Hickel R, Manhart J, García-Godoy F
Department of Restorative Dentistry and Periodontology, Ludwig-Maximilians-University, Munich, Germany.
Am J Dent. 2000 Nov;13(Spec No):41D-54D.
To (1) review the literature and analyze the longevity and reasons for failure of direct resin-based composite (RBC), amalgam, and glass-ionomer cement (GIC) restorations in stress-bearing posterior cavities and (2) to assess new material developments and treatment techniques to restore these cavities.
This work reviewed the dental literature predominately of the last decade for longitudinal, controlled clinical studies and retrospective cross-sectional studies. Only studies investigating the clinical performance of restorations in permanent teeth were included. Annual failure rates of direct resin-based composite, amalgam, and GIC restorations were determined and failure reasons were discussed.
Annual failure rates in posterior stress-bearing cavities were determined to be: 0-9% for direct RBC restorations, 0-7% for amalgam restorations, and 1.9-14.4% for GIC restorations. The median annual failure rate of longitudinal studies for amalgam was calculated with 1.1%, for RBCs 2.1% and for GICs 7.7%. GIC is significantly worse compared with amalgam and RBC. Main reasons for failure were secondary caries, marginal deficiencies, fracture, and wear. Longitudinal studies showed a strong trend towards a higher longevity compared with cross-sectional investigations.
（1）回顾文献并分析直接树脂基复合材料（RBC）、汞合金和玻璃离子水门汀（GIC）修复体在承受应力的后牙窝洞中的使用寿命及失败原因，（2）评估用于修复这些窝洞的新材料发展和治疗技术。
本研究回顾了过去十年主要关于纵向对照临床研究和回顾性横断面研究的牙科文献。仅纳入了研究恒牙修复体临床性能的研究。确定了直接树脂基复合材料、汞合金和GIC修复体的年失败率，并讨论了失败原因。
后牙承受应力窝洞的年失败率确定为：直接RBC修复体为0 - 9%，汞合金修复体为0 - 7%，GIC修复体为1.9 - 14.4%。汞合金纵向研究的年失败率中位数计算为1.1%，RBC为2.1%，GIC为7.7%。与汞合金和RBC相比，GIC明显较差。失败的主要原因是继发龋、边缘缺陷、折断和磨损。纵向研究显示与横断面研究相比，有更高使用寿命的强烈趋势。
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