后牙超瓷聚体嵌体3年临床疗效观察

目的:观察后牙超瓷聚体嵌体的临床疗效。方法:前磨牙及磨牙Ⅰ类洞患者345例,随机分为2组:超瓷聚体嵌体组170例(前磨牙42颗,磨牙128颗),复合树脂嵌体组175例(前磨牙45颗,磨牙130颗)作为对照。随访3年后,从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂、颜色匹配等方面进行比较,采用χ2检验进行统计学处理。结果:超瓷聚体嵌体组获得随访166例、复合树脂嵌体组获得随访169例,超瓷聚体嵌体组边缘着色2例、边缘密合158例、外形完整162例、基牙继发龋1例、修复体折裂5例、颜色匹配161例;复合树脂嵌体组边缘着色27例、边缘密合134例、外形完整150例、基牙继发龋20例、修复体折裂5例、颜色匹配146例。超瓷聚体嵌体组在边缘着色、边缘密合度、外形完整、基牙继发龋、颜色匹配等方面优于复合树脂嵌体(P<0.05),但在修复体折裂方面无显著差异(P>0.05)。结论:超瓷聚体嵌体是一种较好的新型牙体修复体。     

一体化氧化锆嵌体修复后牙牙体缺损2年临床疗效观察

目的观察一体化氧化锆嵌体修复后牙牙体缺损的临床疗效。方法选择45位患者共60颗患牙行一体化氧化锆嵌体修复,修复完成后、修复体戴用1年、2年后,从修复体的边缘密合度、解剖形态、基牙继发龋、颜色匹配、磨损与折裂几个方面评价修复体的临床疗效。结果一体化氧化锆嵌体的性能在修复体戴用1年、2年后较修复完成时无显著性改变（P〉0．05）。结论一体化氧化锆嵌体修复后牙牙体缺损具有良好的临床疗效。     

IPS Empress 2全瓷嵌体修复的疗效评价

目的　研究IPSEmpress 2全瓷嵌体修复后牙缺损的临床效果。 方法　IPSEmpress 2全瓷嵌体修复双尖牙和磨牙 313颗 ,从边缘适应性、边缘着色、解剖形态、颜色匹配性、基牙继发龋和修复体折断等方面进行临床评价。结果　经过 6～ 5 1个月的临床追踪观察 ,IPSEmpress 2全瓷嵌体在外形、边缘着色、基牙继发龋方面情况良好。结论　IPSEmpress 2全瓷嵌体修复近期可以取得良好的修复效果。     

Gradia微瓷聚合复合树脂嵌体修复牙体缺损的临床研究

目的：观察Gradia微瓷聚合复合树脂嵌体修复牙体缺损的临床疗效。方法：53例后牙牙体缺损病例采用Gradia微瓷聚合复合树脂嵌体进行修复共125件。分别于修复后2、6、12、24个月进行随访观察,评价修复体完整度、边缘适合度、外形及颜色匹配等。结果：随访125件修复体,均无继发龋发生,其中109例修复体完好,具有良好的边缘密合度,107例颜色匹配,5例修复体折裂,临床合格率87.2%。结论：Gradia微瓷聚合树脂嵌体能满足牙体缺损修复的临床要求。     

Ceramage聚合瓷嵌体在后牙牙体缺损修复中的应用

目的:研究Ceramage聚合瓷嵌体用于后牙牙体缺损修复的临床疗效.方法:前磨牙及磨牙Ⅱ类洞患者130例(共165颗)随机分为两组:制作Ceramage聚合瓷嵌体85件、IPS Impress Ⅱ铸瓷嵌体80件做为对照.随访2年,比较两组嵌体颜色、形态、边缘密合度、基牙继发龋、修复体折裂、牙龈指数、菌斑指数等指标.结果:两组嵌体在颜色、形态、边缘密合度、基牙继发龋、牙龈指数、菌斑指数等指标上无显著性差异;在修复体折裂方面,Ceramage聚合瓷嵌体组优于IPS Impress Ⅱ铸瓷嵌体组.结论:Ceramage聚合瓷嵌体是一种较好的新型牙体缺损修复体.     

