TY  - BOOK
AU  - Mohamed Mohamed Sabry Mohamed, 
AU  - Omaima Mohamed Safwat
AU  - Dina Mounir El kady
TI  - Clinical evaluation of self- adhesive bulk-fill resin composite versus conventionally bonded bulk-fill resin composite in restoration of proximal lesions over a period of 18 months follow-up: A Randomized Clinical Trial / 
U1  - 617.605 
PY  - 2023///
KW  - Oral Surgry
KW  - qrmak
KW  - self- adhesive bulk-fill resin composite
KW  - bulk- fill resin composite
KW  - proximal lesions
N1  - Thesis (Ph.D)-Cairo University, 2023; Bibliography: pages 103-107.; Issues also as CD
N2  - Aim: The current clinical investigation aimed to compare and contrast the clinical efficacy of self- adhesive bulk fill resin composite and traditionally bonded bulk fill resin composite in the restoration of proximal lesions during the course of 18 months.
Methodology: In a parallel study design, forty participants with carious proximal lesions were assigned at random to the intervention (Surefil-one) and comparison (bulk-fill) groups. All ingredients were used in accordance with the directions provided by the manufacturer. Two blinded assessors evaluated restorations at initial screening (one week), six months, twelve months, and 18 months using modified USPHS criteria measuring (marginal adaption, marginal discoloration, surface roughness, anatomic form, postoperative sensitivity, recurrent caries, and retention analysis). 

