Kielbassa Andrej M, Muller Jan, Gernhardt Christian R
Department of Operative Dentistry and Periodontology, CharitéCentrum 3, University School of Dental Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Quintessence Int. 2009 Sep;40(8):663-81.
Dental caries on (proximal) tooth surfaces is still a problem in many industrialized countries. The objectives of this review were to present the scientific basis and the principles of the resin infiltration concept, to discuss the inherent clinical applications, and to describe how these backgrounds can be integrated into the concept of minimal intervention dentistry. Data were identified by searches of the Cochrane Registers, Medline, and Scopus. Articles published in English and German through December 2008 were selected, and most up-to-date or relevant references were chosen. Cross-referencing of significant articles identified additionally relevant articles written in other languages and those of historical value. A total of 23 in vitro studies (focusing on penetration depths or demineralization prevention) were found, and 3 clinical studies (involving 122 subjects) could be retrieved; these studies were not comparable. With an increased understanding of the caries process, it is now recognized that demineralized but noncavitated enamel lesions can be arrested or remineralized in many situations. The clinical research evidence on the resin infiltration technique currently is of moderate extent to reach any decisive conclusions; however, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should reduce (or even stop) the progress of white spot lesions. Combining this ultraconservative restorative approach (which is considered microinvasive) with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long-term restorative needs and costs, thus complementing the concept of minimal intervention dentistry.
在许多工业化国家,(邻面)牙面的龋齿仍然是一个问题。本综述的目的是介绍树脂渗透概念的科学依据和原理,讨论其内在的临床应用,并描述如何将这些背景知识融入微创牙科的概念中。通过检索Cochrane注册库、Medline和Scopus来识别数据。选择截至2008年12月以英文和德文发表的文章,并选取最新或相关的参考文献。对重要文章进行交叉引用,以识别用其他语言撰写的额外相关文章以及具有历史价值的文章。共找到23项体外研究(侧重于渗透深度或防脱矿),并检索到3项临床研究(涉及122名受试者);这些研究无法进行比较。随着对龋病过程认识的增加,现在人们认识到,在许多情况下,脱矿但未形成龋洞的釉质病变可以得到阻止或再矿化。目前关于树脂渗透技术的临床研究证据程度适中,无法得出任何决定性结论;然而,基于现有的实验室和临床研究,釉质病变的树脂渗透似乎有说服力地应能减少(甚至阻止)白斑病变的进展。将这种超保守的修复方法(被认为是微创的)与实质性的龋病再矿化计划相结合,可能会带来治疗益处,并显著降低长期修复需求和成本,从而补充微创牙科的概念。