树脂嵌体修复儿童第一磨牙大面积缺损的临床疗效观察

目的：观察树脂嵌体用于修复儿童第一磨牙牙体大面积缺损的临床效果。方法：采用间接法复合树脂嵌体修复技术,修复儿童第一磨牙牙体大面积缺损28例,随访观察18个月以上。采用USPHS评价标准,分别从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂方面进行评价。结果：观察18个月以上,除一例出现牙体部分折裂外,其余27例临床效果满意。结论：应用复合树脂嵌体修复第一磨牙牙体大面积缺损,能有效恢复年轻恒牙牙体外形和邻接关系,临床效果满意。     

CAD/CAM全瓷嵌体与复合树脂嵌体修复后牙Ⅱ类洞临床疗效对比分析

目的：对比分析CAD/CAM全瓷嵌体与复合树脂嵌体修复后牙Ⅱ类洞的临床疗效。方法：选择在解放军总医院口腔内科就诊的后牙Ⅱ类洞患者193例（共226颗牙）,根据患者意愿,其中101颗采用CAD/CAM全瓷嵌体修复,其余125颗采用复合树脂嵌体修复,分别在术后6个月、12个月、18个月进行随访,观察其修复体磨耗、折裂、脱落、边缘密合性、边缘着色及继发龋等情况。结果：2种嵌体在修复体磨耗及边缘着色的差异有统计学意义（P〈0.05）,在修复体折裂、修复体脱落、继发龋和边缘密合性的差异无统计学意义（P〉0.05）。CAD/CAM全瓷嵌体的成功率为：96.84%,树脂嵌体的成功率为：81.05%,两组之间成功率的差异有统计学意义（P〈0.05）。结论：在后牙Ⅱ类洞缺损的修复治疗中,CAD/CAM全瓷嵌体的效果优于复合树脂嵌体。     

树脂嵌体修复和纳米复合树脂充填磨牙大面积缺损的疗效比较

目的研究间接树脂嵌体修复和纳米复合树脂直接充填磨牙大面积牙体缺损的临床疗效。方法将200颗大面积缺损磨牙分为2组。试验组87颗,采用间接树脂嵌体修复;对照组113颗,用纳米复合树脂直接充填。评价标准采用改良USPHS评价标准。治疗后1年分别对边缘着色、边缘密合度、解剖形态、继发龋、修复体折裂进行评价。结果试验组复诊率为87.4%,复诊76颗患牙,74颗成功,2颗存在缺陷,分别为边缘着色1颗,边缘完整性破坏1颗,无失败牙;对照组复诊率为76.4%,复诊94颗,81颗成功,7颗存在缺陷,主要为边缘着色,边缘完整性破坏、磨损、邻接关系破坏,失败6颗,主要为修复体折裂和脱落。经统计学分析,间接树脂嵌体修复成功率明显高于纳米复合树脂直接充填,差异有统计学意义（χ^2=6.55,P〈0.01）。结论间接树脂嵌体修复磨牙大面积牙体缺损临床疗效优于纳米复合树脂直接充填。     

Tilite含钛医学合金嵌体修复后牙缺损的近期疗效观察

目的评价Tilite含钛医学合金嵌体修复后牙缺损的近期临床疗效。方法收集磨牙龋损病例，共157例214颗患牙，采用Tifite含钛医学合金嵌体修复。临床追踪观察2年，评价其形态、基牙继发龋、修复体边缘密合度、修复体磨耗及折断情况。结果132例患者176件嵌体保持随访，随访率为82．2％。176件嵌体随访期内失败5件，其中3件脱落，继发牙髓炎2件，成功率97．2％；其余171件嵌体2年随访，边缘适应性的合格率为98．8％，修复体形态的合格率是100．0％，磨损和折裂的合格率是100．0％，无基牙继发龋。结论Tilite含钛医学合金嵌体修复后牙缺损的近期疗效好。     

嵌体修复牙体组织缺损过程中的护理

用银汞合金修复牙体缺损由来已久,但由于其性能的限制,对于修复后牙严重缺损者,仍存在一些不足,如牙体或修复体易折裂、边缘易出现继发龋等。嵌体是一种嵌入牙体内部,用以恢复牙体形态和功能的修复体。用嵌体修复后牙邻牙合面洞,由于嵌体为整体铸造完成的修复体,本身折裂几乎不可能;另外,具有良好的边缘封闭性和咬合接触关系,还可免除汞污染,近年在牙体组织缺损修复中得到越来越广泛的应用。嵌体的制作包括以下几个步骤:医生根据嵌体的适应证选择患牙,进行基牙预备、取模、倒模,嵌体的技工制作、试戴,黏结。在这几个步骤中,除了嵌体的技工制…     

Marginal breakdown of 5-year-old direct composite inlays

Objectives: The marginal fit of tooth-coloured inlays luted with composite resin luting materials has been considered to be the weak link of the inlays. The marginal breakdown of 5-year-old direct composite resin inlays was evaluated by scanning electron microscopy.

