Manhart Juergen, García-Godoy Franklin, Hickel Reinhard
Department of Restorative Dentistry, Ludwig-Maximilians-University, Goethe Street 70, D-80336 Munich, Germany.
Dent Clin North Am. 2002 Apr;46(2):303-39. doi: 10.1016/s0011-8532(01)00010-6.
The longevity of dental restorations is dependent on many different factors, including those related to materials, the dentist, and the patient. The main reasons for restoration failure are secondary caries, fracture of the bulk of the restoration or of the tooth, and marginal deficiencies and wear. The importance of direct-placement, aesthetic, tooth-colored restorative materials is still increasing. Amalgam restorations are being replaced because of alleged adverse health effects and inferior aesthetic appearance. All alternative restorative materials and procedures, however, have certain limitations. Direct composite restorations require a time-consuming and more costly treatment procedure and are actually only indicated for patients with excellent oral hygiene. Glass ionomers can be considered only as long-term provisional restorations in stress-bearing posterior cavities. Future treatment regimens that are made possible by the development of sophisticated preparation techniques, improved dentin bonding agents, and resin-based restorative materials will result in the therapy of more small-sized lesions rather than large restorations. The importance of indirect inlay techniques will shift more and more toward the direct restoratives. As the cavities become smaller, it is to be expected that the use of improved direct restorative materials will provide excellent longevity even in stress-bearing situations.
牙齿修复体的使用寿命取决于许多不同因素，包括与材料、牙医和患者相关的因素。修复失败的主要原因是继发龋、修复体主体或牙齿的折断，以及边缘缺陷和磨损。直接放置的、美观的、牙齿颜色的修复材料的重要性仍在不断增加。汞合金修复体正因所谓的健康不良影响和较差的美观外观而被取代。然而，所有替代修复材料和程序都有一定的局限性。直接复合树脂修复需要耗时且成本更高的治疗程序，实际上仅适用于口腔卫生良好的患者。玻璃离子体仅可被视为承受压力的后牙洞的长期临时修复体。先进的制备技术、改进的牙本质粘结剂和树脂基修复材料的发展使未来的治疗方案成为可能，这将导致更多地治疗小型病变而非大型修复体。间接嵌体技术的重要性将越来越多地转向直接修复体。随着龋洞变小，可以预期，即使在承受压力的情况下，使用改进的直接修复材料也将具有出色的使用寿命。
