Department of Dentistry, Seoul National University School of Dentistry, Seoul, Korea.
Oper Dent. 2013 Jul-Aug;38(4):376-85. doi: 10.2341/11-416-C. Epub 2012 Dec 5.
The aim of this retrospective clinical study was to compare the longevity of cervical restorations between resin composite (RC) and glass ionomer (GI) and to investigate variables predictive of their outcome. The clinical performance of the two restorative materials in function was compared using the ratings of the modified United States Public Health Service (USPHS) criteria. A total of 479 cervical restorations were included in the study. Ninety-one already-replaced restorations were reviewed from dental records. The other 388 restorations still in function were evaluated according to the modified USPHS criteria by two investigators. Longevity and prognostic variables were analyzed with the Kaplan-Meier survival analysis and multivariate Cox proportional hazard model. The clinical performances of the two materials were evaluated according to the ratings of the USPHS criteria and compared using the Pearson chi-square test and Fisher exact test. The longevity was not significantly different between RC and GI (median survival time, 10.4 ± 0.7 and 11.5 ± 1.1 years, respectively). The main reasons for failure were loss of retention (82.2%) and secondary caries (17.8%). The longevity of cervical restoration was significantly influenced by tooth group and operator group (Wald test, p<0.05), while material, gender, presence or absence of systemic diseases, arch, and reason for treatment did not affect the longevity. Contrary to the longevity, the clinical performance of RC was superior to GI in the criteria of retention, marginal discoloration, and marginal adaptation, but similar in secondary caries, wear, and postoperative sensitivity.
本回顾性临床研究旨在比较树脂复合材料 (RC) 和玻璃离子体 (GI) 修复体的使用寿命,并探讨影响其预后的因素。两种修复材料的临床性能通过改良后的美国公共卫生服务 (USPHS) 标准进行比较。共纳入 479 例颈修复体。从病历中回顾了 91 例已更换的修复体。其余 388 例仍在功能中的修复体根据改良的 USPHS 标准由两名研究人员进行评估。采用 Kaplan-Meier 生存分析和多变量 Cox 比例风险模型分析生存率和预后因素。根据 USPHS 标准的评分评估两种材料的临床性能,并采用 Pearson 卡方检验和 Fisher 确切概率检验进行比较。RC 和 GI 的使用寿命无显著差异(中位生存时间分别为 10.4 ± 0.7 年和 11.5 ± 1.1 年)。失败的主要原因是固位丧失(82.2%)和继发龋(17.8%)。颈修复体的使用寿命受牙位组和操作医生组的显著影响(Wald 检验,p<0.05),而材料、性别、是否存在系统性疾病、牙弓和治疗原因对使用寿命无影响。与使用寿命相反,RC 在保留、边缘变色和边缘适合性方面的临床性能优于 GI,但在继发龋、磨损和术后敏感方面则相似。