Moncada Gustavo, Fernández Eduardo, Martín Javier, Arancibia Carolina, Mjör Ivar A, Gordan Valeria V
Operative Dentistry Department, University of Chile, Santiago, Chile.
Oper Dent. 2008 May-Jun;33(3):258-64. doi: 10.2341/07-113.
This investigation assessed the effectiveness of alternative treatments for the replacement of amalgam and resin-based composite restorations. Sixty-six patients (age 18 to 80 years, mean = 26.6) with 271 (amalgam [n = 193] and resin-based composite [n = 78]) defective restorations were randomly assigned to one of five different treatment groups: A) Repair (n = 27); B) Sealing of margins (n = 48); C) Refurbishing (n = 73); D) Replacement (n = 42) and E) Untreated (n = 81). USPHS/Ryge criteria were used to determine the quality of the restorations. Two calibrated examiners (Cohen's Kappa 0.74) assessed the restorations independently at the beginning of the study (baseline) and at two years after treatment using seven parameters from the USPHS/Ryge criteria (Marginal Adaptation, Anatomic Form, Roughness, Marginal Stain, Occlusal Contact, Secondary Caries and Luster).
Two-hundred and fifty-six restorations (178 amalgam and 78 resin-based composite) were examined at the two-year recall exam. The sealing of marginal defects showed significant improvements in marginal adaptation (p < 0.05). Refurbishing of the defective restorations significantly improved anatomic form (p < 0.0001), luster (p < 0.016), marginal adaptation (p < 0.003) and roughness (p < 0.0001). The repair significantly improved anatomic form (p < 0.002) and marginal stain (p < 0.002). Replacement showed significant improvements for all parameters (p < 0.05). The Untreated group showed significant deterioration on marginal adaptation (p < 0.013).
The two-year recall examination showed that sealant, repair and refurbishing treatments improved the clinical properties of defective amalgam and resin-based composite restorations by increasing the longevity of the restorations with minimal intervention.
本研究评估了用于替换汞合金和树脂基复合修复体的替代治疗方法的有效性。66名患者（年龄18至80岁，平均年龄 = 26.6岁），共有271个（汞合金修复体[n = 193]和树脂基复合修复体[n = 78]）有缺陷的修复体，被随机分配到五个不同的治疗组之一：A）修复（n = 27）；B）边缘封闭（n = 48）；C）翻新（n = 73）；D）替换（n = 42）和E）未治疗（n = 81）。采用美国公共卫生服务部/赖格标准来确定修复体的质量。两名经过校准的检查者（科恩kappa系数为0.74）在研究开始时（基线）以及治疗后两年，使用美国公共卫生服务部/赖格标准中的七个参数（边缘适应性、解剖形态、粗糙度、边缘染色、咬合接触、继发龋和光泽度）对修复体进行独立评估。
在两年的随访检查中，共检查了256个修复体（178个汞合金修复体和78个树脂基复合修复体）。边缘缺陷封闭在边缘适应性方面有显著改善（p < 0.05）。有缺陷修复体的翻新在解剖形态（p < 0.0001）、光泽度（p < 0.016）、边缘适应性（p < 0.003）和粗糙度（p < 0.0001）方面有显著改善。修复在解剖形态（p < 0.002）和边缘染色（p < 0.002）方面有显著改善。替换在所有参数方面都有显著改善（p < 0.05）。未治疗组在边缘适应性方面有显著恶化（p < 0.013）。
两年的随访检查表明，密封剂、修复和翻新治疗通过以最小的干预提高修复体的寿命，改善了有缺陷的汞合金和树脂基复合修复体的临床性能。
