固位沟用于后牙牙冠大面积缺损修复的探讨

目的：探讨在后牙牙冠大面积缺损修复中增加固位沟的效果。方法：选择符合标准的124颗牙冠大面积缺损的后牙，制备洞型并垫底及作梯，然后在剩余牙体组织或洞底及梯上做固位沟，分别用银汞合金和光固化复合树脂充填，复查1－3a后统计成功率及失败病例，进行分析比较。结果：3年总成功率为74．52％，银汞合金组76．92％，光固化复合树脂组69．57％，两者无显著性差异。结论：增加固位沟可有效提高固位力及抗力，从而提高后牙牙冠大面积缺损的修复成功率。     

螺纹钉中银汞合金修复后牙牙体缺损

采用各种方法努力保存患牙 ,使之恢复咀嚼功能 ,免受拔牙痛苦。前牙常用自攻螺纹钉及螺纹根管桩加光固化树脂来修复 ;后牙虽然也可采用此法 ,但作为主要承受咀嚼压力的磨牙和前磨牙 ,复合树脂的强度存在欠缺。笔者在临床上用银汞合金代替复合树脂修复后牙牙体缺损 ,疗效满意。1　临床资料 :1.1　病例 :共收集后牙牙体缺损 88例 ,其中双尖牙 56例 ,磨牙 32例 ;男性 52牙 ,女性 36牙 ,年龄从2 2～ 6 5岁不等。1.2　缺损原因 :牙冠龋坏超过 1/ 2 ,缺乏固位力 ,干髓治疗后牙体变脆、充填后发生冠折 ;咬合不当外伤性冠折 ;或是隐裂牙受力过大后折…     

银汞合金根冠联合体加全冠修复后牙严重缺损

随着根管治疗术不断完善和成熟，我们对大面积缺损后牙进行根管治疗后，应用银汞合金充填髓腔窝洞，然后全冠修复，取得较好疗效，现报道如下。     

钉固位和粘结固位银汞合金用于后牙大面积修复的临床观察

1．1 临床资料 在门诊选择后牙大面积缺损的患者67人,共74颗龋齿,所有龋齿为活髓,均无牙髓炎和根尖周炎症状,并经X片证实未穿髓,根尖无暗影。其中,男性39例,女性28例,年龄范围18～62岁。根据计算器随机抽取数字,分为钉固位、粘结银汞合金两组,钉固位组35颗,     

银汞合金固位桩修复后牙严重缺损

自１９９４年来,我科用银汞合金修复后牙严重缺损７２例,９６个患牙,年龄１４～７０岁。选择后牙残冠,髓室底完整、牙周组织无严重破坏的病例。材料：银汞合金,成形片,根管充填器,银汞充填器。步骤：患牙常规根管预备（扩大至４０号扩孔钻）,适当消毒后,氯仿糊剂...     

银汞合金桩加牙本质钉修复后牙残根

随着医疗知识的普及以及口腔修复技术的发展，使过去为拔牙适应证的后牙残根的修复成为可能。临床上有些患者不愿拔牙，而要求进行后牙残根修复。笔者对15例后牙残根进行银汞合金桩加牙本质钉固位，银汞合金桩核冠修复治疗，观察1～2年，报道如下。     

牙本质黏结剂用于银汞合金充填的疗效

牙体缺损是口腔科常见病，虽可以修复治疗，但由于材料性能方面的不足，常因微渗漏而致继发龋。2000—06—2005—06我们将牙本质黏结剂用于银汞合金修复，取得了一定效果，现报告如下。     

螺纹钉加银汞合金修复后牙牙体缺损

１临床资料共收集后牙牙体缺损８８例,其中前磨牙５６例,磨牙３２例,均为牙冠龋坏超过１／２或各种原因所致冠折,根面位于龈上或略低于龈下２ｍｍ内,且无明显叩痛。２修复方法死髓牙或慢性牙髓炎者,应行牙髓治疗,先拍Ｘ线牙片了解根尖、牙周情况,根管粗细、数目、...     

