流体树脂应用于恒磨牙预防性充填术3年效果评价

目的探讨光固化流体树脂对年轻恒磨牙窝沟龋预防性充填治疗的疗效。方法对56例7～14岁患儿两侧同名磨牙分别采用两种不同的预防性树脂充填方法。试验组:112颗面窝沟龋在磨除龋坏牙体组织后联用后牙复合树脂与流体树脂对龋坏部位和未龋坏窝沟区域进行预防性充填治疗。对照组:112颗面窝沟龋在磨除龋坏牙体组织后采用传统窝沟封闭剂加后牙复合树脂,评价两组3个月、1年、3年的保留成功率。结果随访3年后发现采用Wave Flow流动复合树脂加后牙复合树脂进行预防性树脂充填治疗,充填成功率高达87.5%,对照组仅为67.7%,两组成功率比较具有非常显著性差异。结论光固化流体树脂加后牙复合树脂对年轻恒磨牙的窝沟龋治疗疗效确切,值得临床推广应用。     

大块充填复合树脂后牙窝洞充填效果的回顾性研究

目的 分析高粘型大块充填复合树脂Filtek Bulk Fill、粘度可变型大块充填复合树脂SonicFill和分层复合树脂Filtek Z350用于后牙深龋窝洞充填的临床效果。方法 回顾分析2019年3月至2019年6月期间于南京大学医学院附属口腔医院牙体牙髓病科行后牙深龋窝洞充填的91例病例,根据治疗时使用的充填材料分为Filtek Bulk Fill(FB)组（n=31）、SonicFill(SF)组（n=27）、Filtek Z350(Z350)组（n=33）。比较三组的充填体术后超过1年的成功率,以及边缘着色、边缘适应性、继发龋、术后敏感等边缘密合性相关指标。结果 大块充填复合树脂在充填体成功率以及边缘密合性方面存在着优于分层复合树脂的趋势,但无统计学意义(均P>0.05)。结论 大块充填复合树脂可用于后牙深龋窝洞充填,且可获得略优于分层复合树脂的治疗效果。     

光固化流体树脂加后牙复合树脂充填3年疗效观察

目的　观察光固化流体树脂加后牙复合树脂充填的临床疗效。方法　用光固化流体树脂加后牙复合树脂充填后牙Ⅰ、Ⅱ类洞 ,并用单纯光固化复合树脂充填后牙Ⅰ、Ⅱ类洞作为对照 ,观察 3年疗效。结果　试验组4 9颗牙 ,3年成功率 85 .71% ;对照组 4 8颗牙 ,3年成功率 6 4 .5 8%。经统计学分析有显著性差异 (P <0 .0 5 )。结论　流体树脂的应用能够增加光固化后牙复合树脂的成功率     

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。     

粘结材料的发展和现状

银汞作为充填材料应用于临床已逾 10 0年了。它具有抗御强大咀嚼力和容易操作的特性 ,至今仍被广泛应用。但粘结复合树脂正在迅速改变着牙科的临床服务现状 ,逐渐成为临床医师首选的充填材料。树脂充填与银汞充填的比较银汞最突出的优点是使用寿命长和容易操作。但现在用于后牙直接或间接充填的复合树脂具有与银汞相似的抗咀嚼能力。而且 ,这些复合树脂的物理特性与牙釉质更加接近。除此以外 ,复合树脂与牙齿结构发生粘结作用 ,这种粘结作用大大提高了充填体的强度 ,并使得充填时需要去除的牙体组织非常少 ,能够保存更多牙齿结构。而且 ,现…     

复合树脂直接充填与树脂嵌体修复治疗垂直型食物嵌塞的临床分析

目的:比较硬质树脂嵌体与复合树脂直接充填治疗后牙垂直型食物嵌塞的临床效果.方法:将符合纳人标准的141个患牙随机分为两组,分别以Solidex硬质树脂嵌体和复合树脂直接充填恢复邻面接触区,1年后随访观察并比较两种治疗后修复体边缘密合情况、牙龈情况、邻接关系和牙髓敏感状况.结果:嵌体修复组的边缘密合性略优于树脂直接充填组,但二者间无显著性差异(P>0.05);嵌体修复后牙龈健康情况和邻接关系显著优于树脂充填组(P<0.05);牙髓敏感情况二者间无显著性差异(P>0.05).结论:硬质树脂嵌体修复较传统复合树脂充填修复能更好地恢复后牙正常的邻接关系,有助于恢复和保持患牙的牙周组织健康.     

