Division of Biomaterials and Biomechanics, Department of Restorative Dentistry, Oregon Health & Science University, Portland, OR 97239, USA.
Dent Mater. 2013 Jan;29(1):51-8. doi: 10.1016/j.dental.2012.06.013. Epub 2012 Jul 17.
The objective of this manuscript is to address the following questions: Why do direct dental composite restorative materials fail clinically? What tests may be appropriate for predicting clinical performance? Does in vitro testing correlate with clinical performance?
The literature relating to the clinical and laboratory performance of dental composite restorative materials was reviewed. The main reasons for failure and replacement of dental composite restorations provided the guidance for identifying specific material's properties that were likely to have the greatest impact on clinical outcomes.
There are few examples of studies showing correlation between laboratory tests of physical or mechanical properties and clinical performance of dental composites. Evidence does exist to relate clinical wear to flexure strength, fracture toughness and degree of conversion of the polymer matrix. There is evidence relating marginal breakdown to fracture toughness. Despite the fact that little confirmatory evidence exists, there is the expectation that clinical fracture and wear relates to resistance to fatigue. Only minimal evidence exists to correlate marginal quality and bond strength in the laboratory with clinical performance of bonded dental composites.
The use of clinical trials to evaluate new dental composite formulations for their performance is expensive and time consuming, and it would be ideal to be able to predict clinical outcomes based on a single or multiple laboratory tests. However, though certain correlations exist, the overall clinical success of dental composites is multi-factorial and therefore is unlikely to be predicted accurately by even a battery of in vitro test methods.
本文旨在探讨以下问题：直接复合树脂修复材料临床上失败的原因是什么？哪些测试可能适合预测临床性能？体外测试与临床性能相关吗？
回顾了与牙科复合修复材料临床和实验室性能相关的文献。失败和更换牙科复合修复体的主要原因为确定对临床结果影响最大的特定材料特性提供了指导。
很少有研究表明实验室物理或机械性能测试与牙科复合材料的临床性能之间存在相关性。有证据表明临床磨损与挠曲强度、断裂韧性和聚合物基质转化率有关。有证据表明边缘破裂与断裂韧性有关。尽管没有确凿的证据，但人们期望临床骨折和磨损与抗疲劳性有关。只有很少的证据表明实验室中边缘质量和粘结强度与粘结牙科复合材料的临床性能相关。
使用临床试验来评估新的牙科复合配方的性能既昂贵又耗时，如果能够基于单个或多个实验室测试来预测临床结果，那就理想了。然而，尽管存在某些相关性，但牙科复合材料的整体临床成功是多因素的，因此即使是一系列体外测试方法也不太可能准确预测。
