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.     

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。     

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。     

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。     

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。     

两种方法修复老年患者磨牙牙体大面积缺损的对比性研究

目的:研究间接树脂嵌体修复和复合树脂直接充填磨牙大面积牙体缺损在老年患者中的临床疗效.方法:选择184例老年患者,将符合纳入标准的200颗患牙随机分为2组,分别以硬质树脂嵌体及复合树脂充填修复牙体外形.随访3年,参考美国公共健康会(USPHS)标准,对其临床效果进行观察.结果:2种方法在色泽匹配、边缘着色、龈指标、磨损程度及继发龋方面无统计学差异(P＞0.05);在邻接关系、边缘完整性及修复体折裂方面具有统计学意义(P＜0.05).结论:硬树脂嵌体修复比复合树脂充填能更好地恢复老年患者磨牙正常邻接关系,防止食物嵌塞,保持牙周组织健康.     

Ceramage聚合瓷嵌体修复牙体缺损疗效观察

目的    对Cermage聚合瓷高嵌体和多面嵌体修复根管治疗后大面积缺损的磨牙与前磨牙临床疗效进行评价。方法    选择2013年3—12月大连医科大学附属第一医院口腔科就诊的52例患者的54颗患牙,完善根管治疗后,按照嵌体预备原则行Ceramage聚合瓷高嵌体和多面嵌体修复,患者戴入修复体后即刻和1年后随访,参照美国公共健康协会（USPHS）的修正标准制定此次研究的嵌体评估标准。结果    修复后即刻检查修复体固位、边缘密合性、牙龈邻接关系以及修复体颜色匹配程度等,44颗聚合瓷嵌体试戴后参照各项嵌体评估标准均达到A级,修复效果满意;10颗修复体颜色与牙齿稍有差异,颜色匹配程度达到B级,修复体颜色的匹配性达81.5%。修复后1年随访率94.2%,失访3例;1年后再次检查评估,51颗修复体表面视诊、探诊均光滑,未出现粗糙面,边缘密合度好,未出现继发龋、牙体折裂,修复效果达到A级;3例修复体边缘有轻微着色,修复效果达到B级;9例修复体与牙体颜色和透明性有差异但不明显,修复效果达到B级;3例修复体与邻牙出现轻微食物嵌塞,但牙线可清除,牙龈稍有红肿,修复效果达到B级;36例修复体各项评估标准满意程度与可接受程度均达到100%。结论    Ceramage聚合瓷高嵌体和多面嵌体修复是用于后牙根管治疗后牙体缺损的一个优先考虑的选择。     

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。     

Clinical evaluation of class II Targis inlays: preliminary results after 1 year

The aim of this study was to evaluate the clinical performance of a new generation of restorative resin, Targis (Vivadent), in class II inlay restorations. Forty class II Targis inlays were placed (18 premolars, 22 molars) in 26 patients (mean age=25.5). All test teeth were vital. All restorations were in occlusion and were placed adhesively using Variolink II high viscosity (Vivadent) in combination with Syntac adhesive system under rubber-dam by the same operator. The restorations were evaluated at baseline and after 6 months and 1 year, according to modified United States Public Health Service (USPHS) criteria by two examiners. The parameters evaluated were: anatomical form, marginal adaptation, marginal discoloration, colour match, surface finish, gingival index and secondary caries. Post-operative sensitivity was determined by direct questioning. Regarding all of the clinical evaluation criteria all 40 inlays exhibited clinically acceptable scores after 1-year evaluation period. Relying on these early 1-year results, the new restorative material (Targis) seems to be promising in class II inlays.     

Clinical evaluation of different posterior resin composite materials: a 7-year report.

OBJECTIVES: The aim of this study was to investigate the clinical performance of 120 posterior composite restorations placed in 38 patients after a period of 7 years. METHOD AND MATERIALS: Eighty-eight Class I and 32 Class II restorations were made (93 molars and 27 premolars) using three different resin composite materials: Z100, Clearfil Ray-Posterior, and Prisma TPH. The restorations were evaluated using Ryge's criteria for color match, marginal discoloration, marginal adaptation, secondary caries, surface texture, and anatomic form at baseline, 1,2, 5, and 7 years. Photographs and radiographs were taken at each recall period. RESULTS: At 7-year recalls, 70 restorations were available for examination. Four restorations had failed due to secondary caries. Saliva sampling was performed to determine the level of mutans streptococci and lactobacilli for the four failed restorations at the last recall. No statistically significant differences were found among the materials in regard to color match, anatomic form, and secondary caries. Clearfil Ray-Posterior had statistically significantly rougher surface texture than the surrounding enamel compared to the other resin composites. Z100 showed more cavosurface margin discoloration after 5 years than the other two resin composites. All materials had slight marginal adaptation problems at the 7-year recall. There was no apparent relationship between the levels of mutans streptococci and lactobacilli in saliva and the failed restorations. CONCLUSION: The three posterior composites tested had acceptable clinical performance after 7 years.     

