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磨牙牙釉质发育不全患牙的黏结修复:一项随机临床试验。

Adhesive restoration of molars affected by molar incisor hypomineralization: a randomized clinical trial.

机构信息

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.

出版信息

Clin Oral Investig. 2021 Mar;25(3):1513-1524. doi: 10.1007/s00784-020-03459-2. Epub 2020 Jul 21.

Abstract

OBJECTIVE

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.

MATERIAL AND METHOD

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.

RESULTS

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.

CONCLUSION

Both restorative protocols presented similar longevity, decreasing self-reported pain and anxiety levels.

CLINICAL RELEVANCE

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.

摘要

目的

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。

材料和方法

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。

结果

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。

结论

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。

临床意义

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。

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