City of Helsinki, Department of Social Services and Health Care, Metropolitan Area Department of Oral Special Care, P.O. BOX 6670, FI-00099 Helsinki, Finland.
Social Statistics, Department of Social Research, Faculty of Social Sciences, University of Helsinki, P.O. BOX 18, FI-00014 Helsinki, Finland.
J Dent. 2017 Jul;62:13-17. doi: 10.1016/j.jdent.2017.05.012. Epub 2017 May 19.
The aim of this patient document-based retrospective study among 25- to 30-year-old Finnish adults was to evaluate longevity of 2- and 3-surface posterior restorations according to type of tooth, size of restoration, and restorative material used.
Data were extracted from electronic patient files of the Helsinki City Public Dental Service (PDS), Finland. A total of 5542 2- and 3-surface posterior composite and amalgam restorations were followed indirectly from 2002 to 2015. Longevity of restorations was illustrated using Kaplan-Meier curves. Annual failure rates (AFRs) of the restorations were calculated separately by type of tooth, size, and material. Differences in longevity were statistically tested with log-rank tests.
Composite restorations formed the majority (93%). The longest median survival times and the smallest failure rates were found for teeth in the upper jaw, for premolars, and for 2-surface restorations. Median survival time of all restorations was 9.9 years (95% CI 9.6, 10.2) and re-intervention of restorations occurred less often in the maxilla (AFR 4.0%) than in the mandible (AFR 4.7%). Median survival time of composite restorations was greater for 2-surface than for 3-surface restorations: in premolars 12.3 vs. 9.6 years (p<0.001) and in molars, 9.2 vs. 6.3 years (p<0.001); for molar amalgams the difference (8.0 vs. 6.3 years) was non-significant (p=0.38). Median survival time of 2- and 3-surface restorations in premolars exceeded that in molars (12.0 vs. 8.7 years; p<0.001).
Longevity of posterior composite multisurface restoration is comparable to amalgam longevity.
Regarding material choices for posterior multisurface restorations, composite and amalgam perform quite similarly in molars, 3-surface restoration being challenge for both materials.
本项基于患者的回顾性研究旨在评估 25-30 岁芬兰成年人中 2 面和 3 面后牙复合树脂和银汞合金修复体的长期效果，分别根据牙齿类型、修复体大小和修复材料进行评估。
从芬兰赫尔辛基市公立牙科服务（PDS）的电子患者档案中提取数据。共有 5542 例 2 面和 3 面后牙复合树脂和银汞合金修复体从 2002 年至 2015 年进行了间接随访。采用 Kaplan-Meier 曲线来展示修复体的长期存活率。按牙齿类型、大小和材料分别计算修复体的年失败率（AFR）。使用对数秩检验对长期存活率的差异进行统计学检验。
复合树脂修复体占大多数（93%）。上颌牙、前磨牙和 2 面修复体的中位生存时间最长，失败率最小。所有修复体的中位生存时间为 9.9 年（95%CI 9.6，10.2），上颌修复体的修复体再干预率（4.0%）低于下颌（4.7%）。上颌前磨牙 2 面修复体的中位生存时间大于 3 面修复体（12.3 年比 9.6 年，p<0.001），上颌磨牙 9.2 年比 6.3 年（p<0.001）；下颌磨牙 2 面和 3 面修复体的差异（8.0 年比 6.3 年）无统计学意义（p=0.38）。上颌前磨牙和下颌磨牙 2 面修复体的中位生存时间均大于 3 面修复体（12.0 年比 8.7 年，p<0.001）。
后牙复合树脂多面修复体的长期效果与银汞合金相当。
在后牙多面修复体的材料选择方面，复合树脂和银汞合金在磨牙中的性能相当，而 3 面修复体对两种材料都是一个挑战。