Results: Intergroup comparisons of both materials revealed no differences of statistical significance in marginal adaptation (P = 0.0952), recurrent caries (P = 0.8728), postoperative sensitivity (P = 0.5936), or retention analysis (P = 0.3173). whereas there was a difference of statistical significance between both materials for marginal discoloration after 18 months (P = 0.0235), surface roughness after 12 and 18 months (P = 0.0013 and P = 0.0001 respectively), and anatomic form after 18 months (P = 0.0023).
Conclusions: Over an 18-month test time frame, self-adhesive bulk-fill resin composite hybrid (surefil-one) revealed clinically less satisfying performance when compared to traditionally bonded bulk-fill resin composite; ﻓﻲ ﺗﺼﻤﯿﻢ اﻟﻔﻢ اﻟﻤﻮازي ، ﺗﻢ أﺧﺘﯿﺎر أرﺑﻌﻮن ﻣﺸﺎر  ًﻛﺎ ﯾﻌﺎﻧﻮن ﻣﻦ آﻓﺎت ﻣﺘﺎﺧﻤﺔ )ﻣﻦ اﻟﺪرﺟﺔ اﻟﺜﺎﻧﯿﺔ( ﺑﺸﻜﻞ ﻋﺸﻮاﺋﻲ وﺗﻢ ﺗﺮﻣﯿﻢ ﻋﺪد
ﻋﺸﺮون ﻓﺠﻮة  ﺑﺄﺳﺘﺨﺪام ﻛﺒﺴﻮﻻت ﺗﺤﺘﻮي ﻋﻠﻰ ﻣﺮﻛﺐ راﺗﻨﺞ ذاﺗﻲ اﻟﻠﺼﻖ ﻛﺘﻠﻲ اﻟﻤﻠﺊ و ﺗﻢ أﺳﺘﺨﺪام ﻣﺮﻛﺐ اﻟﺮاﺗﻨﺞ ﻛﺘﻠﻲ اﻟﻤﻠﺊ ذو
اﻟﻠﺼﻖ اﻟﺘﻘﻠﯿﺪي ﻓﻲ ﻋﺸﺮون ﻓﺠﻮة أﺧﺮى , ﺗﻢ اﺳﺘﺨﺪام ﺟﻤﯿﻊ اﻟﻤﻮاد وﻓﻘًﺎ ﻟﺘﻌﻠﯿﻤﺎت اﻟﺸﺮﻛﺎت اﻟﻤﺼﻨﻌﺔ. ﺗﻢ ﺗﻘﯿﯿﻢ اﻟﺘﺮﻣﯿﻤﺎت ﺑﺎﻟﻨﺴﺒﺔ اﻟﺘﻜﯿﻒ اﻟﮭﺎﻣﺸﻲ ، ﺗﻐﯿﺮ اﻟﻠﻮن اﻟﮭﺎﻣﺸﻲ ، ﺧﺸﻮﻧﺔ اﻟﺴﻄﺢ ، اﻟﺸﻜﻞ اﻟﺘﺸﺮﯾﺤﻲ ، ﺣﺴﺎﺳﯿﺔ ﻣﺎ ﺑﻌﺪ اﻟﺠﺮاﺣﺔ ، اﻟﺘﺴﻮس اﻟﻤﺘﻜﺮر ، وﺗﺤﻠﯿﻞﺑﻘﺎء
اﻟﺤﺸﻮة وﺗﻤﺎﺳﻜﮭﺎ  ﻋﻨﺪ ﺑﺪء اﻟﺪراﺳﺔ )أﺳﺒﻮع واﺣﺪ(،.ﺑﻌﺪ ﺳﺘﺔ أﺷﮭﺮ ، ﺑﻌﺪ ۲۱ ﺷﮭ  ًﺮا ، وﺑﻌﺪ ۸۱ ﺷﮭ  ًﺮا ﺑﻮاﺳﻄﺔ ﻟﺠﻨﺔ ﺗﻘﯿﯿﻢ ﻣﺪرﺑﺔ طﺒﻘﺎ
ﻟﻨﻈﺎم اﻟﺘﻘﯿﯿﻢ اﻟﻤﻌﺪل اﻟﺨﺎص ﺑﺎﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ ﻓﻲ اﻟﻮﻻﯾﺎت اﻟﻤﺘﺤﺪة اﻻﻣﺮﯾﻜﯿﺔ criteria) USPHS .(Modified

ﺗﻢ إﺟﺮاء ﻣﻘﺎرﻧﺎت ﺑﯿﻦ اﻟﻤﺠﻤﻮﻋﺎت ﺑﯿﻦ اﻟﺘﺪﺧﻼت ﺑﺎﺳﺘﺨﺪام اﺧﺘﺒﺎر Chi-Squared ﺑﻤﺴﺘﻮى دﻻﻟﺔ إﺣﺼﺎﺋﻲ ﻣﺤﺪد ﻋﻨﺪ )٥۰٫۰ (P=
