J Am Dent Assoc. 2021 Apr;152(4):329-330.e2. doi: 10.1016/j.adaj.2021.01.011.
Clinicians often encounter defective restorations and are faced with the difficult decision of whether to repair the existing restoration or replace it.
An electronic survey on repairing or replacing defective restorations was developed to assess how clinicians are making these decisions and the technical aspects considered when making a repair. E-mails containing the survey link were sent to the American Dental Association Clinical Evaluators (ACE) Panel on August 14, 2019, and the survey remained open for 2 weeks. Nonrespondents were sent reminders 1 week after deployment.
Approximately 4 of every 5 respondents repair defective restorations. The top 3 conditions for making these repairs were noncarious marginal defects (87%), partial loss or fracture of the restoration (79%), and crown margin repair due to carious lesions (73%). Among respondents who repair defective restorations, almost all repair direct resin composite (98%), whereas approximately one-third do not repair the other restorative materials (that is, amalgam, glass ionomer, and fractured indirect all-ceramic crowns). Resin composite is used most often to repair resin direct composite restorations, and likewise, glass ionomer is used most often to repair glass ionomer restorations. Only 54% of respondents use amalgam to repair amalgam restorations. Surface treatments varied among the 3 available restorations types.
Many dentists are actively making restoration repairs, but choosing clinical scenarios to make these repairs is material dependent.
The repair of defective restorations is an acceptable and more conservative alternative than restoration replacement, and its success depends on proper case selection, material, and technique.
临床医生经常会遇到有缺陷的修复体,并面临着修复还是更换现有修复体的艰难决策。
开发了一项关于修复或更换有缺陷的修复体的电子调查,以评估临床医生如何做出这些决策,以及在进行修复时考虑的技术方面。2019 年 8 月 14 日,向美国牙科协会临床评估员 (ACE) 小组发送了包含调查链接的电子邮件,调查持续了两周。在部署后一周向未回复者发送了提醒。
大约每 5 个受访者中有 4 个会修复有缺陷的修复体。进行这些修复的前 3 个条件是非龋性边缘缺陷(87%)、修复体部分缺失或破裂(79%)和因龋损导致的冠边缘修复(73%)。在修复有缺陷的修复体的受访者中,几乎所有的修复体都是直接复合树脂(98%),而大约三分之一的修复体不会修复其他修复材料(即汞合金、玻璃离子和破裂的间接全瓷冠)。树脂复合材料最常用于修复树脂直接复合树脂修复体,同样,玻璃离子最常用于修复玻璃离子修复体。只有 54%的受访者使用汞合金来修复汞合金修复体。三种可用修复体类型的表面处理方法各不相同。
许多牙医正在积极进行修复体修复,但选择进行这些修复的临床情况取决于材料。
有缺陷修复体的修复是一种可接受且更保守的替代方案,其成功取决于适当的病例选择、材料和技术。