Eidelman E
Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel.
Pediatr Dent. 1999 Mar-Apr;21(2):118-20.
Previous reports suggested that cusp fracture strength increases with the use of bonded composites. The purpose of this study was to assess fracture resistance of undermined cusps, when supported by a layer of bonded composite, in extensive occlusal carious lesions.
Primary and permanent molars in children that were treated included those with extensive occlusal caries with undermined enamel in one or more cavity walls. Following local anesthesia and rubber dam application, cavity outline was prepared with a #330 tungsten bur, and the carious lesion removed. If an unsupported cusp was present, the inner enamel wall and the dentine floor adjacent to this wall was etched with a gel containing 37% phosphoric acid, rinsed and dried and Scotch bond multipurpose applied; a 1-mm layer of Z100 was applied to the unsupported cusp and polymerized; a nongamma 2 amalgam or Z100 was used to restore the tooth.
The children were re-examined after 6, 12 or 24 months. A total of 42 restorations were placed in 39 children (26 boys and 13 girls), ranging in age from 4 to 16 years (mean age 9 years, 6 months). This is a preliminary report on 30 restorations, followed up from 6 to 24 months. All 30 restorations were successful in preventing cuspal fracture. Four teeth developed caries in the proximal surface, but were unrelated to the restoration.
It was concluded that bonded composite can prevent fracture of unsupported cusps.
先前的报告表明，使用粘结性复合材料可提高牙尖断裂强度。本研究的目的是评估在广泛的咬合面龋损中，当有一层粘结性复合材料支撑时，被削弱牙尖的抗折性。
接受治疗的儿童的乳牙和恒牙包括那些在一个或多个洞壁有广泛咬合面龋且釉质被削弱的牙齿。在局部麻醉并使用橡皮障后，用#330钨钢钻制备洞型，去除龋损。如果存在无支撑牙尖，用含37%磷酸的凝胶蚀刻其内侧釉质壁和与其相邻的牙本质底层，冲洗并干燥后应用Scotch bond多功能粘结剂；在无支撑牙尖上涂抹1毫米厚的Z100并聚合；用非γ2型银汞合金或Z100修复牙齿。
在6、12或24个月后对儿童进行复查。共对39名儿童（26名男孩和13名女孩）的42颗牙齿进行了修复，年龄范围为4至16岁（平均年龄9岁6个月）。这是一份关于30颗修复牙齿的初步报告，随访时间为6至24个月。所有30颗修复牙齿均成功预防了牙尖折断。有4颗牙齿的邻面发生龋坏，但与修复无关。
得出的结论是，粘结性复合材料可预防无支撑牙尖折断。
