Department of Operative Dentistry, College of Dentistry, University of Florida Health Science Center, P.O. Box 100415, Gainesville, FL 32610-0415, USA.
J Am Dent Assoc. 2009 Dec;140(12):1476-84. doi: 10.14219/jada.archive.2009.0098.
In a seven-year prospective cohort study, the authors assessed the longevity of defective resin-based composite (RBC) restorations that were not treated or were treated by means of repair, sealing, refinishing or total replacement. They also aimed to identify and quantify the main reasons clinicians diagnosed restorations as defective.
Thirty-seven patients--19 women and 18 men--who were aged 27 through 78 years (mean = 57 years, standard deviation [SD] = 13 years) and had a total of 88 defective restorations participated in the study. Two of the authors assigned each restoration to one of five treatment groups, depending on the patient's treatment need: repair (n = 25), sealing of defective margins (n = 12), refinishing (n = 19), replacement (n = 16) and no treatment (n = 16). The authors conducted a survival analysis (according to modified U.S. Public Health Service criteria) at baseline and again at six months, one year, two years and seven years after treatment.
The authors determined that the main reasons clinicians diagnosed the 88 restorations as being defective were marginal discoloration (n = 53, 60.2 percent), marginal degradation (n = 18, 20.5 percent) and color mismatch (n = 17, 19.3 percent). The authors examined 69 (78 percent) restorations at six months, 68 (77 percent) after one year, 62 (70 percent) after two years and 53 after seven years (60 percent). The percentages of failed restorations for each treatment after seven years were 0 percent for repair, 0 percent for sealing of defective margins, 18 percent for refinishing, 21 percent for replacement and 23 percent for no treatment. The P value for the log-rank test of equality for these groups was .36.
Restorations degraded to varying degrees in all criteria, and the survival of restorations differed among treatment approaches. Longitudinal data collected across seven years support the viability of all nonreplacement restoration treatment strategies.
在一项为期七年的前瞻性队列研究中，作者评估了未治疗或通过修复、密封、重新抛光或完全更换方式治疗的有缺陷的树脂基复合材料（RBC）修复体的寿命。他们还旨在确定和量化临床医生诊断修复体有缺陷的主要原因。
共有 37 名患者（19 名女性和 18 名男性）参与了这项研究，年龄为 27 至 78 岁（平均年龄为 57 岁，标准差 [SD] = 13 岁），共有 88 个有缺陷的修复体。两位作者根据患者的治疗需求，将每个修复体分配到五个治疗组之一：修复（n = 25）、密封有缺陷的边缘（n = 12）、重新抛光（n = 19）、更换（n = 16）和未治疗（n = 16）。作者在基线时和治疗后 6 个月、1 年、2 年和 7 年进行了生存分析（根据美国公共卫生服务修正标准）。
作者确定，临床医生诊断 88 个修复体有缺陷的主要原因是边缘变色（n = 53，60.2%）、边缘降解（n = 18，20.5%）和颜色不匹配（n = 17，19.3%）。作者在 6 个月时检查了 69 个（78%）修复体，1 年后检查了 68 个（77%），2 年后检查了 62 个（70%），7 年后检查了 53 个（60%）。7 年后，每种治疗方法的失败修复体百分比分别为修复组 0%、密封缺陷边缘组 0%、重新抛光组 18%、更换组 21%和未治疗组 23%。这些组的对数秩检验的 P 值为.36。
所有标准的修复体都有不同程度的退化，修复体的存活情况因治疗方法而异。在七年的时间里收集的纵向数据支持所有非替换修复治疗策略的可行性。
