Solidex瓷聚体嵌体修复后牙Ⅱ类窝洞的临床观察

目的 :评价Solidex瓷聚体制作嵌体修复后牙Ⅱ类窝洞的临床观察。方法 :60个Solidex瓷聚体嵌体修复后牙Ⅱ类窝洞 ,在修复后 1周、6个月、1年、2年时应用改良USPHS标准 ,对其解剖外形、边缘适合性、颜色匹配性、表面光洁度进行临床评价。结果 :所有嵌体都达到临床可接受范围。结论 :Solidex瓷聚体嵌体用于后牙Ⅱ类窝洞修复效果良好     

Targis瓷聚体用于后牙嵌体修复的临床评价

目的 对Targis瓷聚体用于后牙嵌体修复进行临床评价。方法 采用口外间接法，用Targis瓷聚体对113例后牙进行嵌体及高嵌体修复，分别于6个月、12个月、18个月进行复查，采用改良的USPHS标准进行临床评价。结果 Targis瓷聚体嵌体修复的边缘密合性、色调协调性1边缘着色、继发龋、表面质地等几项指标在18个月后无显著性改变；患者敏感性在12个月后全部消失，与术后即刻相比有显著性差异。结论 口外间接法使用Targis瓷聚体可作为后牙嵌体修复的一种可行的方法。     

全瓷嵌体修复后牙牙体缺损166例疗效分析

目的:全瓷嵌体修复后牙牙体缺损166例,分析其临床疗效.方法:全瓷嵌体应用于后牙牙体缺损修复,并与复合树脂嵌体作对照,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.结果:经过3年的临床观察,全瓷嵌体在边缘着色、基牙继发龋、解剖形态、颜色匹配等方面的临床疗效优于复合树脂嵌体.结论:全瓷嵌体是一种较好的新型牙体缺损修复体.     

复合树脂嵌体修复牙体缺损3年疗效观察

目的：观察复合树脂嵌体远期疗效。方法：用光固化复合树脂制成嵌体用于牙体I、Ⅱ、Ⅴ类洞的充填,并以单纯光固化复合树脂充填作为对照,观察3年疗效。结果：嵌体组515例,复查285例,成功率93.33%;对照组651例,复查362例,成功率67.68%。结论：复合树脂嵌体具有很好的远期疗效,是一种较好的新型牙体修复体。     

复合树脂嵌体充填牙体窝洞5年疗效观察

目的 观察复合树脂嵌体的远期疗效。方法 用光固化复合树脂制成嵌体应用于后牙,并以单纯光固化复合树脂充填的后牙作对照,观察治疗5a后的效果。结果 复合树脂嵌体有很好的远期疗效。结论 复合树脂嵌体是一种很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。     

瓷聚体嵌体的临床应用研究进展

嵌体是口腔修复中的一种常用修复体形式,其常用的材料有复合树脂、金属(包括贵金属和贱金属)和陶瓷.瓷聚体是一种新型的牙科材料,可应用于各种修复体.本文就瓷聚体的特点及近年来对瓷聚体.嵌体所做的研究作了综述.     

Ceramage 聚合瓷嵌体修复牙体缺损3年的临床疗效观察

用Ceramage聚合瓷嵌体和铸瓷嵌体分别修复大面积牙体缺损104例和94例。修复后1年复查2组各项指标差异无统计学意义(P>0.05)。修复后3年复查修复体折裂发生于聚合瓷嵌体(3.1%)铸瓷嵌体10.6%(P<0.05),其他指标组间无差异(P>0.05)。     

冠及嵌体修复后牙牙体缺损的临床疗效观察

后牙牙体缺损是牙体硬组织的常见病、多发病,目前临床有多种修复治疗方式,包括冠、嵌体、充填等,但对冠和嵌体这二种修复方式的成功率及比较报道较少。自1997年以来,我们对450例后牙牙体缺损的患者进行修复,并对修复满3年的病例进行随访观察,对远期疗效进行了比较。1材料与方法     

后牙复合树脂嵌体在牙体修复中的临床应用

1998年以来，应用复合树脂嵌体对215例牙体缺损患牙（主要用于[牙合]面洞、邻[牙合]面洞、牙颈部洞，要求患牙具有足够的健康牙体组织）进行充填修复，其中男112例，女103例，年龄18～60岁，报道如下。     

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     

Clinical efficacy of composite versus ceramic inlays and onlays: A systematic review

Objectives

Large tooth substance losses are frequent in posterior teeth because of primary caries or aging restorations. Inlays and onlays are often the minimal invasive solution in such cases, but the efficacy of the composite and ceramic materials used is unknown. We performed a systematic review of randomized controlled trials comparing the efficacy of composite and ceramic inlays or onlays.

Data sources

MEDLINE, Embase and the Cochrane Central Register of Controlled Trials were searched without any restriction on date or language, as were references of eligible studies and ClinicalTrials.gov.

Study selection

Eligible studies were randomized trials comparing the clinical efficacy of composite to ceramic inlays or onlays in adults with any clinical outcome for at least 6 months. From 172 records identified, we examined reports of 2 randomized controlled trials involving 138 inlays (no onlays evaluated) in 80 patients and exhibiting a high-risk of bias. Outcomes were clinical scores and major failures. The 3-year overall failure risk ratio was 2 [0.38–10.55] in favor of ceramic inlays although not statistically significant. The reported clinical scores (United States Public Health Services and Californian Dental Association) showed considerable heterogeneity between trials and could not be combined.

Conclusions

We have very limited evidence that ceramics perform better than composite material for inlays in the short term. However, this result may not be valid in the long term, and other trials are needed. Trials should follow Fédération dentaire internationale recommendations and enhance their methodology. Trials comparing composite and ceramic onlays are needed.     

