后牙病理性磨损树脂修复的临床效果探讨

目的:观察用直接树脂充填法和间接树脂充填法修复后牙病理性磨损的临床效果。方法:选择后牙牙合面有病理性磨损且具有充填空间的患者48例,患牙144颗,其中有牙本质过敏症状者38例98颗牙。患者按门诊顺序随机分为直接法修复组和间接法修复组2组各24例,在不备洞的情况下分别采用可乐丽菲露复合树脂直接或间接修复,比较治疗3个月及1年后树脂充填的临床效果、牙本质敏感情况和咀嚼效率改变情况。结果:治疗后3个月时复查,直接法和间接法两组患牙树脂充填体A级率无显著性差异(卡方检验,P>0.05);治疗1年后复查,间接法组患牙树脂充填体A级率优于直接法组,两组差异有统计学意义(卡方检验,P<0.05)。间接法组牙本质敏感治疗总有效率优于直接法组,两组差异有统计学意义(卡方检验,P<0.05)。治疗3个月及治疗1年后,间接法组的咀嚼效率高于直接法,两组差异有统计学意义(t检验,P<0.01)。结论:间接树脂法比直接树脂充填法修复后牙病理性磨损有较好的临床效果。

Clinical evaluation of resin composite restorations used to treat localised posterior tooth wear

Objective： To evaluate the clinical performance of direct and indirect resin composite restorations used to treat localized posterior tooth wear.Methods： A total of 144 pathological wore posterior teeth with restorable space in occlusal surface in 48 patients,98 of which in 38 patients with dentin sensitive symptom,were randomized block designed into two groups.The control group： 69 posterior teeth wear in 24 patients were filled with Clearfil AP-X resin composite directly.the experimental group： 75 posterior teeth wear in 24 patients were filled with Clearfil AP-X resin composite indirectly.The restorations were evaluated according to the modified the United States Public Health Service（USPHS） criterion after 3 months and 1 year.The patients’clinical symptom and masticatory efficiency were also compared before and after treatment.Results： There was no statistical difference between the two groups of the A rate after 3 months,while the A rate of the indirect filling group was significantly higher than that of the direct filling group（Chi square test,P 〈0.05） after 1 year’s treatment.The effective rate of dentin sensitive relief of the indirect filling group was also significantly higher than that of the control group（Chi square test,P 〈0.05）.The masticatory efficiency of the indirect filling group was higher than that of the control group.There was significantly statistical difference between the two groups（T test,P〈0.01）.Conclusion： The indirect resin composite restorations had a better clinical performance than the direct resin composite restorations,which is a good choice for posterior tooth wear.