[牙合]力对楔状缺损发病的影响

目的：探讨咬合力与楔状缺损发病的关系。方法：应用T-ScanII型咬合检测仪对楔状缺损患牙及其对侧无缺损的同名牙（对照牙）的正中[牙合][牙合]力值进行测量,并分析其与楔状缺损严重程度的关系,结果进行统计学分析。结果：楔状缺损患牙[牙合]力值大于对照牙[牙合]力值,组间差异具有显著性（P〈0.001）;楔状缺损磨损指数与年龄之间无线性相关关系,但与[牙合]力值之间具有线性正相关关系（r=0.6807）。结论：楔状缺损患牙的[牙合]力值明显高于对照牙,并与磨耗指数呈正形线性相关关系,[牙合]力因素在楔状缺损的发病中起重要作用。     

AngleⅡ类错(牙合)畸形患者牙弓宽度的测量分析

目的：比较分析AngleⅡ类错[牙合]畸形患者牙弓宽度及其牙弓形态特点。方法：选择AngleⅡ^1类错[牙合]畸形患者（平均年龄15．6岁）、AngleⅡ^2类错[牙合]畸形患者（平均年龄15．8岁）和对照组AngleⅠ类轻度错[牙合]畸形患者（平均年龄16．2岁）的原始模型各40副,测量每副模型的上下尖牙、第一前磨牙、第二前磨牙、第一磨牙之间的距离,计算上、下颌对应牙弓宽度差;对各组各项牙弓宽度和牙弓宽度差进行t检验。结果：AngleⅡ^1类错[牙合]畸形患者上颌牙弓宽度较AngleⅠ类轻度错[牙合]畸形患者狭窄,但差异无显著性（Jp〉0．05）,AngleⅡ^1类错[牙合]畸形患者下颌牙弓宽度与AngleⅠ类轻度错[牙合]畸形患者无显著差异（P〉0．05）;AngleⅡ^2类错[牙合]畸形患者上颌中、后牙弓宽度和下颌牙弓宽度较AngleⅠ类轻度错[牙合]畸形患者的牙弓宽度窄,差异有显著性（P〈0．05）;AngleⅡ^1类错[牙合]畸形患者下颌牙弓宽度比AngleⅡ^2类错[牙合]畸形患者下颌牙弓宽大,差异有显著性（P〈0．05）;AngleⅡ^1类错[牙合]畸形患者上下颌宽度差小于AngleⅠ类轻度错[牙合]畸形患者,尖牙、第二前磨牙处差异有显著性（P〈0．05）;AngleⅡ^2类错[牙合]畸形患者上下颌牙弓宽度差与AngleⅠ类轻度错[牙合]畸形患者无显著差异（P〉0．05）;AngleⅡ^1类错[牙合]畸形患者上下颌牙宽度差比AngleⅡ^2类错[牙合]畸形患者小,尖牙处宽度差差异有显著性（P〈0．05）。结论：AngleⅡ^1、AngleⅡ^2错[牙合]畸形患者上颌牙弓以及AngleⅡ^2错[牙合]畸形患者下颌牙弓宽度发育均有不足．治疗中可适当进行扩弓。     

Teetester对于楔状缺损危险因素的初步探讨

目的：探讨引起楔状缺损的危险因素。方法：应用Teetester咬合分析系统对30例患者的420颗上颌牙齿进行咬合观测，记录早接触患牙、分离时间及力百分比，通过统计学方法分析楔状缺损的危险因素。结果：上颌各类楔状缺损患牙中，前磨牙占比最高，为46.49%；64颗早接触牙齿中42颗伴有楔状缺损，经卡方检验，Pearsonχ2=25.732，P<0.001，OR=4.0，95% 置信区间（2.282~7.015），提示早接触与楔状缺损的发生有统计学意义；26颗分离时间过长牙齿中17颗伴有楔状缺损，经卡方检验，Pearsonχ2=9.285，P<0.05，OR=3.427，95%置信区间（1.489~7.890），提示分离时间与楔状缺损的发生有统计学意义；对比41颗楔状缺损患牙与对侧同名正常牙所受力大小，差异具有统计学意义（P<0.05）；对比43颗楔状缺损深度较深的患牙与对侧楔状缺损深度较浅的同名患牙所受力大小，差异具有统计学意义（P<0.05）。结论：上颌前磨牙区是楔状缺损的易患区域；早接触、分离时间及力大小是楔状缺损的危险因素。     