      ، وأﺟﺮﯾﺖ ﻣﻘﺎرﻧﺎت ﺑﯿﻦ اﻟﻤﺠﻤﻮﻋﺎت داﺧﻞ ﻛﻞ ﺗﺪﺧﻞ ﺑﺎﺳﺘﺨﺪام اﺧﺘﺒﺎر Chi-Squared ﻣﻊ ﻣﺴﺘﻮى دﻻﻟﺔ إﺣﺼﺎﺋﻲ ﻣﺤﺪد ﻋﻨﺪ )۳۸۰۰٫۰(P= ﺑﻌﺪ ﺗﺼﺤﯿﺢ Bonferroni . ﺑﻌﺪ ۸۱ ﺷﮭ   ًﺮا ، ﻟﻢ ﺗﻈﮭﺮ اﻟﻤﻘﺎرﻧﺔ ﺑﯿﻦ اﻟﻤﺠﻤﻮﻋﺎت ﺑﯿﻦ ﻛﻠﺘﺎ اﻟﻤﺎدﺗﯿﻦ أي ﻓﺮق ﻣﻌﺘﺪ ﺑﮫ
إﺣﺼﺎﺋﯿﺎ ﻟﻠﺘﻜﯿﻒ اﻟﮭﺎﻣﺸﻲ ) ۲٥۹۰٫۰(P= ، واﻟﺘﺴﻮس اﻟﻤﺘﻜﺮر )۸۲۷۸۰٫۰(P= ، وﺣﺴﺎﺳﯿﺔ ﻣﺎ ﺑﻌﺪ اﻟﺠﺮاﺣﺔ )٦۳۹٥٫۰(P= ،
وﺗﺤﻠﯿﻞ اﻻﺣﺘﻔﺎظ )۳۷۱۳٫۰.(P= ﺑﯿﻨﻤﺎ  ﻛﺎن  ھﻨﺎك  ﻓﺮق  ذو  دﻻﻟﺔ  إﺣﺼﺎﺋﯿﺔ ﺑﯿﻦ ﻛﻠﺘﺎ  اﻟﻤﺎدﺗﯿﻦ  ﻟﻠﺘﻐﯿﺮ  اﻟﮭﺎﻣﺸﻲ  ﺑﻌﺪ  ۸۱  ﺷﮭ  ًﺮا
)٥۳۲۰٫۰(P= وﺧﺸﻮﻧﺔ اﻟﺴﻄﺢ ﺑﻌﺪ ۲۱ و ۸۱ ﺷﮭ ًﺮا )۳۱۰۰٫۰P= و ۱۰۰۰٫۰P= ﻋﻠﻰ اﻟﺘﻮاﻟﻲ( واﻟﺸﻜﻞ اﻟﺘﺸﺮﯾﺤﻲ ﺑﻌﺪ 18 ﺷﮭ ًﺮا )۳۲۰۰٫۰.(P= ﻓﯿﻤﺎ ﯾﺘﻌﻠﻖ ﺑﺎﻷداء اﻟﺴﺮﯾﺮي ، أظﮭﺮت ﻛﻠﺘﺎ اﻟﻤﺎدﺗﯿﻦ ا\ درﺟﺎت ﻣﻘﺒﻮﻟﺔ ﺳﺮﯾﺮﯾﺎ ﻓﻲ ﻏﺎﻟﺒﯿﺔ اﻟﻤﻌﺎﯾﯿﺮ )ﺑﺎﺳﺘﺜﻨﺎء اﻟﺘﺮﻣﯿﻤﺎت
اﻟﻔﺎﺷﻠﺔ.(

اﻟﺨﻼﺻﺔ:
ﻓﻲ ظﻞ ﻗﯿﻮد اﻟﺪراﺳﺔ اﻟﺤﺎﻟﯿﺔ ﯾﻤﻜﻦ اﺳﺘﺨﻼص اﻻﺳﺘﻨﺘﺎﺟﺎت اﻟﺘﺎﻟﯿﺔ:
۱. ﻋﻨﺪ ﻣﻘﺎرﻧﺘﮭﺎ ﺑﻤﺮﻛﺐ اﻟﺮاﺗﻨﺞ ﻛﺘﻠﻲ اﻟﻤﻠﺊ ذو اﻟﻠﺼﻖ اﻟﺘﻘﻠﯿﺪي، أظﮭﺮ ﻣﺮﻛﺐ اﻟﺮاﺗﻨﺞ ذاﺗﻲ اﻟﻠﺼﻖ ﻛﺘﻠﻲ اﻟﻤﻠﻲء أداء أﻗﻞ إرﺿﺎء
ﺳﺮﯾﺮﯾﺎ ﺧﻼل ﻓﺘﺮة اﺧﺘﺒﺎر ﻣﺪﺗﮭﺎ ۸۱ ﺷﮭ  ًﺮا.

۲. ۲. ﻧﻈ  ًﺮا ﻟﺒﻌﺾ اﻟﻤﺨﺎوف ﻓﻲ اﻟﻤﻌﺎﻟﺠﺔ ووﻗﺖ اﻟﺘﻄﺒﯿﻖ، ﻻ ﯾﻤﻜﻦ اﻋﺘﺒﺎر ﻣﺮﻛﺐ اﻟﺮاﺗﻨﺞ ذاﺗﻲ اﻟﻠﺼﻖ ﻛﺘﻠﻲ اﻟﻤﻠﻲء ﺧﯿﺎرا أﻗﻞ ﺣﺴﺎﺳﯿﺔ
ﻟﻠﺘﻘﻨﯿﺔ ﻋﻨﺪ ﻣﻘﺎرﻧﺘﮫ ﺑﺎﻟﻤﻮاد اﻟﺘﺮﻣﯿﻤﯿﺔ اﻟﺘﻘﻠﯿﺪﯾﺔ.
اﻟﺘﻮﺻﯿﺎت اﻟﻌﻤﻠﯿﺔ:
۱ .ﻟﺘﺄﻛﯿﺪ اﻟﻨﺘﺎﺋﺞ اﻟﺤﺎﻟﯿﺔ ، ﯾﻠﺰم إﺟﺮاء ﺗﺠﺎرب ﺳﺮﯾﺮﯾﺔ ذات أوﻗﺎت ﻣﺘﺎﺑﻌﺔ أطﻮل وأﺣﺠﺎم ﻋﯿﻨﺎت أﻛﺒﺮ.
۲ .ﻟﺪﻋﻢ اﺳﺘﺨﺪام اﻟﻤﻮاد اﻟﺠﺪﯾﺪة ﻓﻲ اﻟﺘﻄﺒﯿﻘﺎت اﻟﻌﻼﺟﯿﺔ اﻟﻤﺘﻨﻮﻋﺔ ، ﯾﻮﺻﻰ ﺑﺈﺟﺮاء ﺗﺠﺎرب إﻛﻠﯿﻨﯿﻜﯿﺔ ﻟﺘﻘﯿﯿﻢ أداء أظﮭﺮ ﻣﺮﻛﺐ راﺗﻨﺞ
ذاﺗﻲ اﻟﻠﺼﻖ ﻛﺘﻠﻲ اﻟﻤﻠﺊ.
۳. ﯾﻤﻜﻦ اﺳﺘﺨﺪام ﻣﺮﻛﺐ اﻟﺮاﺗﻨﺞ ذاﺗﻲ اﻟﻠﺼﻖ ﻛﺘﻠﻲ اﻟﻤﻠﻲء ﻛﺒﺪﯾﻞ ﺳﺮﯾﺮي أﻗﻞ ﺣﺴﺎﺳﯿﺔ ﻟﻠﺘﻘﻨﯿﺔ ﻓﻲ اﻟﺘﺮﻣﯿﻤﺎت اﻟﻤﺘﻮﺳﻄﺔ ﻗﺼﯿﺮة اﻟﻤﺪى
ER  -