牙体修复失败原因探讨

目的 通过对256颗牙体修复失败原因分析，探讨提高牙体修复质量的各种相关因素。方法 收集因牙体修复失败需重新治疗235位患者的256颗牙齿，其中银汞修复146颗牙;高分子材料修复110颗牙。分别对其修复失败原因和修复体在口腔中存在时间长短，进行总结分析。结果 无论用银汞合金，还是高分子材料修复，失败比例最高为继发龋，分别占28．76％和23．64％；其次，银汞合金为牙折、洞型设计不良、根尖炎、He创伤、修复体脱落、修复体折断、牙髓炎、食物嵌塞和悬突。高分子材料为色素沉积、He创伤、修复体折断、修复体脱落、牙髓炎、修复体磨损、根尖炎、悬突和食物嵌塞。分析修复体存在口腔中存留的时间发现，银汞合金和高分子材料修复中，1～3年组失败最高，分别占44．52％和32．73％。结论 在牙体修复中，预防继发龋的发生，调整咬合关系，对延长修复体的使用寿命是至关重要的。

Analysis of restorative failure in filled teeth

Objective To enhance the quality of restoration and offer the theoretical support for clinical doctors by analyzing, the unsuccessful reasons of 256 filled teeth. Methods The causes of restorative failure and time-dependent relationship of restoration located in 256 teeth (amalgam restoration 146 cases and macromolecular materials restoration 110 cases) from 138 patients were evaluated. Results Being the main factor of restorative failure, the occurrence of secondary caries was 28.76% in the amalgam group and 23.64% in the macromolecular materials group. Secondly, the former may be caused by tooth fracture, cavity preparation, periapical periodontitis, malocclusion, dislocation of filling, cracked fdling, pulpitis, food impaction, overhang; while the latter may be induced by pigmentation, malocclusion, cracked fllling, dislocation of filling, pulpitis, abrasion, periapical periodontitis, overhang, food impaction. It could be found that the rates of the occurrence of restorative failure of amalgam and macromolecular materials were the highest during 1-3 year period, which were 44.52% and 32.73%, respectively. Conclusion The prevention of secondary caries and adjustment of occlusion may play an important role in extending the life of restoration.