107-113
• 21 Mahmoud SH, Al-Wakeel Eel S. Marginal adaptation of ormocer-, silorane-, and methacrylate-based composite restorative systems bonded to dentin cavities after water storage. Quintessence Int 2012; 42: 131-139
• 22 Meyer-Lückel H, Paris S, Ekstrand K. Karies: Wissenschaft und Klinische Praxis. Stuttgart: Thieme Verlag; 2012
• 23 Olio G, Jorgensen KD. Effect of bevelling on the occurence of fractures in the enamel surrounding composite fillings. J Oral Rehabil 1977; 4: 304-309
• 24 Krämer N, Reinelt C, García-Godoy F et al. Nanohybrid composite vs. fine hybrid composite in extended class II cavities: clinical and microscopic results after 2 years. Am J Dent 2009; 22: 228-234
• 25 Krämer N, Reinelt C, Richter G et al. Nanohybrid vs. fine hybrid composite in Class II cavities: clinical results and margin analysis after four years. Dent Mater 2009; 25: 750-759
• 26 Lutz F, Krejci I, Barbakow F. Quality and durability of marginal adaptation in bonded composite restorations. Dent Mat 1991; 7: 107-113
• 27 Manhart J, Chen HY, Hickel R. Clinical evaluation of the posterior composite Quixfil in class I and II cavities: 4-year follow-up of a randomized controlled trial. J Adhes Dent 2010; 12: 237-243
• 28 Spreafico RC, Krejci I, Dietschi D. Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo. J Dent 2005; 33: 499-507
• 29 Versluis A, Douglas WH, Cross M et al. Does an incremental filling technique reduce polymerisation shrinkage stress?. J Dent Res 1996; 75: 871-878
• 30 Bortolotto T, Onisor I, Krejci I. Proximal direct composite restorations and chairside CAD/CAM inlays: Marginal adaption of a two-step self-etch adhesive with and without selective enamel conditioning. Clin Oral Invest 2007; 11: 35-43