女性骨性Ⅱ类错[牙合]患者20例非拔牙矫治上颌牙槽弓宽度的变化

目的分析女性骨性Ⅱ类错[牙合]非拔牙矫治上颌牙槽弓宽度的变化及对矫治效果的影响。方法选择女性骨性Ⅱ类错[牙合]不拔牙矫治患者20例,使用口外弓颈牵引及固定矫治器联合治疗,测量分析矫治前后记存模型上颌第一磨牙、第一前磨牙、尖牙间牙槽弓宽度的变化。结果上颌第一磨牙、第一前磨牙及尖牙牙槽弓宽度矫治后分别增加了2.39、3.17和1.65mm,与矫治前相比均有显著性差异（P〈0.05）。结论通过扩大腭弓改善上颌牙槽弓宽度的不调在骨性Ⅱ类错[牙合]不拔牙矫治中是非常重要的。     

老年人牙齿楔状缺损危险因素的Logistic回归分析

目的：分析老年人牙齿楔状缺损的患病情况并探讨其相关因素。方法：采用分层随机抽样，对大连市631例60岁以上老年人，使用Smith和Knight牙齿磨损指数（TWI）进行楔状缺损患病情况的调查，数据应用SPSS13．0统计软件进行Logistic多因素回归分析。结果：该组人群楔状缺损患病率为86．67％，52例147颗患牙舌侧有不同程度的楔状缺损。年龄、牙龈退缩、近中错骀、咬合面磨损、偏侧咀嚼、横向刷牙方法，以及刷牙频率是该病形成和发展的危险因素。结论：老年人牙齿形成楔状缺损受多因素影响，其危险因素是年龄、牙龈退缩、近中错[牙合]、咬合面磨损、偏侧咀嚼、横向刷牙方法以及刷牙频率。     

安氏Ⅱ类1分类错(牙合)咬合功能的研究

目的：研究安氏Ⅱ类1分类错[牙合]患者的咬合功能状况。方法：用T—scanⅡ系统4．02版记录26名安氏Ⅱ类1分类错[牙合]患者在牙尖交错位（ICP）的[牙合]力总值（TOF）、[牙合]力不对称指数（AOF）、[牙合]接触点数（NOC）、[牙合]接触面积不对称指数（AOA）、[牙合]力中心点的位置（COF）、[牙合]力中心点的最大位移（MMCOF）及黯干扰指数（OII），并与26名正常黯者的同一指数对照分析。结果：错黯组TOF低于正常黯组，有显著统计学差异（P〈0．01）；错骀组NOC与正常胎组无统计学差异（P〉0．05）；错[牙合]组AOF，AOA，COF，MMCOF，OII均高于正常[牙合]组，有统计学差异（P〈0．01）。结论：安氏Ⅱ类1分类错[牙合]患者两侧咬合不平衡，可能存在[牙合]干扰等相关病症，应及时进行矫正，以消除明显的咬合不利因素。     

纤维桩对穿髓型楔状缺损抗折性修复的临床对比观察

目的：针对穿髓型楔状缺损牙颈部抗力薄弱易折断的潜在隐患,评价不同修复术式对牙颈部抗折性能的临床效果。方法：临床随机选择穿髓型楔状缺损患者48例,（牙合）面完整,男性20例,女性28例,年龄45-73岁。其中第一前磨牙28例（上颌19例,下颌9例）,第二前磨牙9例（上颌6例,下颌3例）;尖牙11例（上颌8例,下颌3例）。在（牙合）面开髓根管治疗后,将所有患者随机分为A、 B两组各24颗牙,以2种术式分别进行修复。 A组：（牙合）面及楔状缺损处以Filtek Z350 XT纳米树脂完成修复; B组：根管纤维桩粘固后（牙合）面及楔状缺损处以Filtek Z350 XT纳米树脂完成修复。结果：临床观察2年, A组出现6例颈部折断, B组未出现颈部折断,经卡方检验连续校正公式计算,χ^2=4.68, P〈0.05,说明是否使用纤维桩修复与牙颈部折断间有统计学差异,使用纤维桩可增强牙颈部抗折断力。结论：在穿髓型楔状缺损根管内粘固玻璃纤维桩的一端,再以复合树脂将纤维桩的另一端与牙冠粘接,使纤维桩、树脂、整个牙齿（冠与根）三者整合为一体,不但增强了颊颈部修复体的固位,更提高了牙颈部的抗折性能,是一种合理、微创的牙颈部抗折修复形式,较好地体现了整体修复理念。     