四种复合树脂充填修复磨牙的临床评估

目的:采用改良的USPHS评价标准和扫描电镜,评估4种复合树脂充填修复磨牙的临床效果。方法:选择4种复合树脂(通用型树脂3M Filtek Z350 XT和Dentsply Spectrum TPH3,后牙专用型树脂3M Filtek P60和大块树脂Voco X-tra fil)充填修复后牙I类洞缺损,在充填术后1、12个月,采用USPHS分级评价标准评估其临床效果。同时在扫描电镜下进一步观察充填体的表面微观形貌。结果:术后1月,大块树脂组在颜色匹配性能上显著逊色于3种传统树脂组(P<0.05),其余性能指标方面4组无统计学差异(P>0.05)。术后12月,大块树脂各项性能显著逊色于其余3组(P<0.05);大块树脂各项指标均显著下降(P<0.05),而其余3组各项指标无显著下降(P>0.05)。扫描电镜观察显示,Z350组表面最光滑,X-tra组表面较粗糙。结论:大块树脂在各方面性能指标上的长期效果均不如传统分层充填树脂,尤其表现在颜色匹配性上。     

不同复合树脂充填方法修复后牙深洞的临床疗效观察

目的 :探讨 3种不同复合树脂充填方法修复后牙深洞的临床效果。方法 :15 9例后牙Ⅱ类深洞 ,随机分为3组 :Ⅰ组采用玻璃离子垫底加复合树脂充填技术 ,即“夹心”技术 ;Ⅱ组采用流动树脂垫底加复合树脂充填技术 ;Ⅲ组采用直接复合树脂充填技术 ,在充填后的 1月 ,6月 ,12月采用改良USPHS方法进行临床评价。结果 :边缘密合度、充填体完整性、继发龋 3组之间没有显著性差异 ;而边缘变色则Ⅲ组明显高于Ⅱ组 (P <0 .0 5 ) ;充填后反应Ⅰ组明显高于Ⅱ组 (P <0 .0 5 )。结论 :采用流动树脂垫衬加复合树脂修复后牙深洞可以取得最佳效果。     

光固化复合树脂充填后牙大面积缺损的临床观察

后牙因龋坏引起的大面积缺损,在用传统的银汞合金充填时,常难以获得满意的固位形和抗力形,致使充填后充填物脱落或部分脱落,或者引起牙体折裂。70年代末,随着后牙复合树脂研究的进展,它的耐磨性,密合度有了较大改进,国内已研制成功了Bis-GMA树脂体系和Si_3N_4填料的高强度复合树脂,着重解决了耐磨性,应用于临床充填后牙窝洞。为此,作者应用后牙可见光固化复合树脂来充填后牙大面积缺损,对缺损较大的结合应用自攻自断螺纹钉,经1年以上的临床观察,取得了较满意的疗效。     

树脂嵌体冠修复无髓牙的临床研究

目的:比较树脂嵌体冠与口内直接树脂修复、瓷嵌体修复方法临床疗效的差别.方法:将符合纳入标准的94个患牙随机分为3组,分别以硬质树脂嵌体冠、复合树脂充填和瓷嵌体修复牙体外形.随访2年,观察比较3种修复体边缘密合情况、邻接恢复、牙周健康、术后牙体组织折裂率.结果:树脂嵌体冠组术后2年牙齿和修复体折断率为零.其边缘密合性、邻接恢复、牙周健康程度均明显优于树脂直接充填组(P<0.05),与全瓷嵌体相比无统计学筹异.结论:嵌体冠能精准地修复无髓牙的邻、(牙合)面外形,较复合树脂直接充填有助于患牙的牙周组织健康,降低无髓牙受力折裂的几率.     

Clinical challenges and the relevance of materials testing for posterior composite restorations.

