Bohaty Brenda S, Ye Qiang, Misra Anil, Sene Fabio, Spencer Paulette
Department of Pediatric Dentistry, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA; ; Department of Pediatric Dentistry, Children's Mercy Hospital, Kansas City, MO, USA;
Clin Cosmet Investig Dent. 2013 May 15;5:33-42. doi: 10.2147/CCIDE.S42044. Print 2013.
Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient's caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth-restoration bond, and the ability of the restorative material to produce a sealed tooth-restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of posterior composite restorations, the emphasis must remain on advancing our understanding of the clinical variables that impact the formation of a durable seal at the restoration-tooth interface. This paper presents an update of existing technology and underscores the mechanisms that negatively impact the durability of posterior composite restorations in permanent teeth.
使用树脂基复合材料修复后牙在临床医生中越来越受欢迎，并且对这类美学修复体的需求也在增加。事实上，树脂复合材料是牙用汞合金最常见的美学替代材料。然而，中到大尺寸的后牙复合树脂修复体有更高的失败率、更多的继发龋，以及更高的替换频率。全球各地的研究人员正在研究新材料和新技术，以改善复合树脂修复材料的临床性能、操作特性以及机械和物理性能。尽管受到如此关注，但中到大尺寸的后牙复合树脂修复体的临床使用寿命仍然只有牙用汞合金的大约一半。虽然对于修复体预备设计、修复体放置和聚合技术有众多建议，但目前的研究表明，修复体的使用寿命取决于几个变量，而牙医可能难以控制这些变量。这些变量包括患者的患龋风险、牙齿位置、患者习惯、修复面的数量、牙齿与修复体粘结的质量，以及修复材料形成密封的牙齿-修复体界面的能力。尽管临床医生在评估后牙复合树脂修复体的成败时往往侧重于牙齿外形，但重点必须仍然是加深我们对影响修复体与牙齿界面形成持久密封的临床变量的理解。本文介绍了现有技术的最新情况，并强调了对恒牙后牙复合树脂修复体耐久性产生负面影响的机制。
