南通市1080例老年干部牙列缺损及修复情况的调查

目的 了解南通市1080例老年干部牙列缺损及修复情况。方法 对1 080例老年干部进行问诊及口腔检查。结果1 080例老年干部中缺牙者939例,患病率86.94％。缺牙修复者509例,修复率54.21％,其中不良修复体149例,占29.27％。结论 牙列缺损患病率高,患者修复率低,且义齿合格率也低。因而要及时修复缺牙,修复体要适应老年人的生理、心理特点。     

上海市离退休干部失牙及修复状况调查

目的：调查上海离退休干部的失牙和修复状况。方法：对415位离退休干部，其中男性339人，女性76人；年龄60－880岁，平均年龄66．72岁，进行统计分析。结果：总失牙率81．93％。受检人群中，全牙列缺失率2．17％，牙列缺损率79．76％。单颌牙列缺失（伴牙列缺损）率4．81％。人均失牙5．58只。缺失牙以第一磨牙和第二磨牙为多，以下依次是第二双尖牙，第一双尖牙和前牙。人牙数最少的是尖牙。后牙缺失人数和失牙数目显多于前牙；失牙数随年龄而增多，男女性别差异无显性。失牙原因首先是龋病，占50．16％；牙周病其次，占28．38％；龋病合并牙周病占12．87％；外伤3．63％；其他4．29％。龋病失牙女性多于男性；牙周病失牙男性多于女性。失牙人群义齿修复率为45．29％。活动义齿占64．05％；固定义齿占35．95％。9．74％的人同时有2种修复体。修复体平均使用时间为7．74年，最长已达50年。活动义齿中不合格修复体占72．80％；固定义齿中不合格修复体占41．82％。结论：上海市离退休干部的牙齿状况值得关注。需要重新做义齿的比例甚高，为被检人群的72．29％。     

1312名大学生牙列缺损及修复情况调查分析

目的：调查1312名山东大学在校大学生牙列缺损及修复情况,为指导大学生口腔保健提供依据.方法：按照1997年世界卫生组织（WHO）《口腔健康调查基本方法》,对山东大学1312名大学生的牙列缺损及修复情况进行调查,调查方式包括问卷调查和口腔检查,对牙列缺损、修复情况与性别、年级、专业、城乡差异的关系,口腔健康行为和认知与专业的关系以及牙列缺损的原因进行统计分析.结果：1312名大学生中,牙列缺损者145名,牙列缺损发病率11.05％,主要病因为龋病.有义齿修复者53名,义齿修复率为36.55％.结论：大学生缺牙后修复情况不佳,且非医学专业学生口腔保健意识不强,需有针对性地制定口腔健康教育计划,提高大学生缺牙后修复率,促进大学生的口腔健康.     

老年患者的活动义齿修复

目的 了解老年人缺牙及修复情况。方法 依据本院门诊修复科就诊的７８５例老年人缺牙，缺牙病因及义齿修复情况。结果 ７８５例老年人中，缺牙者６２８全钻总人数的８０％，缺牙病因是龈病和牙周病，修复者３４２人，占５５％，接近其他调查，其中９７例为不良修复体。结论 积极开展老年人口腔卫生保健，修复体要适应老年人心理，生理特点，以提高义经及合格率。     

南京市411名老年干部牙齿缺失后修复情况的调查

本文调查了南京市411名老年干部牙齿缺失后的修复情况。牙齿缺失者350人,患病为率85.16％,缺牙修复者159人,修复率为45.43％,修复体共231件,其中不良修复体62件,占26.83％,主要原因为(牙合)(切)磨耗。牙列缺损患者不仅修复率低,而且义齿合格率也低,因而要及时修复缺失牙。修复前妥善处理余留牙,提出完整的治疗方案,修复体要适应老年人的特点,舒适、稳固,保护口腔组织,修复后应定期复查,避免产生不良修复体。     