Methods: Replica impressions were made of the occlusal, axial-proximal and accessible cervical-proximal margins of 21 inlays and the marginal quality was quantified.

Results: More than 84% of the total investigated length of the enamel/luting composite agent-luting composite/composite inlay interfaces revealed gap free margins. Proximal margins showed the largest breakdown at the enamel/composite resin interface, while the occlusal margin interfaces showed only a slight difference between the interfaces. The composite inlay and the luting composite resin showed a similar degree of wear in more than 50% of the evaluated marginal length. Medium gap width varied between 60 μm for the occlusal and axial-proximal and 87 μm for the cervical-proximal margins, with a range of 7.6–266 μm.

Conclusion: The direct composite inlays investigated showed good marginal integrity after 5 years in clinical service.     

Poss复合树脂嵌体与牙体间微渗漏的研究

目的：比较Poss复合树脂嵌体与其余3种临床常用复合树脂嵌体与牙体间的微渗漏情况,为临床选择提供依据。方法：将40颗离体牙随机分成4组,每组10颗,按照国际标准,备Ⅱ类洞,分别用Poss,Z250,Solidex,Sol-itaire2树脂制作嵌体,恒温保存,品红染色后,近远中方向剖开牙体,体视显微镜下观察每组嵌体龈壁和轴壁的微渗漏最显著部位,并测量3次取平均值。结果：Poss复合树脂嵌体与牙体间微渗漏最小,其余3种无统计学差异。结论：Poss复合树脂可以考虑作为临床嵌体材料。     

Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years

Objectives

This longitudinal randomized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years.

Methods

21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth (89 adult patients) luted with dual-curing resin cements. Clinical evaluation was performed up to 4 years using modified USPHS criteria.

Results

87.2% of Artglass and 76.6% of Charisma inlays were assessed to be clinically excellent or acceptable. Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms, bulk fracture, and loss of marginal integrity. No significant differences between both composite resin materials could be detected at 4 years for all clinical criteria (Mann-Whitney U-test, p > 0.05). The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms (p < 0.05), deterioration of surface texture quality, marginal and restoration integrity (p < 0.05) for both inlay systems. However, the changes were mainly effects of scoring shifts from alfa to bravo. Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays (p < 0.05). For Charisma inlays no such influences were revealed.

Conclusions

Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2% and 5.9% that is within the range of published data. Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations.     

两种全瓷材料用于后牙嵌体修复的疗效评价

目的 对比研究IPS Empress可铸陶瓷系统和In-ceram全瓷系统用于后牙嵌体修复的临床疗效。方法 分别制作IPS Empress瓷嵌体28件和In-ceram瓷嵌体30件。在戴用修复体0.5-3年后，比较两种瓷嵌体的颜色，形态，基牙龋患率，修复体边缘的密合度，修复体的磨耗及折断情况。结果 IPS Empress瓷嵌体的透明度和颜色优于In-ceram瓷嵌体，而In-ceram瓷嵌体的磨耗，折断情况优于IPS Empress瓷嵌体，在修复体的形态，基于龋患率，修复体边缘密合度方面两者差别无显著性（P＞0．05）。结论IPS Empress瓷嵌体用于美观要求较高时效果较好In-ceram瓷嵌体则适合修复He力较大的情况。两种瓷嵌体都是一种修复效果好的全瓷材料。     

