Kielbassa Andrej M, Glockner Georg, Wolgin Michael, Glockner Karl
Quintessence Int. 2017;48(1):9-18. doi: 10.3290/j.qi.a37211.
With the Minamata Convention the use of mercury will be phased down, and this undoubtedly will have an effect on dental treatment regimens and economic resources. Composite resin restorations are considered viable alternatives to amalgam fillings; however, these will not be covered completely by health insurance systems in many countries. Recently, a high-viscosity glass-ionomer cement (hvGIC) processed with a resinous coating (RC) has been introduced, and has been marketed as a restorative material in load-bearing Class I cavities (and in Class II cavities with limited size), thus serving as a possible alternative to amalgam fillings.
To discuss the outcome based on the evaluation presented in Part I of this paper, and to critically appraise the methodologies of the various studies.
Two of the included studies were industry-funded, and status of the other clinical trials remained unclear. Quality of study reporting was considered perfectible. The use of a light-cured nanofilled resin coating material would seem advantageous, at least when regarding short- and medium term outcomes.
Within the respective indications and cavity geometries, the hvGIC/RC approach would seem promising, could merge the phase-down of mercury and the objectives of minimally invasive treatment to some extent, and might be a restorative alternative for patients suffering from allergies or not willing to afford other sophisticated or expensive techniques. These recommendations are based on studies evaluating EQUIA Fil (GC), but are not transferable to clinical perspectives of the glass hybrid successor product (EQUIA Forte; GC).
随着《水俣公约》的实施,汞的使用将逐步减少,这无疑会对牙科治疗方案和经济资源产生影响。复合树脂修复体被认为是汞合金填充物的可行替代品;然而,在许多国家,这些修复体不会被医疗保险系统完全覆盖。最近,一种带有树脂涂层(RC)的高粘度玻璃离子水门汀(hvGIC)已被推出,并作为一种用于I类承重洞型(以及尺寸有限的II类洞型)的修复材料进行销售,从而成为汞合金填充物的一种可能替代品。
根据本文第一部分给出的评估结果进行讨论,并对各项研究的方法进行批判性评价。
纳入的两项研究由行业资助,其他临床试验的资助情况仍不明确。研究报告的质量有待完善。至少从中短期结果来看,使用光固化纳米填充树脂涂层材料似乎具有优势。
在各自的适应症和洞型几何形状范围内,hvGIC/RC方法似乎很有前景,可以在一定程度上兼顾汞的逐步减少和微创治疗的目标,对于过敏患者或不愿承担其他复杂或昂贵技术费用的患者而言,可能是一种修复选择。这些建议基于对EQUIA Fil(GC)的评估研究,但不能直接应用于玻璃混合后继产品(EQUIA Forte;GC)的临床情况。