Mobarak Enas H, Shabayek Mohamed M, El-Deeb Heba A, Mulder Jan, Hassan Fayez M, Van der Sanden Wil J M, Frencken Jo E
Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt.
Department of Restorative and Aesthetic Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
J Adv Res. 2019 Jan 31;17:117-123. doi: 10.1016/j.jare.2019.01.015. eCollection 2019 May.
The study question was whether the use of high-viscosity glass-ionomer with chlorhexidine (HVGIC/CHX) for the Atraumatic Restorative Treatment (ART) prepared cavities could achieve a higher restoration survival percentage and be more effective for preventing dentine carious lesions adjacent to the restoration than the use of HVGIC without CHX. The study followed a split-mouth, quadruple-blind, randomized controlled clinical design and lasted 2 years. Patients with at least two small- to medium-sized occlusal cavities were included. The occlusal cavities were prepared according to the ART method and restored with HVGIC/CHX (test) and HVGIC (control). A replica of all restorations available and digital photographs were fabricated at baseline and after 0.5, 1, 1.5 and 2 years and evaluated by two examiners using the ART and Federation Dentaire International (FDI) restoration assessment criteria. Survival curves were constructed using the Kaplan-Meier method, and the log-rank test was used to test for significance between the survival percentages. A total of 100 subjects with an average age of 14.4 years participated. According to the ART restoration assessment criteria, the 2-year survival percentages of ART/HVGIC/CHX (96.8%) and ART/HVGIC (94.8%) did not differ significantly and no significant difference was found between the test (97.9%) and control (96.9%) groups according to the FDI restoration assessment criteria. Eight and five occlusal restorations failed according to the ART and FDI restoration criteria, respectively. No dentine carious lesions along the restoration margin were observed. The 2-year survival of ART restorations in both groups was high. The development of carious dentine lesions adjacent to the restoration was not observed in either treatment group. There is no evidence for modifying HVGIC by incorporating chlorhexidine in order to prevent dentine carious lesion development or to improve the survival of ART restorations in occlusal surfaces in permanent teeth. HVGIC without chlorhexidine can be used successfully to restore occlusal 'ART-prepared' cavities in permanent teeth.
研究问题是，对于非创伤性修复治疗（ART）制备的窝洞，使用含氯己定的高粘度玻璃离子水门汀（HVGIC/CHX）是否比使用不含CHX的HVGIC能获得更高的修复体存留率，并且在预防修复体相邻牙本质龋损方面更有效。该研究采用了双侧对照、四重盲法、随机对照临床设计，为期2年。纳入了至少有两个中小型咬合面龋洞的患者。根据ART方法制备咬合面龋洞，并用HVGIC/CHX（试验组）和HVGIC（对照组）进行修复。在基线以及0.5、1、1.5和2年后制作所有可用修复体的复制品和数码照片，由两名检查者使用ART和国际牙科联盟（FDI）修复体评估标准进行评估。使用Kaplan-Meier方法构建生存曲线，并使用对数秩检验来检验存留率之间的显著性差异。共有100名平均年龄为14.4岁的受试者参与。根据ART修复体评估标准，ART/HVGIC/CHX组（96.8%）和ART/HVGIC组（94.8%）的2年存留率无显著差异，根据FDI修复体评估标准，试验组（97.9%）和对照组（96.9%）之间也未发现显著差异。根据ART和FDI修复标准，分别有8个和5个咬合面修复体失败。未观察到修复体边缘处的牙本质龋损。两组ART修复体的2年存留率都很高。在任何一个治疗组中均未观察到修复体相邻部位发生龋损牙本质病变。没有证据表明通过在HVGIC中加入氯己定来预防恒牙咬合面牙本质龋损的发展或提高ART修复体的存留率是有效的。不含氯己定的HVGIC可成功用于修复恒牙中ART制备的咬合面龋洞。
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