安氏Ⅱ^类错[牙合]与正常[牙合]牙弓宽度的研究

目的：以正常[牙合]为对照,研究安氏Ⅱ^1类错[牙合]牙弓宽度的特点。方法：选择12～16岁的安氏Ⅱ^1类错[牙合]和正常[牙合]各60例,取标准研究模型,利用3DSS（光栅扫描仪）扫描后,以Geomajic软件进行图像拟合处理,并测量上下颌牙弓前、中、后段长度,分析安氏Ⅱ^1类错[牙合]与正常[牙合]牙弓宽度的差异。结果：①.正常[牙合]男性上下颌牙弓宽度均比女性大,其中上颌牙弓及下颌后段牙弓宽度有显著性差异（P〈0.05）。②.安氏Ⅱ^1类错[牙合]男性上下颌牙弓宽度均大于女性,其中上颌牙弓后段及下颌牙弓前段、后段宽度有显著性差异（P〈0.05）。③.安氏Ⅱ^1类错[牙合]无论男女,上颌牙弓后段宽度明显小于正常[牙合],有显著性差异（P〉0.05）。结论：安氏Ⅱ^1类错[牙合]患者上颌牙弓小于正常[牙合]牙弓,治疗时应扩展上颌后段牙弓使腭侧倾斜的后牙颊倾,或用牙弓与基骨联合扩展的方法加大上颌后段牙弓宽度,利于下牙弓前移,建立正常的磨牙关系。     

不同拔牙模式正畸矫治对成年女性牙弓宽度和软组织正貌的影响

目的：研究不同拔牙模式对安氏Ⅱ1错牙合成年女性治疗前后牙弓宽度和面部软组织正貌的影响。方法：将40例安氏Ⅱ1错牙合需拔牙矫治的成年女性患者随机分为两组。 A组拔除上颌2颗第一前磨牙,下颌拔除2颗第二前磨牙,B组拔除4颗第一前磨牙。分析比较两组病例治疗前后牙弓宽度和面部软组织正貌指标的变化。结果：正畸治疗后,组内比较显示两组病例上下颌尖牙间宽度均增加,上下颌第一磨牙间宽度均减小,差异有统计学意义（P＜0.05）;组间比较仅下颌尖牙和下颌第一磨牙间宽度变化有统计学意义（P＜0.05）,B组下颌尖牙宽度增加量大于A组,B组下颌第一磨牙牙弓宽度减小量小于A组。治疗前后比较,两组病例在面宽、口裂宽、下颌角间宽、容貌面长和鼻下颏下距的差异均无统计学意义（P＞0.05）。Pearson相关性分析显示牙弓宽度与软组织正貌指标之间无相关关系（P＞0.05）。结论：安氏Ⅱ1错牙合病例正畸矫治后成年女性软组织正貌的变化不受拔牙模式影响,不同拔牙模式仅影响矫治后牙弓宽度的变化。     

中老年人群牙颈部非龋性缺损与（牙合）面磨损的临床分析

目的：调查中老年人群牙颈部非龋性缺损（NCCL）与（牙合）面磨损发生情况,并对两者的发病因素和相互关系进行探讨。方法：对568名45岁及以上机关干部,使用Smith和Knight牙齿磨损指数（TWI）进行牙颈部非龋性缺损与（牙合）面磨损的患病情况调查。结果：该研究人群NCCL的患病率为73．24％,（牙合）面磨损患病率为87．50％。NCCL和（牙合）面磨损的患病率和严重程度与性别和年龄相关,发生（牙合）面磨损的患牙更易发生NCCL,反之亦然（P〈0．05）。该人群的磨牙症史、饮食习惯及刷牙方法与NCCL和（牙合）面磨损的发生没有明显相关性。结论：牙颈部非龋性缺损与（牙合）面磨损在中老年人中较常见,两者的发生有一定的联系,（牙合）力、机械摩擦和时间为其发生的共同因素,但加重原因不尽相同。     

The anatomy of non-carious cervical lesions

Objective

The term “non-carious cervical lesion” (NCCL) describes a dental hard tissue defect of unknown origin. Two very distinct variations are known: wedge-shaped and saucer-shaped lesions. Reasons for occurrence of two forms might include different contributing factors.

Methods

Forty-two teeth, 19 wedge-shaped and 23 saucer-shaped lesions, were analysed by light and confocal laser scanning microscopy (CLSM) to investigate presence of calculus and organic matter, surface structure of the lesion, borders of the lesion, and potential fractures in the dental hard tissues.

