Unemori Masako, Matsuya Yoko, Hyakutake Hiroto, Matsuya Shigeki, Goto Yasuharu, Akamine Akifumi
Department of Endodontology and Operative Dentistry, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
J Dent. 2007 Jun;35(6):535-40. doi: 10.1016/j.jdent.2007.02.005. Epub 2007 Apr 10.
To test the hypothesis, derived from a previous short-term (7-day) assessment, that the absence of conventional pulp protection is not responsible for long-term pulp complications of composite resin restorations with self-etching adhesives.
All 150 patients who received the restorations with self-etching adhesives were recalled at least 2 years after the placement of restorations. Of the 47 patients (31%) who responded, 106 restorations aged from 2.2 to 6.5 years were examined for tooth sensitivity and pulp vitality regarding long-term pulp complications. The results were subjected to a multivariable logistic regression analysis with regard to cavity depth, provision of conventional pulp protection and short-term pulp complications.
No positive cases were found in the assessment of tooth sensitivity. Four restorations (3.7%) made in deep cavities with conventional pulp protection resulted in pulpectomy due to inflammation, of which three cases presented short-term pulp complications. The 95% confidence intervals for the odds ratios estimated by the multivariable logistic regression analysis were (1.54, infinity) for cavity depth (1.50, infinity) for short-term pulp complications and (0.02, infinity) for conventional pulp protection. Namely, the last variable had no significant effect on long-term pulp complications and thus the hypothesis was verified.
The absence of conventional pulp protection was not responsible for long-term pulp complications even in deep cavities with the use of self-etching adhesives. A deep cavity and the existence of short-term pulp complications were two critical predictors for the occurrence of long-term pulp complications.
检验基于先前短期（7天）评估得出的假设，即对于使用自酸蚀粘结剂的复合树脂修复体，未进行传统牙髓保护并非导致牙髓长期并发症的原因。
所有接受自酸蚀粘结剂修复的150例患者在修复体放置至少2年后被召回。在回复的47例患者（31%）中，对106颗年龄在2.2至6.5岁之间的修复体进行了牙齿敏感性和牙髓活力检查，以评估长期牙髓并发症。对结果进行多变量逻辑回归分析，分析因素包括窝洞深度、是否提供传统牙髓保护以及短期牙髓并发症。
在牙齿敏感性评估中未发现阳性病例。4颗在深窝洞且有传统牙髓保护的修复体因炎症导致牙髓摘除，其中3例出现短期牙髓并发症。多变量逻辑回归分析估计的优势比的95%置信区间为：窝洞深度为（1.54，无穷大），短期牙髓并发症为（1.50，无穷大），传统牙髓保护为（0.02，无穷大）。也就是说，最后一个变量对长期牙髓并发症没有显著影响，因此该假设得到验证。
即使在使用自酸蚀粘结剂的深窝洞中，未进行传统牙髓保护也不是导致牙髓长期并发症的原因。深窝洞和短期牙髓并发症的存在是长期牙髓并发症发生的两个关键预测因素。