佳木斯市老年患者缺牙原因及修复意愿分析

目的：了解老年患者缺牙原因及修复情况和修复意愿。方法：采用一例一卡制进行问诊和口腔检查。分析佳木斯市口腔医院500例就诊老年患者缺牙原因、就诊目的、修复意愿并进行分析。结果：500例患者中龋病是其缺牙的主要原因（占50.8%）,其就诊原因主要是影响咀嚼和美观（分别占42.4%,23.2%）,最终进行修复治疗的患者占80.8%,有10%的患者因不能接受修复前必须的基础治疗（牙体治疗、牙周治疗、拔除残根残冠等）而放弃修复。结论：应大力开展老年人口腔卫生保健和缺牙后及时修复必要性的卫生宣教工作,改善老年人口腔健康状况。     

老年缺牙患者口腔健康与就医心理调查分析

目的：了解老年修复患者口腔与全身健康特点,以及与修复有关的社会心理因素,为老年人群的修复工作提供有针对性的基础性资料。方法：采用问卷调查的方法,内容包括老年患者的背景资料、全身健康状况、自觉口腔健康状况、缺牙状况、对口腔健康知识的认知情况及就诊习惯等。结果：1.老年患者口腔中存在的问题主要依次为：牙齿松动（47.3%）,食物嵌塞（39.2%）,牙齿冷热过敏（27.0%）,口干（27.0%）等;2.牙周病及龋病仍是老年人缺牙的主要原因,占90.3%,一年以内修复的患者仅占58.3%,缺牙主要影响老年人进食,其次为发音,62.2%的患者不知道失牙后多长时间修复,对假牙的要求主要为咀嚼功能好（68.9%）及结实耐用（52.7%）。牙疼无法忍受才看牙者占47.3%;3.全身患有一种或多种系统性疾病者占66.2%。结论：1.老年缺牙患者口腔中存在较多问题,修复条件差;2.修复知识知晓率低,对口腔保健重视不够,对义齿要求主要为功能方面;3.全身健康状况不良。     

湖南省老年人牙齿缺失及修复情况抽样调查

目的了解湖南省老年人牙齿缺失及义齿修复情况。方法采用分层随机整群抽样的方法,对湖南省老年人牙齿缺失及义齿修复情况进行抽样调查。结果老年人牙齿缺失率为64.8%,无牙颌率为2.44%,义齿修复率为35.6%,牙齿修复率为41.8%。不同性别、城乡间牙齿修复率有差异（P〈0.05）,缺牙率差异无统计学意义（P〉0.05）;义齿修复种类以＂不良修复体＂所占比例最高。结论湖南省老年人牙齿修复率有待进一步提高,且要避免不良修复体。     

上海地区女性口腔健康状况分析

目的调查上海市女性口腔健康状况。方法选择13 788例来我院做健康体检的上海市女性,对龋病、牙周病、牙列缺损、义齿修复等情况进行分析研究。结果患龋率为27.3%,龋均为3.8,牙周病发生率为33.6%,牙列缺损占24.3%,义齿修复率为39.3%。中年组的患龋率和龋均高于青年组和老年组。口腔检查无异常的比例随年龄增加而降低。结论受检女性龋病、牙周病发病率高,牙列缺损多,口腔健康状况不容乐观。     

2112例绍兴市教师缺牙及修复情况的调查分析

目的：了解绍兴市教师牙列缺失、牙列缺损的特点及修复状况。方法：由专职口腔医生,统一标准,采取一例一表制,对2112名绍兴市教师进行口腔检查。调查结果采用SPSS11.5软件统计分析。结果：牙列缺损、牙列缺失的总患病率为41.34%,缺牙均数与年龄的增长成正比;缺牙患病率在男女性别上差异无显著性;缺牙修复率为55.56%。结论：应在教师中积极开展口腔卫生保健和缺牙后修复必要性的健康教育宣传,义齿设计及制作应符合口腔健康要求。     

排龈技术在牙体缺损修复中的应用

目的观察排龈对3MZ250复合树脂修复牙体缺损疗效的影响。方法选择31例120颗唇颊面牙颈部龋缺损牙,随机分为实验组和对照组,每组60颗,经窝洞预备后,实验组排龈线排龈后3MZ250复合树脂修复,对照组直接树脂修复,随访2年,评价修复体保存、继发龋以及边缘密合状况。结果充填后1周复查,使用排龈线组修复后悬突的发生率低于对照组,差异有显著性（P〈0．01）。充填后0．5年复查两组脱落率无明显差异;1年及2年后复查实验纽充填体的脱落率明显低于对照组（P〈0．05）。结论排龈可提高3MZ250复合树脂修复牙体缺损的修复体保存率,可以作为一项常规使用措施。     

ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years

Atraumatic restorative treatment (ART) consists of removing demineralised tooth tissues with hand instruments only, restoring the prepared cavity and sealing the adjacent pits and fissures with an adhesive filling material. This relatively painless, no-handpiece, minimal intervention approach to controlling dental caries is described. ART was applied in an oral health care programme in Zimbabwe that was carried out amongst secondary school students from 1994 to 1997. A new glass ionomer (Fuji IX) was used as the restorative and sealant material. Sealants were placed in high caries risk students using the ‘press-finger’ technique. A total of 297 one-surface ART restorations and 95 glass ionomer sealants were placed in 142 and 66 students, respectively. After 3 years, the lost-to-follow-up percentages for one-surface ART restorations and glass ionomer sealants were 30.6% and 30.5%, respectively. Actuarial (life table) analysis resulted in 3-year survival rates of one-surface ART restorations of 88.3% (95% CI: 92.4%–84.2%), ranging from 94.3% to 65.4% per operator. A total of 28 ART restorations placed in 25 students failed. Reasons for failure related to the material and the operator (11 restorations or 5.3% each), and to caries adjacent to the restoration (one restoration or 0.5%). Reasons for failure were not recorded for five restorations (2.3%). Seal-ants were placed on surfaces diagnosed as early enamel lesions. After 3 years, 71.4% (95% CI: 81.7%–61.1%) of the fully and partially retained sealants survived with a range of 100% to 55.6% per operator. Of the sealed surfaces 96.3% (95% CI: 100%–92.2%) survived 3 years without developing caries. Experienced operators placed better ART restorations than inexperienced operators. This study has demonstrated that ART with a glass ionomer restorative material and sealants provided high quality preventive and restorative dental care to this student population. ART has become one of the treatment modalities available to oral health workers in managing dental caries.     

Underestimation of the prevalence of approximal caries and inadequate restorations in a clinical epidemiological study

The prevalence of clinically diagnosed approximal caries and inadequate approximal restorations is usually underestimated, when compared with radiographic assessment as a 'gold standard'. OBJECTIVE: The aim of this study was to determine the degree of this underestimation in a clinical epidemiological project. METHODS: Clinical data (n = 951) of 17- and 23-year-olds were collected by calibrated examiners and bitewing radiographs were taken after obtaining the participant's consent. The radiographic examination of the approximal surfaces on the radiographs of 621 participants was based on criteria derived from the clinical protocol. A second examiner judged 20% of the radiographic material to determine the interobserver agreement, using Cohen's kappa. The agreement proved to be good (kappa = 0.66) for dentine caries diagnosis, and fair (kappa = 0.44) for restoration assessment. RESULTS: Of the total number of recorded decayed or inadequately restored surfaces only 10.8% and 13.8% respectively were found clinically. Of the total number of clinically sound surfaces, 10.1% had dentine caries on the bitewing radiograph. The percentage of clinically adequate restorations needing replacement was 25.7%. CONCLUSION: It was concluded that the prevalence of approximal caries and inadequate restorations in this clinical epidemiological study was highly underestimated. At least for these age groups the results contain a serious warning for epidemiologists and general dental practitioners with respect to the outcome of clinical caries diagnosis.     

Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial

BACKGROUND: Failure of dental restorations is a major concern in dental practice. Replacement of failed restorations constitutes the majority of operative work. Clinicians should be aware of the longevity of, and likely reasons for the failure of, direct posterior restorations. In a long-term, randomized clinical trial, the authors compared the longevity of amalgam and composite. SUBJECTS, METHODS AND MATERIALS: The authors randomly assigned one-half of the 472 subjects, whose age ranged from 8 through 12 years, to receive amalgam restorations in posterior teeth and the other one-half to receive resin-based composite restorations. Study dentists saw subjects annually to conduct follow-up oral examinations and take bitewing radiographs. Restorations needing replacement were failures. The dentists recorded differential reasons for restoration failure. RESULTS: Subjects received a total of 1,748 restorations at baseline, which the authors followed for up to seven years. Overall, 10.1 percent of the baseline restorations failed. The survival rate of the amalgam restorations was 94.4 percent; that of composite restorations was 85.5 percent. Annual failure rates ranged from 0.16 to 2.83 percent for amalgam restorations and from 0.94 to 9.43 percent for composite restorations. Secondary caries was the main reason for failure in both materials. Risk of secondary caries was 3.5 times greater in the composite group. CONCLUSION: Amalgam restorations performed better than did composite restorations. The difference in performance was accentuated in large restorations and in those with more than three surfaces involved. CLINICAL IMPLICATIONS: Use of amalgam appears to be preferable to use of composites in multisurface restorations of large posterior teeth if longevity is the primary criterion in material selection.     

Posterior dental restoration material choices in privately insured people in the United States, 2017 through 2019

BackgroundIn the context of evolving dental materials and techniques and a national agenda to phasedown use of dental amalgam, estimates of dental amalgam placement are necessary for monitoring purposes.MethodsNumbers of amalgam and composite posterior restorations from 2017 through 2019 were calculated using retrospective dental claims analysis of privately insured patients. Kruskal-Wallis and multilevel, multivariable negative binomial regression models were used to test for differences in rates of amalgam and composite restoration placement by age group, sex, urban or rural area, and percentage race and ethnicity area distribution. Statistical significance was set at 0.05, with Benjamini-Hochberg correction for false discovery rate.ResultsThe rate of amalgam restorations declined over time from a mean of 6.29 per 100 patients in 2017 to 4.78 per 100 patients in 2019, whereas the composite restoration rate increased from 27.6 per 100 patients in 2017 to 28.8 per 100 in 2019. The mean number of amalgam restorations placed per person were lowest in females compared with males, in urban areas compared with rural areas, and in areas with more than 75% non-Hispanic White residents.ConclusionsAmalgam restoration placements in privately insured people in the United States declined from 2017 through 2019. Amalgam restoration placements may be unevenly distributed by location.Practical ImplicationsAchieving further declines of dental amalgam use may require changes to insurance coverage, incentives, and provider training as well as augmented disease prevention and health promotion efforts. These efforts should focus particularly on groups with high caries risk or higher rates of amalgam placement.     

Five-year clinical performance of posterior resin composite restorations placed by dental students

OBJECTIVES: To investigate the survival over a five-year period of posterior resin composite restorations placed by students. METHODS: Class I and II resin composite restorations placed by second-fourth year dental students were evaluated. Patients attended the dental school every 6 months for a regular check-up during which all restorations were checked on their clinical acceptability. In case of replacement or repair of a restoration, this was registered in the patient's record. From each record the survival time and reasons for failure of resin composite restorations were gathered. RESULTS: Seven-hundred three posterior resin composite restorations in 382 patients (49% female and 51% male, age 22-78) were evaluated. At 5 years 560 of the 703 restorations were still considered to be "clinically acceptable". Forty-nine restorations were considered as "functionally present", of which 44 were restored with a crown and four had received a new restoration adjacent to the existing restoration without its removal. Ninety-four restorations had failed. The main reasons for failure were restoration fracture, caries, endodontic treatment, defective margin and lack of proximal contact. The survival rate of the restorations was 87% at 5 years, resulting in an annual failure rate of 2.8%. CONCLUSIONS: Dental students are able to place resin composite restorations in posterior teeth with an acceptable mean annual failure rate.     

Influence of patient factors on age of restorations at failure and reasons for their placement and replacement

