Lyons Karl
Department of Oral Rehabilitation, School of Dentistry, Dunedin.
N Z Dent J. 2003 Mar;99(1):10-5.
The purpose of this paper is to provide guidelines to assist in the selection of dental materials for restoring posterior teeth in adolescents. Currently, amalgam is still the best plastic restorative material for some Class I cavities, and for Class II cavities and all multi-surface restorations. Tooth-coloured materials are preferred by some patients and dentists, however these alternatives are more technique sensitive than amalgam. Composite resin is the most common direct placement alternative to dental amalgam, providing patients with relatively low cost, tooth-coloured restorations. However, composite resins have limited indication, their placement is more time-consuming than for amalgam, cost-benefit considerations are a concern, difficulty in obtaining a marginal seal persists and there are few long-term studies published in the peer reviewed scientific literature. The literature currently supports the use of composite resin for the restoration of a limited range of Class I and Class II cavities. Composite resin restorations are not recommended for MOD or other multi-surface restorations. In selected clinical situations, fissure sealants, preventive resin restorations and glass ionomer cement are also appropriate materials to use to restore posterior teeth. Fissure sealants, when properly maintained, can play a significant role in the prevention and control of dental caries in pits and fissures in primary and permanent teeth. Preventive resin restorations should be placed to restore deep pits and fissures with incipient caries and/or developmental defects in primary and permanent teeth. Glass ionomer cement may be used for restoring Class V cavities where appearance is not the primary concern, for conservative Class III cavities, and as a provisional restorative material. It is not recommended for Class II or IV restorations.
本文旨在提供指导方针，以协助为青少年后牙修复选择牙科材料。目前，汞合金仍是一些I类洞、II类洞及所有多面修复的最佳塑形修复材料。一些患者和牙医更青睐牙齿颜色的材料，然而这些替代品比汞合金对技术更敏感。复合树脂是牙科汞合金最常见的直接填充替代品，为患者提供相对低成本的牙齿颜色修复体。然而，复合树脂的适应证有限，其填充比汞合金更耗时，成本效益是一个问题，难以获得边缘封闭，且同行评审科学文献中发表的长期研究很少。目前的文献支持使用复合树脂修复有限范围的I类和II类洞。不建议使用复合树脂修复MOD或其他多面修复。在特定临床情况下，窝沟封闭剂、预防性树脂修复体和玻璃离子水门汀也是用于修复后牙的合适材料。窝沟封闭剂如妥善维护，可在预防和控制乳牙及恒牙窝沟龋方面发挥重要作用。预防性树脂修复体应用于修复乳牙及恒牙有早期龋和/或发育缺陷的深窝沟。玻璃离子水门汀可用于修复外观不是主要考虑因素的V类洞、保守的III类洞，以及作为临时修复材料。不建议用于II类或IV类修复。
