Qin Man, Liu HongSheng
Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.
Oper Dent. 2005 Sep-Oct;30(5):580-7.
This clinical study evaluated the retention and caries protection of a flowable resin composite (Flow Line) and a flowable compomer (Dyract Flow) used in preventive resin restorations as compared to the conventional preventive resin technique which uses a resin composite (Brilliant) and a sealant (Concise). This study observed 205 permanent molars with small carious cavities less than 1.5 mm in width, which were obtained from 165 children aged 7 to 15 years. Flowable resin composite was used to treat 75 teeth, and 71 teeth were treated with flowable compomer in both cavities and caries-free fissures. For the control group, 59 teeth were treated with resin composite in cavities and sealant in caries-free fissures. The teeth were evaluated at 3, 6, 12, 18 and 24-month intervals. After three months, all 205 treated teeth were completely intact. After six months, 66 of the 71 teeth treated with flowable resin composite and 65 of the 70 teeth treated with flowable compomer were complete, compared to 57 of the 58 teeth treated with the conventional preventive resin technique. After 12 months, 60 of the 67 teeth treated with flowable resin composite and 61 of the 67 teeth treated with flowable compomer were complete, compared to 51 of the 55 teeth treated with the conventional preventive resin technique. After 18 months, 53 of the 61 teeth treated with flowable resin composite and 54 of the 62 teeth treated with flowable compomer were complete, compared to 47 of the 53 teeth treated with the conventional preventive resin technique. After 24 months, 49 of the 58 teeth treated with flowable resin composite and 45 of the 57 teeth treated with flowable compomer were complete, compared to 42 of the 52 teeth treated with the conventional preventive resin technique. There were no statistically significant differences in retention rates among all groups after 3, 6, 12, 18 or 24-months (p>0.05). One tooth treated with flowable resin composite and one tooth treated with flowable compomer developed caries after 18 and 24 months, respectively, resulting from partial loss at "caries-free fissures." Five teeth developed caries in the conventional preventive resin group; one after 12 months, two after 18 months and one after 24 months, due to loss at cavities. The final caries occurred after 24 months, resulting from partial loss at "caries-free fissures." The differences in caries development among the three groups were not statistically significant (p>0.05). This study suggested that flowable resin composite and flowable compomer could be used for preventive resin restorations. Meanwhile, a vigilant recall should be followed-up due to the risk of failure for flowable materials in "caries-free" fissures. The repair should be performed immediately, in case the preventive resin restoration develops a fracture or loss.
本临床研究评估了用于预防性树脂修复的可流动树脂复合材料(Flow Line)和可流动复合体(Dyract Flow)的保留率及防龋性能,并与使用树脂复合材料(Brilliant)和封闭剂(Concise)的传统预防性树脂技术进行了比较。本研究观察了205颗宽度小于1.5毫米的小龋洞恒牙,这些牙齿取自165名7至15岁的儿童。用可流动树脂复合材料治疗75颗牙齿,71颗牙齿在龋洞和无龋裂沟均用可流动复合体治疗。对照组中,59颗牙齿在龋洞用树脂复合材料治疗,在无龋裂沟用封闭剂治疗。在3、6、12、18和24个月的间隔时间对牙齿进行评估。三个月后,所有205颗治疗牙齿均完全完好。六个月后,用可流动树脂复合材料治疗的71颗牙齿中的66颗和用可流动复合体治疗的70颗牙齿中的65颗完好,而用传统预防性树脂技术治疗的58颗牙齿中的57颗完好。十二个月后,用可流动树脂复合材料治疗的67颗牙齿中的60颗和用可流动复合体治疗的67颗牙齿中的61颗完好,而用传统预防性树脂技术治疗的55颗牙齿中的51颗完好。十八个月后,用可流动树脂复合材料治疗的61颗牙齿中的53颗和用可流动复合体治疗的62颗牙齿中的54颗完好,而用传统预防性树脂技术治疗的53颗牙齿中的47颗完好。二十四个月后,用可流动树脂复合材料治疗的58颗牙齿中的49颗和用可流动复合体治疗的57颗牙齿中的45颗完好,而用传统预防性树脂技术治疗的52颗牙齿中的42颗完好。在3、6、12、18或24个月后,所有组之间的保留率无统计学显著差异(p>0.05)。用可流动树脂复合材料治疗的一颗牙齿和用可流动复合体治疗的一颗牙齿分别在18个月和24个月后发生龋坏,原因是“无龋裂沟”处部分缺失。传统预防性树脂组有五颗牙齿发生龋坏;一颗在12个月后,两颗在18个月后,一颗在24个月后,原因是龋洞处缺失。最终龋坏发生在24个月后,原因是“无龋裂沟”处部分缺失。三组之间龋坏发展的差异无统计学显著意义(p>0.05)。本研究表明,可流动树脂复合材料和可流动复合体可用于预防性树脂修复。同时由于可流动材料在“无龋”裂沟处有失败风险,应进行密切随访。一旦预防性树脂修复出现折断或缺失,应立即进行修复。