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 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.     

Clinical and quantitative marginal analysis of feldspathic ceramic inlays at 4 years

The aim of this clinical study was to evaluate feldspathic ceramic inlays both by clinical criteria and quantitative margin analysis in continuation of an earlier, identically conducted 2-year study. Fifty feldspathic ceramic inlays were adhesively luted in Class II preparations with all margins located in enamel. The inlays were evaluated clinically according to modified USPHS criteria after 3 and 4 years. Quantitative margin analysis was performed with a scanning electron microscope (SEM). Clinically, the inlays showed no recurrent caries and no changes in colour, but superficial marginal discolouration (6%) was apparent after 4 years. Margins were perceptible clinically in 64% of the cases after 4 years. Quantitative margin analysis showed significantly more marginal gaps at the composite/ceramic interface than at the enamel/composite interface. There was neither a significant decrease in perfect margins nor a significant increase in marginal gaps and marginal imperfections at both interfaces between the third and fourth year. Clinically, the inlays performed very well up to 4 years. Clinical evaluation using an explorer only detected substance loss in the cementation gap. The SEM evaluation showed significantly higher changes in marginal qualities during the first 2-year interval of clinical service compared to the second 2-year interval following an exponential mathematical regularity. Quantitative margin analysis should be included in clinical long-term trials to detect early marginal deficiencies at the luting interfaces. Received: 1 September 1997 / Accepted: 31 October 1997     

Retrospective clinical investigation and survival analysis on ceramic inlays and partial ceramic crowns: results up to 7 years

This study retrospectively evaluated the clinical performance of 287 all-ceramic restorations placed during routine patient care in the University setting in the past 7 years. All patients (n = 106) with ceramic inlays or partial ceramic crowns (PCC), placed during 1988–1994 (n = 327) by five experienced dentists were asked to take part in a clinical investigation, and 92 patients with 287 restorations (232 inlays, 55 PCC) agreed to do so. The following ceramics were used: 44 (15.3%) Dicor (Dentsply), 126 (43.9%) IPS-Empress (Ivoclar), 82 (28.7%) Mirage II, 33 (11.5%) Cerec-Vita-Mark I (Vita), and 2 (0.7%) Duceram LFC (Ducera) restorations. The restorations were placed using the following luting composites: 73 (25.4%) Dual Cure Luting Cement (Optec), 81 (28.3%) Variolink high viscosity (Ivoclar), 32 (11.1%) Microfill Pontic C (Kulzer), 51 (17.8%) Dual Zement (Ivoclar), 40 (13.9%) Dicor Light Activated Cement (Dentsply), and 10 (3.5%) Vita Cerec Duo Cement (Vita). Restorations were evaluated according to the modified USPHS criteria. Kaplan-Meier analysis was used to calculate the probability of survival. Of the 287 restorations 270 (94.2%) were still in function without any need of intervention. Fourteen restorations (4.8%) had failed before starting the clinical investigation, and in three a fracture was found during the investigation. These 17 failed restorations consisted of 14 PCC and 3 ceramic inlays. The results of the clinical investigation revealed 59.2% Alpha-ratings for marginal adaptation. Only one restored tooth showed recurrent caries. The probability of survival (95% confidence interval) for 7 years was 98% (97.99–98.01%) for ceramic inlays and 56% (46–66%) for PCC. Our findings show that ceramic inlays can be regarded as an acceptable alternative to cast gold restorations within the methodological limitations of the present study. For PCC further experience with more recent ceramics is warranted. Received: 6 August 1998 / Accepted: 26 September 1998     

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.     

活髓后牙(高)嵌体修复2年的临床疗效及失败病例分析

目的 探讨活髓后牙较大缺损(两面或多面洞)嵌体修复2年的临床疗效及失败病例分析.方法 本研究为56位患者60颗患牙制作金钯嵌体33例、金钯高嵌体13例及铸瓷嵌体(Empress 2)14例,随诊2年,统计生存率,并用改良USPHS系统对2年的随访结果进行评估.结果 所有修复体2年生存率为90.0%,前磨牙与磨牙修复体及3种修复体间生存率无显著差异.按USPHS评估系统逐条分析发现铸瓷嵌体与金钯(高)嵌体在解剖形态、边缘密合度、继发龋坏、牙髓活力各项标准均一致.失败的主要原因是修复体脱落、牙髓炎、瓷崩裂和继发龋坏.结论 金钯(高)嵌体适合咬合力较大的患者,金钯高嵌体能保存活髓并最大程度恢复患牙的功能;在恰当选择适应证和遵守严格的生物力学原则下,使用牙色修复材料铸瓷嵌体能取得良好临床功能及美学效果.     

The clinical performance of ceramic inlays: a review

The availability of improved ceramic materials, bonding techniques, new technology and issues of amalgam safety have led to a revival of interest in ceramic inlays in dentistry over the past ten years. Clinical studies have been carried out during this time using various evaluation techniques to assess the clinical performance of these restorations. In this paper, recent clinical studies are examined and a review of the current state of knowledge regarding the clinical performance and survival statistics of ceramic inlays is presented. The major problems associated with ceramic inlay therapy appear to be fracture, hypersensitivity, degree of fit, maintenance of marginal integrity, microleakage, bond failures and cement wear. Other areas which also affect the clinical performance of ceramic inlays are ceramic wear, opposing tooth wear, plaque accumulation, gingivitis, secondary caries, colour stability, anatomic form and radiopacity. Recommendations based on the findings of clinical studies are also presented and whilst no specific material or technique has been shown to be clearly superior, certain principles which predispose to success can be identified. When compared with other forms of aesthetic intracoronal restorations, ceramic inlays perform well. However, their high cost and extreme technique sensitivity would appear to restrict their use to certain limited clinical situations.