OBJECTIVE: This study examined the reasons given by a selected group of dental practitioners for placement and replacement of restorations and correlated the data provided with patient factors, such as patients' age and gender, caries risk, occlusal function and oral hygiene, with restoration longevity. METHOD: A group of general dental practitioners (GDPs) were recruited to take part in the study. Each participant was asked to record the reason for placement or replacement of restorations from a list of potential reasons. The age and Class of the restoration being replaced was also recorded, as also was the material being used and the material being replaced. RESULTS: Details of reason for placement/replacement was received on 3196 restorations from 32 GDPs. Of the restorations placed, 54% were amalgam, 32% composite, 8% compomer and 7% glass ionomer. The reasons for placement/replacement of the restorations were principally primary caries (28%), secondary caries (29%), margin fracture (10%), tooth fracture (7%), and non-carious defects (6%). Overall, the mean age of restorations at failure was 7.1 years. Of the patients who received glass ionomer restorations, 29% were rated as having poor oral hygiene, compared with 18% of the patients who received amalgam restorations, 18% of the patients who received composite restorations and 23% of the patients who received compomer restorations. Of the patients who received glass ionomer restorations, 35% were rated as having high caries susceptibility, compared with 27% of those receiving amalgam restorations, 21% of those receiving composite restorations and 30% of those receiving compomer restorations. CONCLUSION: Primary caries was the principal reason for initial restorations. Secondary caries was the most prevalent reason for replacement of restorations. The results also indicate a selective application of different materials for different patients.     

Repair or replacement of defective restorations by dentists in The Dental Practice-Based Research Network

BackgroundThe authors aimed to determine whether dentists in practices belonging to The Dental Practice-Based Research Network (DPBRN) were more likely to repair or to replace a restoration that they diagnosed as defective; to quantify dentists' specific reasons for repairing or replacing restorations; and to test the hypothesis that certain dentist-, patient- and restoration-related variables are associated with the decision between repairing and replacing restorations.MethodsThis cross-sectional study had a consecutive patient and restoration recruitment design. Practitioner-investigators (P-Is) recorded data for consecutively seen restorations in permanent teeth that needed repair or replacement. The DPBRN is a consortium of dental practitioners and dental organizations in the United States and Scandinavia. The collected data included the primary reason for repair or replacement, tooth surface or surfaces involved, restorative materials used and patients' demographic information.ResultsP-Is collected data regarding 9,484 restorations from 7,502 patients in 197 practices. Seventy-five percent (7,073) of restorations were replaced and 25 percent (2,411) repaired. Secondary caries was the main reason (43 percent, n = 4,124) for treatment. Factors associated with a greater likelihood of repairing versus replacing restorations (P N/A .05) included having graduated from dental school more recently, practicing in a large group practice, being the dentist who placed the original restoration, patient's being of an older age, the original restorative material's being something other than amalgam, restoration of a molar and the original restoration's involving fewer tooth surfaces.ConclusionsDPBRN dentists were more likely to replace than to repair restorations. Secondary caries was the most common reason for repairing or replacing restorations. Certain dentist-, patient- and restoration-related variables were associated with the repair-or-replace decision.Clinical ImplicationsThe selection of minimally invasive treatment for an existing restoration is critical, as it may affect the longevity of the tooth.     

Placement, replacement and longevity of composite resin-based restorations in permanent teeth in Greece

Objectives: The aims of the present study were to assess the reasons for the placement and replacement of resin‐based composite (RBC) restorations in permanent teeth and to establish the longevity of replaced restorations. Methods: The study population consisted of 2,480 individuals attending a private practice. Clinical examination involved the evaluation of the numbers of decayed teeth (primary caries) and failed restorations, respectively, and the reasons for the placement and replacement of RBC restorations. In addition, possible associations between the placement and replacement of restorations and type of cavity, and the reasons for the placement and replacement of RBC restorations by tooth type were assessed. Statistical analysis was accomplished using the chi‐squared test. Results: A total of 3,528 restorations were identified; 2,046 (58%) of these were first‐time restorations and 1,482 (42%) were replacement restorations. The main reason for first‐time RBC restorations was primary caries (56%). Secondary caries was the most frequent reason for the replacement of RBC restorations (43%). Statistically significant differences were recorded between cavity type and first‐time (P = 0.0083) and replacement (P = 0.0067) restorations. No statistically significant differences were observed between tooth type and the reasons for first‐time (P = 0.067) or replacement (P = 0.073) RBC restorations. The median longevity of replaced restorations was approximately 4 years (39%). Conclusions: Primary and secondary dental caries were the principle reasons for first‐time and replacement restorations, followed by tooth and restoration discolouration, respectively. Therefore, patients at high risk for developing caries may require more frequent dental care.