Results

One hundred percent of the wedge-shaped teeth showed evidence of additional abrasion (incisal/occlusal surface) but only 70 % of the saucer-shaped teeth. In most teeth, the edge was rounded. Tiny grooves parallel to the cemento-enamel junction (CEJ) were present in 11 % of the wedge-shaped and in 39 % of the saucer-shaped lesions. Seventy-nine percent wedge-shaped and 52 % saucer-shaped lesions had some sort of apposition. Eighty-eight percent of all teeth had dead tracts, 62 % of which were located directly next to the defect (in the lesion). In 48 %, sclerotic dentin was present right next to the defect (in the lesion). Tertiary dentin was visible in 60 %. Not a single fracture was detected.

Conclusion

Different characteristics associated with each type of cervical lesion support the theory of different aetiology or at least of differing contributions from different factors that participate in the development of NCCLs.

Clinical relevance

Only knowledge of the correct aetiology of NCCLs will allow the best treatment and prevention for such lesions.     

The cervical wedge-shaped lesion in teeth: a light and electron microscopic study

Background:  The cervical non-carious wedged-shaped lesion is controversial in that its aetiology may involve attrition, erosion, abrasion and stress-corrosion (abfraction). This study examined the histopathology of anterior teeth with cervical wedge-shaped lesions by light and electron microscopy to elucidate their pathogenesis.
Methods:  Ten undecalcified human teeth with cervical lesions were available for investigation. Patency of the dentine tubules was tested using red dye penetration from the pulp chamber. The morphology of normal and sclerotic dentine adjacent to the cervical wedge-shaped lesions was investigated by scanning electron microscopy. The numbers and diameters of dentinal tubules were measured at different levels beneath the surfaces of the lesions.
Results:  The gross and microscopic features of the worn teeth were described. Red dye penetration tests showed white tracts of sclerotic tubules contrasted with red tracts of patent tubules. Numbers of tubules per square area and diameters of patent and sclerotic tubules varied at different levels within the dentine due to deposits of intratubular dentine.
Conclusions:  The cervical wedge is shaped by interactions between acid wear, abrasion and dentinal sclerosis. No histopathological evidence of abfraction was found. Clinical diagnosis, conservation and restoration of non-carious cervical lesions need to take into account the extent of sclerotic dentine beneath wedge-shaped lesions.     

老年病人磨牙缺失后前磨牙楔形缺损和面磨耗的临床研究

目的:研究前磨牙楔形缺损和面磨耗在磨牙缺失老年病人的发生情况。方法:收集磨牙缺失而前磨牙保留完整的老年病人22例,共174个前磨牙,观察并记录前磨牙楔形缺损和面磨耗的情况。研究设置对照组,即双侧后牙牙弓完整的老年病人20例,共160个前磨牙。比较两组楔形缺损和面磨耗的发生情况并进行统计学分析。结果:磨牙缺失组中,前磨牙2度以上楔形缺损144个,检出率83%,面磨耗至牙本质暴露112个,检出率64%。对照组中,2度以上楔形缺损的前磨牙81个,检出率为51%,牙合面磨耗至牙本质暴露66个,占检出率41%。统计结果显示:磨牙缺失组前磨牙楔形缺损和面磨耗的检出率明显高于对照组(P<0.05)。结论:老年病人磨牙缺失发生楔形缺损和面磨耗较后牙牙弓完整者可能性高。力过大可能是导致前磨牙楔形缺损和面磨耗加重的一个重要原因。     

Wedged cervical lesions produced by toothbrushing

PURPOSE: To compare the morphology of experimentally induced cervical toothbrush abrasion lesions to teeth demonstrating non-carious cervical lesions in vivo. METHODS: Eighteen premolars extracted for orthodontic reasons were each subjected to 80 hours (1.4 million strokes) of horizontal brushing in a custom fabricated toothbrushing machine. Toothpaste slurry was applied continuously and specimens were subjected to 300 gms of toothbrushing force. Denture base resin was used to simulate gingival recession of 1 mm and a sulcus width of 0.1 mm. Cervical abrasions were analyzed by optical and scanning electron microscopy and classified as either V-shape/wedged vs. U-shape/rounded lesions. When lesions exhibited both shapes, they were classified as mixed. Shapes of experimentally induced lesions then were compared to naturally occurring ones found on extracted premolars. RESULTSts: Experimentally induced toothbrush abrasion duplicated the classical clinical shapes. Half (9/18) of the experimentally induced toothbrush abrasions exhibited wedged lesions, 28% (5/18) showed a mixed wedged/rounded lesion, and 22% (4/18) showed rounded lesions. Serial photography showed progression of the morphology of the lesions. Toothbrush abrasion apparently begins apical to the cemento-enamel junction, progresses to dentin, and then undermines enamel with loss of the original cemento-enamel junction. Wedged lesions may appear with the apex oriented coronal or apical, or may be symmetrical.     