Posterior composite restorations have been in use for approximately 30 years. The early experiences with this treatment indicated there were more clinical challenges and higher failure rates than amalgam restorations. Since the early days of posterior composites, many improvements in materials, techniques, and instruments for placing these restorations have occurred. This paper reviews what is known regarding current clinical challenges with posterior composite restorations and reviews the primary method for collecting clinical performance data. This review categorizes the challenges as those related to the restorative materials, those related to the dentist, and those related to the patient. The clinical relevance of laboratory tests is discussed from the perspective of solving the remaining clinical challenges of current materials and of screening new materials. The clinical problems related to early composite materials are no longer serious clinical challenges. Clinical data indicate that secondary caries and restoration fracture are the most common clinical problems and merit further investigation. The effect of the dentist and patient on performance of posterior composite restorations is unclear and more clinical data from hypothesis-driven clinical trials are needed to understand these factors. Improvements in handling properties to ensure void-free placement and complete cure should be investigated to improve clinical outcomes. There is a general lack of data that correlates clinical performance with laboratory materials testing. A proposed list of materials tests that may predict performance in a variety of clinical factors is presented. Polymerization shrinkage and the problems that have been attributed to this property of composite are reviewed. There is a lack of evidence that indicates polymerization shrinkage is the primary cause of secondary caries. It is recommended that composite materials be developed with antibacterial properties as a way of reducing failures due to secondary caries. Post-operative sensitivity appears to be more related to the dentin adhesives' ability to seal open dentinal tubules rather than the effects of polymerization shrinkage on cuspal deflections and marginal adaptation.     

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.     

Trends in material choice for posterior restorations in an Israeli dental school: composite resin versus amalgam

According to a recent American Dental Association survey, posterior composite resin restorations now outnumber amalgam restorations in the United States. Dental schools around the world vary considerably in the extent to which they teach the use of composite resins. We aimed to determine if there has been an increase in the placement of posterior composite restorations in an Israeli dental school and if faculty experience affects the type of posterior restoration placed. In this retrospective study, we recorded and analyzed all the restorations performed by undergraduate students in the last five academic years at the Hebrew University Hadassah School of Dental Medicine in Jerusalem. All clinical records of student treatments between 2004 and 2009 were screened, and direct restorations were registered. Out of 6,094 posterior restorations performed during the study period, 42.3 percent were made of composite resin, increasing from 36.8 percent in 2004-05 to 48.5 percent in 2008-09, an increase of 11.7 percent. When clinical instructors were asked to state their preference if they themselves were to undergo posterior restoration, similar results were obtained. Instructors with less than ten years' experience preferred posterior composite resin restorations in 54.8 percent of the hypothetical situations, compared with 37.2 percent preferred by instructors with ten years of experience or more. It appears that the use of composite resin was influenced mainly by the prevailing trend and was not based on scientific evidence. Dental faculties should define criteria, based on up-to-date clinical studies, for using new materials, taking into consideration differences among instructors regarding treatment concept.     

Fabrication times for indirect composite resin restorations.

Fabrication times for indirect posterior composite resin restorations were recorded in a prospective clinical efficacy study. Four operators completed 132 one-visit inlays and onlays utilizing a new indirect posterior composite resin system (ICS). The mean time needed for the fabrication of one ICS restoration was 90 min, including the 'laboratory time'. When two restorations were provided simultaneously, the overall mean fabrication time was 120 min. The fabrication times were significantly influenced by the operator and the number of restorations. In several clinical phases a 40 per cent difference in mean fabrication time could be identified between operators. The extent of the restoration had no influence on mean fabrication time. The results of this study are considered to provide some indication of the cost-effectiveness of ICS restorations.     

Extensive composite molar restorations: 3 years clinical evaluation

Abstract Objective. To evaluate the clinical performance of extensive direct composite restorations in molars after 1 and 3 years and to find out the importance of extent of the restorations and other factors related to their performance. Materials and methods. Seventy-four patients with a molar tooth in need of a restoration covering at least three surfaces and one cusp were selected. Patient-related factors were registered and the tooth was prepared and restored by using a nano-filled composite. A topographic system for classification of extensive posterior restorations was developed. At baseline, the operator recorded a clinical evaluation, using modified USPHS-criteria. After 1 and 3 years, an independent observer evaluated the restorations. Post-operative problems arising during the observation period were registered. Results. A change in clinical score from baseline to the 1 and 3 year recall was recorded for all clinical criteria. A total of nine restorations were graded as unacceptable after 3 years (3-year survival rate of 87.7% and a mean annual failure rate of 4.2%). Except for gender (p = 0.022), none of the patient-related factors investigated (age, caries risk, extension of the restoration and presence of cervical enamel) had a significant influence on the survival of the restorations. Conclusions. Extensive direct posterior composite restorations showed an acceptable clinical performance after 3 years. Men had a significantly greater restoration failure rate than women.     

