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Is there an association between clinical and SEM quantitative marginal analysis in a 90-month trial?Brückner, Amelie Verena Barbara 21 December 2021 (has links)
Purpose: To assess possible correlations between clinical outcomes and SEM marginal analysis in a prospective
long-term clinical study using two adhesives in incisors and canines.
Materials and Methods: Thirty-five patients received class III and IV restorations with two different adhesives, either
the one-step self-etch adhesive iBond Gluma inside (1-SE) or the two-step etch-and-rinse adhesive Gluma Comfort
Bond (2-ER) combined with the fine particle hybrid composite Venus. The restorations were clinically evaluated
(modified USPHS criteria) over 90 months. Based on resin replicas, a quantitative marginal SEM analysis was performed
using the criteria “gap”, “perfect margin”, “overhang”, and “underfilled”. The results of the quantitative
marginal analysis were statistically compared and related to clinical evaluations. The SEM data were analyzed statistically
using the Kolmogorov-Smirnov test, Wilcoxon test, and mixed models test.
Results: Of the 35 subjects at baseline, 16 (1-SE) and 17 (2-ER) were clinically re-examined after 90 months. 13 patients
were included in the SEM analysis due to uninterrupted documentation over 90 months or until restoration
loss. SEM analysis showed larger discriminative power between groups than did the clinical examination, but the
trend was the same. Marginal analysis (“gap”, “perfect margin”) showed significant differences between the materials
after 12 months, which clinically began to show a trend from 12 months, and were statistically verified after 48
and 90 months. “Overhang” and “underfilled” did not reveal significant differences between the systems or over time.
Conclusion: SEM marginal analysis using the replication technique is a powerful tool to reveal differences between
adhesives. Compared to clinical evaluation, group differences can be detected earlier, with both outcome parameters
confirming each other over long observation periods.:1. Referat 3
2. Einführung in die Thematik 4
Grundlagen des Adhäsivverbundes 4
Adhäsivsysteme 5
Untersuchung des Adhäsivverbundes 7
Anforderungen an Testverfahren 7
Testverfahren 8
Rasterelektronenmikroskopische Analyse des Restaurationsrandes 9
Vorhersage des klinischen Erfolgs 10
3. Zielsetzung und Hypothesen 12
4. Publikation 13
5. Zusammenfassung der Arbeit 24
6. Literaturverzeichnis 28
7. Wissenschaftliche Veröffentlichungen 33
Im Rahmen der Promotion 33
Im Rahmen der Weiterbildung zur Fachzahnärztin für Oralchirurgie 33
8. Erklärung über die eigenständige Abfassung der Arbeit 34
9. Lebenslauf 38
10. Danksagung 39
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