Examining the prevalence and characteristics of abfractionlike cervical lesions in a population of U.S. veterans.

BACKGROUND: Abfraction is believed to be caused by biomechanical loading forces. It may be due to flexure and ultimate fatigue of tooth tissues that occur away from the point of occlusal loading. Other possible causes of cervical lesions include toothbrush abrasion and erosion. The purpose of this study was to investigate the characteristics and prevalence of abfraction-like lesions in a population of U.S. veterans. METHODS: The authors evaluated 103 teeth with noncarious cervical lesions in 32 subjects and characterized them based on the surface on which the lesion was located, history of toothbrush abrasion, size of the lesion, presence of plaque, surface texture, and presence and size of occlusal wear facets. RESULTS: Clinical examination revealed that adjacent control teeth had a significantly lower percentage of surfaces with plaque than did teeth with cervical lesions. Control teeth also had significantly less gingival recession than did affected teeth. Seventy-five percent of subjects reported a history of using a firm toothbrush, and 78.1 percent reported using a brushing technique that is known to cause toothbrush abrasion in the affected area. Affected teeth had neither significantly different occlusal wear facets nor occlusal contacts than control teeth. No significant correlations were found between cervical lesion dimensions and facet area. CONCLUSIONS: Toothbrush abrasion is strongly suspected as contributing to the formation of the majority of wedge-shaped lesions in this group of subjects. A small subset of lesions is thought to have resulted from some other phenomenon. Although the presence or contribution of occlusal stresses in the direct formation of these lesions could not be measured directly, the possibility of abfraction could not be eliminated. CLINICAL IMPLICATIONS: Because the existence of abfraction could not be ruled out in about 15 percent of the cases, teeth with noncarious, wedge-shaped lesions warrant careful occlusal evaluation, with the possible need for occlusal adjustment or bitesplint therapy to treat bruxism.     

牙颈部非龋性硬化牙本质经自酸蚀粘结剂处理后的超微形态

目的:观察牙颈部非龋性硬化牙本质经一步法自酸蚀粘结剂处理后树脂—牙本质界面的超微结构变化。方法:实验组选择因牙周病拔除的有典型牙颈部非龋性缺损的前磨牙,使用一步法自酸蚀粘结剂AdperPrompt L-Pop处理硬化牙本质表面,并用树脂修复缺损。对照组为正畸拔除的正常前磨牙,人工机械制备牙颈部楔形缺损。扫描电镜观察自酸蚀处理后硬化牙本质表面的超微形态以及树脂—牙本质界面的微观表现。结果:牙颈部非龋性硬化牙本质表面的牙本质小管大部分被柱状的矿化结晶体堵塞。自酸蚀粘结剂AdperPrompt L-Pop酸蚀不能去除小管内的矿化结晶。硬化牙本质与树脂的粘结界面可见到树脂突,但与正常牙本质比较,树脂突的数量较少、长度较短。结论:硬化牙本质的粘结特性与正常牙本质存在差异。树脂突的数量及长度不足可能影响硬化牙本质的粘结。     

楔状缺损深度与合面磨损指数的Spearman等级相关分析

目的　探讨楔状缺损与牙合面磨损发病率的相关性及二者程度的相关性 ;分析二者在发生和加重方面的共同因素。方法　随机选取口腔内科就诊的患者 393例 ,调查活髓双尖牙 ,记录年龄、性别、刷牙习惯、咀嚼习惯、疲劳微裂、楔状缺损深度 (mm)与磨损指数 (TWI) ,进行统计学分析。结果　楔状缺损与牙合面磨损的发病率具有相关性 ,楔状缺损深度与牙合面磨损指数在一定范围内呈正相关 ,等级相关系数有极显著性意义。楔状缺损与磨损同时发生的患者中 ,喜用力刷牙并长期使用横刷法的占 74 % ;喜爱咀嚼耐磨食物或硬物的占 6 7% ;疲劳微裂发生率为 95 % ;男性发病率与病损程度均高于女性 ;随年龄增加 ,楔状缺损与磨损的发病率与程度均有所增加。结论　牙合力与机械摩擦是二者发生的共同因素。时间因素 ,机械摩擦与牙合力积累是二者共同的加重因素     

