Department of Stomatology, Universidade Federal do Parana Setor de Ciencias da Saude, Av. Prefeito Lothário Meissner 632, Curitiba, State of Paraná, 80210-170, Brazil.
School of Health and Biological Sciences, Universidade Positivo, Curitiba, Brazil.
Clin Oral Investig. 2021 Mar;25(3):1513-1524. doi: 10.1007/s00784-020-03459-2. Epub 2020 Jul 21.
This randomized clinical trial evaluated the survival of direct restorations on first permanent molars (FPMs) with molar incisor hypomineralization (MIH) and its impact on self-reported dental pain and dental anxiety.
FPMs with MIH of 35 patients aged 7 to 16 years were included. The FPMs were randomized into the following two groups: total-etch (TE-37% phosphoric acid etching) and self-etch (SE-no prior etching). The FPMs were restored with universal adhesive and bulk-fill resin composites. The restoration survival was evaluated according to USPHS criteria modified by a blinded examiner. Dental anxiety (Venham picture test) and dental pain (Faces pain scale-revised) were evaluated before treatment and at 1, 6, and 12 months post-treatment. Survival rates were analyzed by the Kaplan-Meier method and the log-rank test. Nonparametric tests compared pain and anxiety in the follow-up periods.
A total of 64 FPMs were restored (TE = 33; SE = 31). Survival rates were 96.9% (TE) and 96.7% (SE) after 1 month, 90.5% (TE) and 80.6% (SE) after 6 months, and 80.8% (TE) and 62.3% (SE) after 12 months (p > 0.05). Self-reported dental pain and anxiety level decreased after treatment in both groups (p < 0.05). Self-reported pain decreased after 1 month in SE, but it occurred at 6 months in TE.
Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels.
A universal adhesive could be appropriate for restoration of MIH-affected teeth, and the survival of restorations could be higher in the total-etch technique, reducing dental pain and anxiety.
本随机临床试验评估了伴有低矿化磨牙(MIH)的第一恒磨牙(FPM)直接修复体的存活率及其对自我报告的牙齿疼痛和牙科焦虑的影响。
纳入了 35 名 7 至 16 岁患有 MIH 的 FPM 患者。FPM 随机分为以下两组:全酸蚀(TE-37%磷酸酸蚀)和自酸蚀(SE-无预处理酸蚀)。FPM 用通用粘结剂和块状填充树脂复合材料修复。修复体的存活率根据改良后的 USPHS 标准由盲法检查者评估。在治疗前、治疗后 1、6 和 12 个月时评估牙科焦虑(Venham 图片测试)和牙齿疼痛(修订后的 Faces 疼痛量表)。通过 Kaplan-Meier 方法和对数秩检验分析存活率。非参数检验比较了随访期间的疼痛和焦虑。
共修复了 64 个 FPM(TE=33;SE=31)。治疗后 1 个月时,存活率分别为 96.9%(TE)和 96.7%(SE),6 个月时分别为 90.5%(TE)和 80.6%(SE),12 个月时分别为 80.8%(TE)和 62.3%(SE)(p>0.05)。两组治疗后自我报告的牙齿疼痛和焦虑水平均降低(p<0.05)。SE 组的自我报告疼痛在治疗后 1 个月时下降,但在 TE 组中则在 6 个月时下降。
两种修复方案均具有相似的长期效果,可降低自我报告的疼痛和焦虑水平。
通用粘结剂可适用于 MIH 受累牙齿的修复,全酸蚀技术可提高修复体的存活率,降低牙齿疼痛和焦虑。