A 2-year clinical study of composite and ceramic inlays

Objective long-term clinical data are necessary to evaluate the performance of dental restorations. This prospective clinical trial evaluated composite and ceramic inlays for clinical acceptability as restorative materials in posterior teeth and provided 2-year results. The study involved 7 student operators placing 47 composite inlays (Tetric, blend-a-lux, Pertac) and 24 ceramic inlays (Empress) under the supervision of an experienced dentist. Clinical assessment of 56 inlays (78.9%) was performed after 2 years with modified USPHS criteria and statistically analyzed using the Mann-Whitney U test and Fisher’s exact test. All the ceramic inlays and 90% of the composite inlays were considered clinically excellent or acceptable. During the first year 3 composite inlays failed and during the second evaluation period 1 had to be replaced. Ceramic inlays produced significantly better ”anatomic form of the surface” (P=0.038) and ”integrity of the restoration” values (P=0.043). Inlays in small cavities exhibited superior ”marginal integrity” (P=0.026) and ”marginal discoloration” values (P=0.034). Fisher’s test revealed a significantly higher failure rate in molars than in bicuspids (P=0.034). Posterior tooth- colored inlays exhibited a success rate of 100% for ceramic inlays and 90% for composite inlays even if placed by relatively inexperienced but supervised student operators. Received: 4 June 2000 / Accepted: 3 August 2000     

PANAVIA^TM F粘接系统粘接后牙Ⅱ类洞嵌体的临床效果

目的观察PANAVIATMF系统粘接后牙Ⅱ类洞钛合金和全瓷嵌体的临床效果。方法对后牙邻面、龈边缘在釉牙骨质界下方的Ⅱ类缺损进行全瓷嵌体或钛合金嵌体修复,并分析PANAVIATMF粘接系统的粘接效果。结果所有后牙全瓷嵌体或钛合金嵌体2年内的各项临床指标均在可接受的范围内。结论PANAVIATMF粘接系统粘接全瓷嵌体或钛合金嵌体修复后牙Ⅱ类洞缺损有较好的短期效果。     

One-year clinical evaluation of composite fillings and inlays in posterior teeth

In the course of a prospectively designed long-term clinical trial, composite fillings and inlays were evaluated for clinical acceptability as restorative materials in one, two or more surface cavities of posterior teeth over a 1-year period. In 45 patients, 88 restorations were placed by nine student operators, under the supervision of an experienced dentist, to compare the two half sides using the composite resins Tetric (Vivadent), blend-a-lux (Blend-a-med), and Pertac-Hybrid Unifil (Espe). The first clini-cal follow-up check took place within a time period of 11 – 13 months after placement of the restorations using modified USPHS criteria. The interpretation of the clinical criteria showed satisfactory results over this time period: more than 85% of the inlays and direct fillings were rated ``alpha' or ``bravo', using the parameters of assessment defined in this study. Only three restorations (two fillings, one inlay), all in molars, were rated ``delta', i. e., unacceptable. The reasons for their replacement were mar-ginal opening, secondary caries, and loss of sensitivity. For the criteria ``surface texture', ``anatomical form of the surface', and ``occlusion', composite inlays were significantly better than composite fillings. These results indicate that posterior composite restorations provide acceptable and excellent clinical service, even if they are placed by relatively inexperienced student operators.     

Clinical and semiquantitative marginal analysis of four tooth-coloured inlay systems at 3 years

Objectives: The marginal quality of four tooth-coloured inlay systems was clinically investigated and subjected to computer-aided semiquantitative marginal analysis under scanning electron microscopy (SEM) after 3 years of clinical service.

Methods: Three of the restoration types were made using the Cerec CAD-CAM apparatus: one was milled from preformed glass ceramic blocks, and the two other inlay types were milled from preformed porcelain blocks. The fourth system was based on an experimental indirect resin composite inlay system. Each inlay type was luted with a different luting resin composite. The clinical evaluation was performed with a mirror and explorer by two clinicians separately, and the marginal analysis was conducted microscopically on replicas (SEM × 200).

Results: After 3 years in situ, all the restorations were clinically acceptable. No recurrent caries was observed. Marginal analysis under SEM detected a high percentage of submargination for all four systems, which suggests that their respective resin composite luting agents were all subject to wear. The percentage of marginal fractures on the enamel side as well as on the inlay side did not increase dramatically compared to the 6-month results.

Conclusion: The first recall after 6 months of clinical service indicated how tooth-coloured inlays behave at their margins. The 3-year results confirmed the early findings, indicating that wear of resin composite lutes is important and present in all systems. The two ceramic materials showed a similar behaviour at the margins. The resin composite inlay performed better at the inlay site than at the enamel site.