上颌前磨牙非龋性颈部缺损修复的有限元研究

目的:探讨充填治疗非龋性颈部缺损时,洞型设计、窝洞深度及充填材料和咬合调整因素的影响。方法:构建成人上颌第一前磨牙三维有限元模型,其颊侧颈部有不同洞型(楔形、矩形和弧形)和窝洞深度(0.5mm、1.0mm和1.5mm),模拟用玻璃离子黏固剂(GIC)、复合树脂和银汞合金充填,计算模型在正常的侧向、垂直向加载及创伤的侧向、垂直向加载时,应力值和应力分布。结果:正常颊侧颈部主要为拉应力,近根尖向出现压应力,应力分布较均匀;创伤时主要也为拉应力但应力集中,且较正常产生更大的应力。2种咬合状态在侧向加载都比垂直向产生更大应力和加重应力集中。不同窝洞深度间应力差异小,但有深度加深、应力变大的正相关性。深度0.5mm、1.0mm的楔形、弧形和矩形洞型差异小。但在1.5mm时,矩形洞型产生的应力远大于楔形(约4倍),楔形洞型应力略大于弧形(0.8～4.1MPa)。相同条件下,银汞合金充填体界面应力值大于GIC和复合树脂(3～9倍),GIC小于复合树脂(0.2～2.4MPa)。结论:窝洞较浅时,洞型不是影响治疗的首要因素,窝洞较深则应避免矩形洞型。     

The Effects of Occlusal Loading on the Margins of Cervical Restorations

BackgroundResearchers have proposed the restoration of abfraction lesions, but limited information is available about the effects of occlusal loading on the margins of such restorations. Because abfraction is a well-recognized problem, the authors conducted a study to assess the effects of occlusal loading on the margins of cervical restorations.MethodsThe authors prepared 40 wedge-shaped cavities in extracted premolars and restored them with a resin-based composite. They subjected specimens to occlusal loading (150 newtons, 10⁶ cycles) on the buccal cusp, on the central fossa or on the lingual cusp, and they stored the control group specimens in deionized water. The authors used fluorescein to delimit marginal defects and evaluated the defects by using laser scanning confocal microscopy.ResultsResults of χ² and Kruskal-Wallis tests (P < .05) showed that specimens subjected to occlusal loading had a higher percentage of marginal gaps (53.3 percent) than did the control specimens (10.0 percent). There were no differences between groups in marginal defect formation or in defect location, length or width.ConclusionsOcclusal loading led to a significant increase in gap formation at the margins of cervical resin-based composite restorations.Clinical ImplicationsThe clinician cannot underestimate the effects of occlusal loading when restoring teeth with cervical wedge-shaped lesions. If occlusal loading is the main factor contributing to lesion formation, the clinician should identify and treat it before placing the restoration or otherwise run the risk that the restorative treatment will fail because of marginal gap formation.     

排龈联合流动树脂衬层技术修复楔状缺损临床疗效观察

目的：评估采用排龈联合流动树脂衬层技术修复楔状缺损的临床疗效。方法选择65例楔状缺损患者,每个患者的双侧上颌前磨牙均存在齐龈的4个楔状缺损（共260颗牙）,将每个患者的4颗楔状缺损牙随机分为Ⅰ、Ⅱ、Ⅲ、Ⅳ4组,分别用光固化复合树脂直接充填,排龈+光固化复合树脂直接充填,光固化流动树脂衬层+复合树脂充填,排龈+光固化流动树脂衬层+复合树脂充填4种方式进行修复,于修复后1年进行观察对比。以改良的美国公共卫生署的直接临床评价系统（USPHS）评估疗效,数据进行卡方检验。结果1年复查结果显示,色泽协调性、边缘着色、边缘密合性、表面形态4个方面,4组间A、B分级间差异均无统计学意义（P>0.05）。成功率方面Ⅰ组和Ⅳ组间差异有统计学意义（P<0.05）,Ⅳ组排龈+光固化流动树脂衬层+复合树脂充填临床疗效最好。结论排龈联合光固化流动树脂衬层技术,然后再行复合树脂充填是比较好的楔状缺损修复方式。