利用根管固位钉结合银汞合金修复后牙残冠的临床体会

近年来由于修复技术的不断发展 ,尽可能地保留患牙残根 ,并对其修复是目前临床上提高修复质量的有效手段之一。桩核是目前残冠修复中最为普遍选择的一种方法 ,其优点是固位好 ,可根据患者具体情况在桩上附加其他修复体 ,选择余地较大。前牙由于在口内容易操作 ,因而多采用铸造法修复 ,而后牙受口腔条件的制约 ,铸造核桩的蜡型采取难度较大。为此 ,作者自 1999年以来对临床 2 4例后牙残冠病例 ,选择成品桩加自攻断螺纹钉结合银汞合金充填形成内核 ,并行全冠修复 ,在修复后 1年多的时间里对患者进行追踪观察 ,其临床效果比较满意 ,现将修复过…     

Reasons for replacement and the age of failed restorations in posterior teeth of young Finnish adults

Using dentist characteristics, our aim was to evaluate the reasons for replacements of fillings, the age of failed restorations in the posterior teeth of young adults, and replacement rates. Altogether 205 patient records from the Public Oral Health Service of the City of Vantaa, Finland were evaluated. Patient age was restricted to between 25 and 30 years and type of tooth to posterior teeth only (third molars excluded). Information collected from the records included the patient's date of birth, latest DMFS and DMF, and the code for background data on the dentist. Details of each filled premolar and molar included the restorative material, location, and surface coverage of filling(s). The age of replacement of filling in premolar(s) or molar(s) was screened retrospectively from patient records. The total number of filled premolars and molars was 1873, with 1969 fillings. Forty percent of the patients had undergone replacement of filling in premolar(s) or molar(s). In all, 140 replacements had been made, accounting for 6.9% of amalgam fillings and 8.5% of tooth-colored fillings. Secondary caries, along with fractures, overhangs, and marginal discrepancy, was the most common reason for replacement. The mean age of failed amalgam fillings was 8.9 years (SD 5.2) and of failed tooth-colored fillings 2.4 years (SD 1.6). In the public sector, female dentists form the majority and their replacement rate for amalgam fillings was twice that of male dentists (7.6% vs 3.2%; P = 0.01).     

Type and time of first re-intervention of posterior restorations – 13-year scenario at the public dental service

Abstract

Objectives: We investigated the first re-interventions of two- and three-surface direct restorations on posterior teeth, specifically noting the type and time of the first re-intervention.

Materials and methods: In 2002, altogether 5542 posterior two- and three-surface composite and amalgam restorations were done for 3051 patients aged 25–30?years at Helsinki City Public Dental Service (PDS). Based on electronic patient records, we analysed all restorations (n?=?2445) having re-intervention during a 13-year follow-up. We recorded the type of tooth, restoration size, and type of first re-intervention. The time to re-intervention was the interval between the date of the placement of restoration at the year 2002 and its first re-intervention.

Results: Restorative treatment was the most common (77.9%) first re-intervention, followed by endodontics (11.5%), extractions (5.2%), and other (5.4%). Males, more frequently than females, had extraction or endodontics as first re-intervention. The average time to re-intervention was 5.7?years (SD 3.8; median 5.2). Both median and mean times were shortest for cases involving endodontics or extractions.

Conclusions: For the majority of two- and three-surface posterior restorations, the first re-intervention is restorative (replacement or repair of restoration). The shortest time to re-intervention is for restorations that have endodontics or extraction as the first re-intervention.     

The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial

BACKGROUND: Limited information is available from randomized clinical trials comparing the longevity of amalgam and resin-based compomer/composite restorations. The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New England Children's Amalgam Trial. METHODS: The authors randomized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam (n=267) or compomer (primary teeth)/composite (permanent teeth) (n=267) restorations and followed them up semiannually. They compared the longevity of restorations placed on all posterior surfaces using random effects survival analysis. RESULTS: The average+/-standard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations. In primary teeth, the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams (P=.10), with 3.0 percent versus 0.5 percent (P=.002), respectively, due to recurrent caries. In permanent teeth, the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams (P=.45), and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams (P=.02). CONCLUSION: Although the overall difference in longevity was not statistically significant, compomer was replaced significantly more frequently owing to recurrent caries, and composite restorations required seven times as many repairs as did amalgam restorations. CLINICAL IMPLICATIONS: Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations, even within five years of placement.     

