Estay J, Martín J, Viera V, Valdivieso J, Bersezio C, Vildosola P, Mjor I A, Andrade M F, Moraes R R, Moncada G, Gordan V V, Fernández E
Oper Dent. 2018 Jan/Feb;43(1):12-21. doi: 10.2341/16-313-C. Epub 2017 Oct 4.
The objective of this study was to clinically evaluate repaired posterior amalgam and composite restorations over a 12 year period, investigate the influence of repair in the survival of restorations, and compare their behavior with respect to controls.
Thirty-four patients, 18 to 80 years of age with 167 restorations, 67 composite resin (RC), and 100 amalgam (AM) restorations, participated. Restorations with localized, marginal, anatomical deficiencies and/or secondary caries, and "clinically judged" suitable for repair or replacement according to US Public Health Service (USPHS) criteria, were randomly assigned to four groups: repair (n=35, 20 AM, 15 RC), replacement (n=43, 21 AM, 22 RC), positive control (n=71, 49 AM, 22 RC), or negative control (n=18, 10 AM, 8 RC). The quality of the restorations was blind scored according to the modified USPHS criteria. Two examiners scored them at initial status (κ=0.74) and after one to five, 10, and 12 years (κ=0.88). Wilcoxon and Mann-Whitney tests provided for comparisons within the same group and between years, respectively.
After 12 years, all groups behaved similarly in marginal adaptation, marginal stain, teeth sensitivity, anatomic form, and luster ( p≥0.05). Better behavior in roughness was observed in replaced RC ( p=0.049).
Given that most clinical parameters investigated were similar between all groups during the follow-up, the repair of RC and AM restorations is a good clinical option because it is minimally invasive and can consistently increase the longevity of restorations.
本研究的目的是在12年的时间里对修复后的后牙汞合金和复合树脂修复体进行临床评估,研究修复对修复体存留率的影响,并将它们与对照修复体的表现进行比较。
34名年龄在18至80岁之间的患者参与了研究,共有167个修复体,其中67个复合树脂(RC)修复体和100个汞合金(AM)修复体。根据美国公共卫生服务(USPHS)标准,具有局部、边缘、解剖学缺陷和/或继发龋且“临床判断”适合修复或替换的修复体被随机分为四组:修复组(n = 35,20个AM,15个RC)、替换组(n = 43,21个AM,22个RC)、阳性对照组(n = 71,49个AM,22个RC)或阴性对照组(n = 18,10个AM,8个RC)。根据改良的USPHS标准对修复体质量进行盲法评分。两名检查者在初始状态(κ = 0.74)以及1至5年、10年和12年后(κ = 0.88)对它们进行评分。Wilcoxon检验和Mann-Whitney检验分别用于同一组内和不同年份之间的比较。
12年后,所有组在边缘适应性、边缘染色、牙齿敏感性、解剖形态和光泽方面表现相似(p≥0.05)。在替换的RC修复体中观察到粗糙度方面表现更好(p = 0.049)。
鉴于在随访期间所有组之间调查的大多数临床参数相似,RC和AM修复体的修复是一种良好的临床选择,因为它微创且能持续提高修复体的使用寿命。