de Amorim Rodrigo Guedes, Leal Soraya Coelho, Mulder Jan, Creugers Nico H J, Frencken Jo E
Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Clin Oral Investig. 2014 Jan;18(1):117-24. doi: 10.1007/s00784-013-0955-x. Epub 2013 Mar 2.
The aims of this study were to compare 2-year cumulative survival rates of amalgam and atraumatic restorative treatment (ART) restorations in primary molars and to investigate the determinants of the survival rate of restorations.
A controlled clinical trial using a parallel group design was carried out on 258 children aged 6-7 years old, allocated to two treatment groups: conventional restorative treatment using amalgam and ART using high-viscosity glass ionomer. A total of 364 amalgam restorations and 386 ART restorations were placed by three pedodontists in 126 and 158 children, respectively, and were evaluated after 0.5, 1, and 2 years. Restorations were placed in vital primary molars with neither pain nor signs of pulp involvement. The survival analysis was conducted using the proportional hazard rate regression model with frailty correction.
The 2-year cumulative survival rates for all amalgam (77.3%) and ART (73.5%) restorations were not statistically significantly different, but there was an effect of "type of surface" (single/multiple) and "cavity filling time" on the survival rates. Both amalgam and ART single-surface restorations had higher survival rates than multiple-surface restorations of the same material. Secondary caries was responsible for 36 and 38% of failures in amalgam and ART restorations, respectively. Mean time for restoring all type of cavities with amalgam and ART restorations was 13.6 and 13.7 min, respectively.
Amalgam and ART restorations presented similar survival rates over a 2-year period for all, single-surface, and multiple-surface restorations.
In the cause of finding alternatives to amalgam, ART restorations using high-viscosity glass ionomer might be a suitable option for managing cavitated dentine carious lesions in vital primary molars.
本研究旨在比较乳牙中银汞合金修复体和非创伤性修复治疗（ART）修复体的2年累积生存率，并调查修复体生存率的决定因素。
对258名6 - 7岁儿童进行了一项采用平行组设计的对照临床试验，将其分为两个治疗组：使用银汞合金的传统修复治疗组和使用高粘性玻璃离子体的ART治疗组。三名儿童牙医分别在126名和158名儿童中放置了总共364个银汞合金修复体和386个ART修复体，并在0.5年、1年和2年后进行评估。修复体放置在无疼痛且无牙髓受累迹象的活髓乳磨牙中。使用带有脆弱性校正的比例风险率回归模型进行生存分析。
所有银汞合金修复体（77.3%）和ART修复体（73.5%）的2年累积生存率在统计学上无显著差异，但“表面类型”（单/多）和“窝洞充填时间”对生存率有影响。银汞合金和ART单表面修复体的生存率均高于相同材料的多表面修复体。继发龋分别导致银汞合金修复体和ART修复体失败的36%和38%。用银汞合金和ART修复体修复所有类型窝洞的平均时间分别为13.6分钟和13.7分钟。
对于所有修复体、单表面修复体和多表面修复体，银汞合金修复体和ART修复体在2年期间的生存率相似。
在寻找银汞合金替代品的过程中，使用高粘性玻璃离子体的ART修复体可能是治疗活髓乳磨牙中龋化牙本质龋损的合适选择。