圆锥型套筒冠义齿修复重度牙周炎伴牙列缺损的临床效果评价

目的 评价圆锥型套筒冠义齿修复重度牙周炎伴牙列缺损的临床效果.方法 重度牙周炎伴牙列缺损患者12例,行牙周基础治疗和根管治疗后,采用圆锥型套筒冠义齿修复,记录患者的主观感觉及义齿使用情况.修复前及修复后6个月、1年和3年复诊时,测量并记录牙龈指数(gingival index,CI)和探诊深度(probing depth,PD),实验室检测龈沟液碱性磷酸酶(alkaline phosphatase,ALP)活性.结果 12例患者,圆锥型套筒冠义齿均可正常使用,9例患者对外貌及义齿的使用和语音功能满意,3例基本满意,无不满意.牙龈指数G1在修复后6个月、1年、3年和修复前相比差异无统计学意义(P＞0.05).PD在修复后6个月、1年、3年和修复前相比差异均有统计学意义(P＜0.01).龈沟液ALP活性在修复后6个月和修复前相比差异均有统计学意义(P＜0.01),而在修复后1年、3年和修复前相比差异亦有统汁学意义(P＜0.05).结论 对于重度牙周炎伴牙列缺损,圆锥型套筒冠义齿是一种可行、有效的修复方法,同时也有助于患者牙周状况的改善.     

三种不同类型嵌体修复后牙II类洞的疗效对比

目的 研究3种不同类型嵌体修复后牙II类洞的疗效。方法 选取130例(患牙150颗）后牙II类洞患者,按随机数法随机分为3组：A组50颗患牙给予复合树脂嵌体修复;B组51颗患牙给予CAD/CAM全瓷嵌体修复;C组49颗患牙给予Ceramage聚合瓷嵌体修复,评估牙体修复后的预后情况。结果 C组患者修复效果明显优于A组和B组。C组患者的GI、PI和SBI评分显著低于A组和B组。修复一年后,各组GI和PI评分与刚修复后相比均增加,且C组评分显著低于B组和C组(P<0.05）;C组牙体磨损和边缘着色发生率显著低于A组和B组(P<0.05）。结论 Ceramage聚合瓷嵌体修复效果明显优于复合树脂嵌体修复和CAD/CAM全瓷嵌体修复效果,可以有效保护牙周健康,且预后良好。     

后牙氧化锆全锆冠修复的临床效果研究

目的 研究氧化锆全锆冠用于后牙牙体缺损修复的效果,为其临床应用提供理论参考.方法 选取47例后牙牙体缺损患者的50颗后牙,采用计算机辅助设计和制作的氧化锆全锆冠行全冠修复,分别于修复后1、3、6、12个月采用美国加利弗尼亚牙科学会的全瓷修复临床标准对修复体的临床效果进行评价,每个指标分为A、B、C级,全部符合A级标准视为成功.结果 在修复后1、3、6、12个月随访过程中,在修复体完整性、边缘适合性、继发龋、边缘着色方面所有患者均达A级.修复后6个月时2颗患牙牙龈轻微炎症牙龈状况评价为B级, 12个月时牙龈状况恢复健康达A级.3个全冠色彩明暗度稍不匹配评价为B级.修复后1年成功率为94％.结论 氧化锆全锆冠对牙周健康影响小,性能稳定,修复成功率高,用于后牙牙体缺损修复的临床效果良好.     

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.     

Evaluation of dental composite shrinkage and leakage in extracted teeth using X-ray microcomputed tomography

ObjectiveUse X-ray microcomputed tomography (μCT), to test the hypothesis that composite shrinkage and sites of potential leakage in human teeth are non-uniformly distributed and depend on cavity geometry and C-factor.MethodsTwo holes of equal volume but different dimensions were drilled into the exposed dentin of extracted human molars. The cavities were filled with composite and teeth were scanned, before and after curing, using μCT. Three-dimensional (3D) reconstructions of the data were prepared and analyzed using image analysis software.Results3D reconstructions showed that cavity geometry did not affect the polymerization shrinkage. The shrinkage for all restorations was 2.66 ± 0.59%, and cavity dimensions did not affect the volume lost, either in quantity or location on the sample. Potential leakage sites were identified by gap formations and found to be non-uniformly distributed along the tooth–composite interface. Leakage in regions calculated by μCT was confirmed by visualization of sectioned samples with confocal laser scanning microscopy.SignificanceμCT evaluation will add tremendous value as part of a suite of tests to characterize various properties of dental materials. The non-uniform distribution of potential leakage sites about the cavities that was determined by μCT emphasizes the inadequacy of traditional methods of determining leakage, which are capable of analyzing only limited areas. Additionally, μCT evaluation can produce quantitative analyses of shrinkage and leakage, compared to the conventional methods, which are qualitative or semi-quantitative. Finally, experimentally determined shrinkage and leakage of composite in extracted teeth agrees with the results of similar experiments in model cavities, confirming the validity of those models.