Razi Journal of Medical Sciences

fa به کارگیری مدل آمیخته خطی چندسطحی در مقایسه آزمایشگاهی انبساط آبی سه نوع کامپوزیت Application of multilevel linear mixed model for experimental comparison of hygroscopic expansion in three composites آمار حیاتی Biostatistics پژوهشي Research زمینه و هدف: تخریب دندان یکی از علل شایع مراجعه بیماران به مراکز دندانپزشکی است. امروزه استفاده از کامپوزیت ها به علت هم رنگ بودن آن‌ها با دندان و سازگاری بیشتر با بافت دندان مورد استقبال و توجه زیادی قرار گرفته اند. انبساط آبی کامپوزیت‌ها یکی از مهم‌ترین مسائلی است که باعث کاهش کارایی آن‌ها می‌شود. هدف این مطالعه مقایسه انبساط آبی سه نوع کامپوزیت رایج است.<o:p /> روش کار: در این مطالعه طولی داده‌های آزمایشگاهی مربوط به سه نوع کامپوزیت (<span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shapetype id="_x0000_t75" stroked="f" filled="f" path="m@4@5l@4@11@9@11@9@5xe" o:preferrelative="t" o:spt="75" coordsize="21600,21600"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path o:connecttype="rect" gradientshapeok="t" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="_x0000_i1025" style="width: 19.5pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image001.png"> </v:imagedata></v:shape>، <span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 15pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image002.png"> </v:imagedata></v:shape> و <span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 25.5pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image003.png"> </v:imagedata></v:shape>) که به مدت 3 ماه در دو محیط آب و بزاق دهان قرار گرفتند، استفاده شد. حجم کامپوزیت ها 18 بار بر روی 540 نمونه مورد اندازه گیری قرار گرفت و میزان انبساط آبی آن ها با استفاده از مدل آمیخنه خطی چندسطحی و نرم افزار SAS نسخه 9.1.3 با یکدیگر مقایسه گردید.<o:p /> یافته ها: نتایج بررسی نشان دهنده موثر بودن زمان (001/0<span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 14.25pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image004.png"> </v:imagedata></v:shape>) و نوع کامپوزیت (032/0p=) برمیزان انبساط کامپوزیت‌ها بود و محیط نگهداری تاثیر معناداری بر روی انبساط آبی کامپوزیت‌ها نداشت. از بین کامپوزیت های مورد مطالعه، <span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 19.5pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image001.png"> </v:imagedata></v:shape> کمترین میزان افزایش حجم را داشت. به علاوه اثر تصادفی مربوط به هر نمونه نیز که نشان دهنده موثر بودن سایر عوامل محیطی بررسی نشده بر روی انبساط آبی است، معنادار شد (001/0<span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 14.25pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image004.png"> </v:imagedata></v:shape>).<o:p /> نتیجه‌گیری: نتایج نشان دهنده آن است که علاوه بر زمان و نوع کامپوزیت، عوامل محیطی دیگری نیز اثر معناداری بر انبساط آبی دارند. ولی با این وجود بهتر است که از کامپوزیت های مناسب‌تر که در طول زمان افزایش حجم کمتری می یابند (مانند <span style="top: 4pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -4.0pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 19.5pt height: 12pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image001.png"> </v:imagedata></v:shape>) برای ترمیم دندان‌ها استفاده شود.<o:p /> Background: Tooth damage is one of the most common reasons that patients visit the dentists. Nowadays composites are increasingly used in dentistry because they have the colour of tooth and are more compatible with tooth tissue. Hygroscopic expansion is one of the most reasons that reduce the efficacy of the composite. Main goal of this article is to compare the hygroscopic expansion of the three common composites.<o:p /> Methods: In this longitudinal study, laboratory data from three common composites (<span style="top: 5.5pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -5.5pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shapetype id="_x0000_t75" stroked="f" filled="f" path="m@4@5l@4@11@9@11@9@5xe" o:preferrelative="t" o:spt="75" coordsize="21600,21600"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:f></v:formulas> <v:path o:connecttype="rect" gradientshapeok="t" o:extrusionok="f"> <o:lock aspectratio="t" v:ext="edit"> </o:lock></v:path></v:stroke></v:shapetype><v:shape id="_x0000_i1025" style="width: 24.75pt height: 16.5pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image001.png"> </v:imagedata></v:shape> <span style="top: 5.5pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -5.5pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 20.25pt height: 16.5pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image002.png"> </v:imagedata></v:shape>, <span style="top: 5.5pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -5.5pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 33.75pt height: 16.5pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image003.png"> </v:imagedata></v:shape>) that were kept in two different environments (distilled water and natural mouth saliva) for three months were used. Their cylinder length was measured 18 times after preparation of 540 samples and their hygroscopic expansion was comprised using multilevel linear mixed model by SAS 9.1.3 software.<o:p /> Results: In this study both, time (p<0.001) and composite (p=0.032) were statistically significant and environment did not have significant effect. Composite <span style="top: 5.5pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -5.5pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 26.25pt height: 16.5pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image004.png"> </v:imagedata></v:shape> had the lowest hygroscopic expansion between the three underlying composites. Also, random effect of the intercept which showed the effect of unobserved factors on the response, was significant (p<0.001). <o:p /> Conclusions: Results showed that in addition to the time and composite type, there are other factors that do not exist in the model but affect the hygroscopic expansion. Nevertheless it’s better to choose the best composite that have the lowest hygroscopic expansion (like <span style="top: 5.5pt line-height: 115% font-family: "Calibri","sans-serif" font-size: 11pt position: relative mso-bidi-language: AR-SA mso-bidi-font-family: Arial mso-ascii-theme-font: minor-latin mso-fareast-font-family: "Times New Roman" mso-fareast-theme-font: minor-fareast mso-hansi-theme-font: minor-latin mso-bidi-theme-font: minor-bidi mso-text-raise: -5.5pt mso-ansi-language: EN-US mso-fareast-language: EN-US"><v:shape id="_x0000_i1025" style="width: 26.25pt height: 16.5pt" type="#_x0000_t75"> <v:imagedata chromakey="white" src="file:///C:UsersMRS~1.NAZAppDataLocalTempmsohtmlclip11clip_image004.png"> </v:imagedata></v:shape>) during the time.<o:p /> رگرسیون آمیخته خطی چندسطحی، انبساط آبی، کامپوزیت. Multilevel linear mixed model, Hygroscopic expansion, Composite. 1 7 http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1433&slc_lang=fa&sid=1 Nasim Vahabi نسیم وهابی 3900319475328460023741 3900319475328460023741 No Iran University of Medical Sciences دانشگاه علوم پزشکی ایران Masoud Salehi مسعود صالحی 3900319475328460023742 3900319475328460023742 Yes Iran University of Medical Sciences دانشگاه علوم پزشکی ایران Farid Zayeri فرید زایری 3900319475328460023743 3900319475328460023743 No Shahid Beheshti University of Medical Sciences دانشگاه علوم پزشکی شهید بهشتی Hassan Torabzadeh حسن تراب زاده 3900319475328460023744 3900319475328460023744 No Shahid Beheshti University of Medical Sciences دانشگاه علوم پزشکی شهید بهشتی