Hannig Christian, Kupilas Florian Jan, Wolkewitz Martin, Attin Thomas
Abteilung für Zahnerhaltungskunde und Parodontologie der Universität Freiburg, Hugstetterstr. 55, D-79106 Freiburg.
Schweiz Monatsschr Zahnmed. 2009;119(4):328-38.
One of the main treatments in dental practice is the exchange of restorations due to secondary or residual caries. Thereby, only restorations indeed infected with secondary or residual caries should be renewed. The aim of the study was to check the validity of different criteria for the replacement of fillings. Three hundred seventeen replacements of dental restorations were evaluated retrospectively by using an examination form. Different clinical parameters were correlated with the finding of caries after removal of the old restoration. Clinical findings were differentiated between caries soft to probing, caries only stainable with caries detector and caries-free cavities. Sixty-seven percent of the cavities showed caries that could be probed, 16.1% were just stainable with caries detector and 17% were caries-free. In general, results of previous replacements of fillings were a valid criterion. Other indicators for caries-free cavities were properly placed fillings with a correctly reconstructed morphology, fillings without marginal defects, a low age of the filling and a positive impression of the patients' general hygiene. Indicators for cavities with secondary caries were marginal gaps, pain within the respective section of the jaw, a high number of filled surfaces and a bad impression of the general hygiene. Systematic diagnostic criteria should be adopted in decision making on replacement of fillings in order to avoid new restorations of caries-free cavities.
牙科临床实践中的主要治疗方法之一是因继发龋或残留龋而更换修复体。因此，仅应更换确实感染了继发龋或残留龋的修复体。本研究的目的是检验不同的补牙更换标准的有效性。通过使用检查表对317例牙科修复体更换病例进行了回顾性评估。将不同的临床参数与去除旧修复体后龋齿的检查结果相关联。临床检查结果分为探诊时龋变软、仅用龋病探测器可染色的龋和无龋洞。67%的龋洞显示探诊时龋变软，16.1%仅用龋病探测器可染色，17%无龋。一般来说，先前补牙更换的结果是一个有效的标准。无龋洞的其他指标包括补牙位置合适、形态重建正确、无边缘缺陷、补牙时间短以及患者口腔卫生状况良好。继发龋洞的指标包括边缘间隙、颌骨相应部位疼痛、补牙面数多以及口腔卫生状况差。在决定是否更换补牙时应采用系统的诊断标准，以避免对无龋洞进行新的修复。
