Tjäderhane Leo, Tezvergil-Mutluay Arzu
Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki University Hospital, PO Box 41, Helsinki 00014, Finland; Research Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, University of Oulu, Oulu, Finland.
Department of Cariology and Restorative Dentistry, Adhesive Dentistry Research Group, Institute of Dentistry, Turku University Hospital, TYKS, University of Turku, Lemminkäisenkatu 2, Turku 20520, Finland.
Dent Clin North Am. 2019 Oct;63(4):715-729. doi: 10.1016/j.cden.2019.05.001. Epub 2019 Jul 13.
Selective carious tissue-removal strategies require specific considerations in selection of restorative materials. A tight marginal seal placed over hard dentin and sound enamel is essential. For selective removal of carious tissue with permanent restoration, bioactive materials, such as high-viscosity glass-ionomer cement (HV-GIC) or calcium silicates, may be preferred over caries-affected firm or leathery dentin to improve remineralization. HV-GICs have the best clinical evidence of caries-arresting effect and demonstrate sufficient longevity as long-term provisional restorations that can later be used in open or closed sandwich restorations. As with any material, oral health maintenance remains important for long-term survival of restorations.
选择性龋组织去除策略在选择修复材料时需要特殊考虑。在硬牙本质和完好釉质上形成紧密的边缘封闭至关重要。对于采用永久性修复进行选择性龋组织去除,生物活性材料,如高粘性玻璃离子水门汀(HV-GIC)或硅酸钙,可能比龋损的坚硬或皮革样牙本质更受青睐,以促进再矿化。HV-GIC具有最佳的阻止龋齿临床证据,并且作为长期临时修复体具有足够的使用寿命,随后可用于开放式或封闭式夹层修复。与任何材料一样,保持口腔健康对修复体的长期存留仍然很重要。