Strober Brad, Veitz-Keenan Analia, Barna Julie Ann, Matthews Abigail G, Vena Donald, Craig Ronald G, Curro Frederick A, Thompson Van P
Biomimetics and Biophotonics Research Group, The Dental Institute, King’s College London, Floor 17 Tower Wing, Guy’s Hospital, London SE1 9RT, England.
J Am Dent Assoc. 2013 Aug;144(8):886-97. doi: 10.14219/jada.archive.2013.0206.
The objectives of this randomized comparative effectiveness study conducted by members of the Practitioners Engaged in Applied Research and Learning (PEARL) Network were to determine whether using a resin-modified glass ionomer (RMGI) liner reduces postoperative hypersensitivity (POH) in dentin-bonded Class I and Class II resin-based composite (RBC) restorations, as well as to identify other factors (putative risk factors) associated with increased POH.
PEARL Network practitioner-investigators (P-Is) (n = 28) were trained to assess sensitivity determination, enamel and dentin caries activity rankings, evaluation for sleep bruxism, and materials and techniques used. The P-Is enrolled 341 participants who had hypersensitive posterior lesions. Participants were randomly assigned to receive an RBC restoration with or without an RMGI liner before P-Is applied a one-step, self-etching bonding agent. P-Is conducted sensitivity evaluations at baseline, at one and four weeks after treatment, and at all visits according to patient-reported outcomes.
P-Is collected complete data regarding 347 restorations (339 participants) at baseline, with 341 (98 percent) (333 participants) recalled at four weeks. Treatment groups were balanced across baseline characteristics and measures. RBC restorations with or without an RMGI liner had the same one-week and four-week POH outcomes, as measured clinically (by means of cold or air stimulation) and according to patient-reported outcomes.
Use of an RMGI liner did not reduce clinically measured or patient-reported POH in moderate-depth Class I and Class II restorations. Cold and air clinical stimulation findings were similar between groups. Practical Implications. The time, effort and expense involved in placing an RMGI liner in these moderate-depth RBC restorations may be unnecessary, as the representative liner used did not improve hypersensitivity outcomes.
由从事应用研究与学习的从业者（PEARL）网络成员开展的这项随机对照有效性研究的目的是，确定使用树脂改性玻璃离子（RMGI）衬层是否能降低牙本质粘结的I类和II类树脂基复合材料（RBC）修复体的术后过敏反应（POH），以及识别与POH增加相关的其他因素（假定风险因素）。
PEARL网络的从业研究人员（P-Is）（n = 28）接受了评估敏感性测定、釉质和牙本质龋活性分级、睡眠磨牙症评估以及所用材料和技术的培训。P-Is招募了341名患有敏感后牙病变的参与者。在P-Is应用一步自酸蚀粘结剂之前，参与者被随机分配接受有或无RMGI衬层的RBC修复体。P-Is在基线、治疗后1周和4周以及所有随访时根据患者报告的结果进行敏感性评估。
P-Is在基线时收集了347个修复体（339名参与者）的完整数据，4周时召回了341个（98%）（333名参与者）。治疗组在基线特征和测量指标上保持平衡。有或无RMGI衬层的RBC修复体在1周和4周时的POH结果相同，这是通过临床测量（通过冷刺激或空气刺激）以及根据患者报告的结果得出的。
在中深度I类和II类修复体中，使用RMGI衬层并未降低临床测量的或患者报告的POH。两组之间的冷刺激和空气临床刺激结果相似。实际意义。在这些中深度RBC修复体中放置RMGI衬层所涉及的时间、精力和费用可能是不必要的，因为所用的代表性衬层并未改善过敏反应结果。