Survey on the teaching and use in dental schools of resin-based materials for restoring posterior teeth

A survey was conducted of 100 dental schools worldwide to investigate the current teaching of posterior resin composite restorations. A 20 multi-part question questionnaire was emailed to the selected schools. Schools were selected by ability to understand and respond in English. The questionnaire consisted of four open-ended questions and 16 closed questions on topics such as material selection for restoring posterior teeth, preclinical teaching of resin composite for posterior teeth, restoration size, contraindications, matrix placement methods, lining use, adhesive selection and finishing. Forty-six schools responded. The outcomes showed all schools included the teaching of resin composite for posterior restorations but varied. The majority of schools (63%) no longer taught amalgam as the preferred posterior restorative material. Half of the schools surveyed set numerical clinical requirements for restoration placement. Australian schools had no requirements whilst 92% of Asian schools did. There was a consensus that larger restorations were less suitable for resin composite. Selection of adhesives depended on region. Generally, the schools surveyed showed minor variations philosophically in teaching of the use and placement of resin composite restorations.     

Three-year clinical performance of composite restorations placed by undergraduate dental students

This retrospective study evaluated the clinical performance and the reasons for failure of anterior and posterior composite restorations placed by undergraduate dental students over a 3-year period. All cavities were restored using Prime & Bond 2.1 and TPH (Dentsply), according to the manufacturer's indications. One hundred and two patients who had received composite restorations by third and forth year undergraduate students were recalled and examined to analyze the quality of the restorations. The restorations were evaluated using the modified USPHS system. Two hundred and fifty-six composite restorations, 170 in anterior teeth and 86 in posterior teeth, were evaluated. Eighty-five percent of the restorations were considered satisfactory after 3 years. Class II and class IV restorations presented the highest prevalence of failure. Loss of the restoration and deficient marginal adaptation were the main causes of failure. No restoration failed due to secondary caries. Most restorations placed by dental students were considered satisfactory after long-term evaluation. Failure was more prevalent in larger restorations and was not associated with secondary caries.     

Clinical performance of posterior composite resin restorations.

Two formulations of posterior composite resin (P-30 and Bisfil-P) were evaluated and compared to a high-copper, dispersed-phase amalgam (Dispersalloy). One hundred twenty-eight restorations were placed in 27 patients so that each patient received at least one of each material. After 3 years of clinical service, all three restorative materials produced clinically acceptable restorations, according to US Public Health Service and Leinfelder criteria. The amalgam restorations, however, underwent less wear (44 microns) than did the posterior composite resin restorations (60 to 74 microns). Stratification of data by type of tooth, class of restoration, and size of restoration produced the same ranking of wear from lowest to highest: Dispersalloy, Bisfil-P, and P-30. Resin restorations showed 45% more wear in molars than in premolars, and more wear was associated with moderately sized restorations than with conservative restorations. The surface texture of restorations of composite resin with porous strontium glass filler was nearly as smooth as that of enamel and was significantly smoother than that of the restorations of composite resin with zinc glass filler or of unpolished amalgam.     

A practice-based,randomized, controlled clinical trial of a new resin composite restorative: one-year results

This study evaluated the performance of a low-shrinking resin composite compared with an amalgam for restoration of Class I and II cavities of moderate size in posterior teeth in a general practice setting. Fifty-two pairs of test and control restorations were placed in 49 patients. Clinical evaluations and assessments of replica models were carried out at baseline, six months and one year. Patients recorded their level of satisfaction with the restorations by means of visual analog scales. Apart from one control restoration that failed due to a fractured cusp, all of the restorations reviewed at six months and one year were intact with no unacceptable scores for any of the evaluation criteria. It was concluded that the resin composite evaluated, when used in conjunction with the recommended adhesive system, may be an appropriate alternative to amalgam in the restoration of posterior teeth over one year in clinical service.     

Marginal seal comparisons between resin-bonded Class II porcelain inlays, posterior composite restorations, and direct composite resin inlays

The microleakage of indirect porcelain and direct composite resin-bonded inlays was compared with that of posterior composite resin restorations using Class II preparations of extracted molar teeth. The resin-bonded inlay restorations provided a better marginal seal at the cervical restoration/dentin interface than did the composite resin restoration. The efficacy of this marginal seal varied with the particular treatments and materials used. Resin-bonded porcelain inlays had a higher incidence of cervical excess from the composite resin luting agent than did the posterior composite resin restorations.