Clinical evaluation of posterior composite restorations in endodontically treated teeth

OBJECTIVE: The purpose of this study was to evaluate the two year clinical performance of posterior composite restorations in endodontically treated premolars and molars using a hybrid composite (Filtek Z-250, 3M ESPE) and a total etch bonding system (Single Bond, 3M ESPE). METHOD AND MATERIALS: Thirty-nine class II restorations in endodontically treated premolars (n=11) and molars (n=28) of 27 patients (14 female, 13 male, mean age 36.51) in 16 maxillar and 23 mandibular teeth were placed by one operator. Restorations were evaluated by two experienced investigators at baseline, 12 months, and 24 months according to the modified United States Public Health Service (USPHS) criteria that included retention, color match, marginal discoloration, secondary caries, anatomic form, marginal adaptation, and surface texture. All restorations were able to be evaluated at baseline, 12 months, and 24 months. RESULTS: Paired samples t-test showed only marginal discoloration showed a statistically significant difference (p<0.05) at the end of 24 months, and no other significant differences were observed for the other variables examined over the duration of the study. None of the restored teeth showed periapical pathology at the end of 24 months. CONCLUSION: At two years, limited deterioration in marginal discoloration was detected. The clinical performance of posterior composite restorations in endodontically treated teeth using Filtek Z250 was found clinically acceptable after two years.     

Targis高嵌体修复无髓后牙缺损的观察

目的：考察Targis瓷聚体作高嵌体修复无髓后牙缺损的临床效果。方法：对47例患者的53个经完善根管治疗术的后牙缺损，采用Targis高嵌体修复。根据改良的USPHS修复体评价标准，分别于修复后1、2,3年对Targis高嵌体进行随访复查。结果：Targis高嵌体的颜色协调性、边缘适合性和边缘着色在观察期内无明显改变，也未见继发龋和余留牙体的折裂，其累计成功率为94．3％。结论：Targis瓷聚体用于无髓后牙缺损的高嵌体修复效果良好，为牙体缺损的美观修复提供了新的选择，但其远期效果有待进一步观察。     

Clinical evaluation of composite and compomer restorations in primary teeth: 24-month results

PURPOSE: This split-mouth, blind study evaluated the clinical performance of Dyract AP, F2000, and Heliomolar placed in primary molars of 30 children (mean age, 6 years and 2 months). MATERIALS AND METHODS: From a total of 79 restorations accomplished, 27 were built with Heliomolar (18 Class I, and 9 Class II), 30 were with F2000 (21 Class I and 9 Class II), and 22 were built with Dyract AP (14 Class I and 8 Class II). All of teeth restored had primary caries lesions. At 6, 12, 18 and 24 months, 60 restorations (75%) were evaluated using USPHS criteria for: color match (CM), marginal adaptation (MA), marginal discoloration (MD), anatomic form (AF) and secondary caries (SC) by three calibrated operators. The Alpha+Bravo score percentage was considered as clinical success. The data were subjected to statistical analysis by Mann-Whitney and Kruskal-Wallis tests (p<0.05). RESULTS: Heliomolar showed the smallest success clinical at 12 months for marginal adaptation and secondary caries, and at 18 months for marginal discoloration. Regarding color match and anatomic form, no significant differences were found among the groups at each evaluation period. When materials were compared, Heliomolar did not show a significant difference among the evaluated periods for any criteria, remaining with the lowest scores. Significant differences were observed at 12 months for F2000 (marginal adaptation), and at 24 months for Dyract AP (marginal discoloration and secondary caries) and for F2000 (color match and marginal discoloration). CONCLUSIONS: It was concluded that Dyract AP and F2000 showed the best clinical performance over 24 month-evaluations for marginal discoloration and secondary caries, and color match and marginal adaptation, respectively. The use of the resin composite Heliomolar in Class I/II restorations in primary molars should be carefully considered.     

Four-year clinical evaluation of posterior resin-based composite restorations placed using the total-etch technique

Purpose : To report the 4-year clinical performance of posterior resin-based composite restorations placed using the total-etch technique.
Materials and Methods : Over a period of 1 year, 726 restorations (248 molars, 478 premolars; 260 Class I, 466 Class II; 540 replacements, 186 primary decay) were placed on conservative preparations, using the incremental placement technique in a clinical environment. Baseline data were collected, and the restorations were evaluated after 4 years. Z100 and Scotchbond Multipurpose (SBMP) (3M Dental Products, St. Paul, Minnesota) were used as the restorative system. The criteria evaluated were color match, marginal adaptation, anatomic form, cavosurface marginal discoloration, axial contour, interproximal contact, secondary caries, postoperative sensitivity, and tooth vitality.
Results : At baseline, 24% of the teeth restored presented postoperative sensitivity; 86% of the sensitive teeth were from the replacement group. At 4 years, all teeth were vital to cold test. Eighteen restorations (2.5%) presented clinically detectable marginal fracture. The shade was acceptable in all restorations. Cavosurface marginal discoloration was observed in 47 restorations (6.5% bravo scores). Axial contour, interproximal contact, and marginal adaptation received 100% alfa scores. No secondary caries was diagnosed in any of the teeth examined. None of the examined restorations required replacement.
CLINICAL SIGNIFICANCE
Under controlled clinical conditions, posterior resin-based composite restorations placed with the total-etch technique and restorative Z1OO/SBMP have the potential to present a high success rate at 4 years. None of the examined restorations required replacement, and there was no clinically detectable wear in any of the restorations. Simultaneous etching of enamel and dentin followed by the application of a resin adhesive can be considered an adequate modality of pulp protection in nonexposed tooth preparations.