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在智力和/或身体残疾的成年患者中,全身麻醉下放置直接复合树脂修复体的存活率。

Survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities.

机构信息

Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.

出版信息

Clin Oral Investig. 2021 Jul;25(7):4563-4569. doi: 10.1007/s00784-020-03770-y. Epub 2021 Jan 15.

Abstract

OBJECTIVES

This study aimed to assess the survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities.

MATERIALS AND METHODS

Survival of composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities was retrospectively analyzed. Failure was defined as the need for replacement of at least one surface of the original restoration or extraction of the tooth. Individual-, tooth-, and restoration-related factors were obtained from dental records. Five-year mean annual failure rate (mAFR) and median survival time were calculated (Kaplan-Meier statistics). The effect of potential risk factors on failure was tested using univariate log-rank tests and multivariate Cox-regression analysis (α = 5%).

RESULTS

A total of 728 restorations in 101 patients were included in the analysis. The survival after 5 years amounted to 67.7% (5-year mAFR: 7.5%) and median survival time to 7.9 years. Results of the multivariate Cox-regression analysis revealed physical disability (HR: 50.932, p = 0.001) and combined intellectual/physical disability (HR: 3.145, p = 0.016) compared with intellectual disability only, presence of a removable partial denture (HR: 3.013, p < 0.001), and restorations in incisors (HR: 2.281, p = 0.013) or molars (HR: 1.693, p = 0.017) compared with premolars to increase the risk for failure.

CONCLUSION

Composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities showed a reasonable longevity as 67.7% survived at least 5 years.

CLINICAL RELEVANCE

Survival of composite restorations depends on risk factors that need to be considered when planning restorative treatment in patients with intellectual and/or physical disabilities. NCT04407520.

摘要

目的

本研究旨在评估在智力和/或身体残疾的成年患者中全身麻醉下放置的直接复合修复体的存活率。

材料和方法

回顾性分析了在智力和/或身体残疾的成年患者中全身麻醉下放置的复合修复体的存活率。失败定义为需要更换原始修复体的至少一个表面或拔牙。从牙科记录中获得个体、牙齿和修复体相关因素。计算 5 年平均年失败率(mAFR)和中位生存时间(Kaplan-Meier 统计)。使用单变量对数秩检验和多变量 Cox 回归分析(α=5%)测试潜在危险因素对失败的影响。

结果

共纳入 101 例患者的 728 个修复体进行分析。5 年后的存活率为 67.7%(5 年 mAFR:7.5%),中位生存时间为 7.9 年。多变量 Cox 回归分析结果显示,与单纯智力障碍相比,身体残疾(HR:50.932,p=0.001)和智力/身体残疾并存(HR:3.145,p=0.016)、存在可摘局部义齿(HR:3.013,p<0.001)以及前磨牙(HR:2.281,p=0.013)或磨牙(HR:1.693,p=0.017)修复体的修复体增加了失败的风险。

结论

在智力和/或身体残疾的成年患者中全身麻醉下放置的复合修复体具有合理的耐用性,67.7%的患者至少存活 5 年。

临床相关性

复合修复体的存活率取决于在智力和/或身体残疾患者的修复治疗计划中需要考虑的危险因素。NCT04407520。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7059/8310491/d01ffd5213c4/784_2020_3770_Fig1_HTML.jpg

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