Sönmez Hayriye, Saat Sinem
J Clin Pediatr Dent. 2017;41(5):336-342. doi: 10.17796/1053-4628-41.5.336.
The aim of this study was to evaluate the clinical effects of deproteinization of the hypomineralized enamel and different cavity designs on the performance of the composite resin restorations(CRRs) placed into the cavities of MIH (molar incisor hypomineralization)-affected molars.
95 MIH-affected permanent first molars (PFMs) and 31 caries but not MIH-affected PFMs (126 teeth in total) were included in the study. The MIH-affected molars were divided into three groups. In Group I, all hypomineralized tissue was removed until healthy enamel was reached. In Group II, carious and cheesy hypomineralized tissue was removed until a reasonable resistance was detected in the hypomineralized tissue. In Group III, cavities designed as Group II, differently from this group deproteinization of the left hypomineralized tissue was performed prior to the placement of CRRs. Group IV served as the control group consisting of unaffected carious PFMs. Restorations were evaluated according to modified USPHS criteria for 24 months.
The retention rates were 93.7% for Group I, 80.7% for Group II, 93.5% for Group III and 100% for Group IV. The success rate for the restorations in Group II proved significantly lower (p<0.05) than that of the other three groups. No significant difference in success rates was observed between Group I, Group III and Group IV (p>0.05) at the end of 24 months.
Failure of the restorations was predominant in the group that the hypomineralized tissue was left surrounding the cavities. Deproteinization of the hypomineralized enamel was found to enhance the retention rates of CRRs.
本研究旨在评估低矿化釉质脱蛋白处理及不同窝洞设计对置于乳牙列发育不全(MIH,即磨牙和切牙低矿化)患牙窝洞内的复合树脂修复体(CRR)性能的临床影响。
本研究纳入了95颗患MIH的恒牙第一磨牙(PFM)和31颗患龋但未患MIH的PFM(共126颗牙)。患MIH的磨牙被分为三组。在第一组中,去除所有低矿化组织直至达到健康釉质。在第二组中,去除龋坏和奶酪样低矿化组织,直至在低矿化组织中检测到合理的抗力。在第三组中,窝洞设计与第二组相同,与该组不同的是,在放置CRR之前对剩余的低矿化组织进行脱蛋白处理。第四组作为对照组,由未患龋的PFM组成。根据修改后的美国公共卫生署(USPHS)标准对修复体进行24个月的评估。
第一组的保留率为93.7%,第二组为80.7%,第三组为93.5%,第四组为100%。第二组修复体的成功率显著低于其他三组(p<0.05)。在24个月结束时,第一组、第三组和第四组之间的成功率没有显著差异(p>0.05)。
在窝洞周围保留低矿化组织的组中,修复体失败占主导。发现低矿化釉质的脱蛋白处理可提高CRR的保留率。