汞合金替换后大面积直接树脂复合材料修复体的临床寿命，平均随访15年。

Clinical longevity of extensive direct resin composite restorations after amalgam replacement with a mean follow-up of 15 years.

作者信息

Hofsteenge Jelte W, Scholtanus Johannes D, Özcan Mutlu, Nolte Ilja M, Cune Marco S, Gresnigt Marco M M

机构信息

Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, AV, Groningen 9713, the Netherlands.

Private practice, Leeuwarden, the Netherlands.

出版信息

J Dent. 2023 Mar;130:104409. doi: 10.1016/j.jdent.2023.104409. Epub 2023 Jan 6.

DOI:10.1016/j.jdent.2023.104409

PMID:36623686

Abstract

OBJECTIVES

The aim of this retrospective clinical study was to determine the survival of extensive direct resin composite restorations after amalgam replacement on vital molars and premolars after a mean observation period of 15 years.

METHODS

Between January 2007 and September 2013, a total of 117 extensive cusp replacing direct resin composite restorations were placed in 88 patients in a general dental practice. These were indicated for replacement of existing amalgam restorations. Tooth vitality, the absence of at least one cusp in premolars, and at least two cusps in molars were considered for inclusion. The long-term follow-up of the restorations, re-evaluated after up to 17 years using the original evaluation criteria is reported.

RESULTS

81 of 88 patients (92.1%) and 106 of 117 restorations (90.6%) were available for follow-up. The cumulative success rate was 62.0% (95% CI: 47.3-76.2, AFR 2.79%) after a mean observation time of 163.4 months, the cumulative survival rate was 74.7% (95% CI: 59.8-89.6%, AFR: 1.70%) after a mean observation time of 179.1 months. The number of cusps replaced in premolars had a statistically significant influence on the success and survival rate of the restorations (HR of respectively, 2.974 and 3.175, p = <0.0005). Premolars with two cusps replaced had 297% more chance of failure than premolars with one cusp replaced.

CONCLUSIONS

Extensive direct resin composite restorations placed after amalgam replacement showed good survival after a mean observation period of 15 years. The number of cusps involved had a statistically significant influence on the longevity of the restorations in premolars.

CLINICAL SIGNIFICANCE

With good survival and low annual failure rates, direct resin composite restorations are a suitable treatment for repairing extensive defects in posterior teeth involving multiple cusps and surfaces, provided that they are placed by a dentist who has long experience and is skilled in the placement of direct composite materials.

摘要

目的

本回顾性临床研究旨在确定在平均观察期为15年后，对活髓磨牙和前磨牙进行汞合金置换后，大面积直接树脂复合体修复体的存留情况。

方法

在2007年1月至2013年9月期间，一家普通牙科诊所的88例患者共进行了117次大面积牙尖替换直接树脂复合体修复。这些修复是为了替换现有的汞合金修复体。纳入标准为牙齿有活力，前磨牙至少一个牙尖缺失，磨牙至少两个牙尖缺失。报告了使用原始评估标准对修复体进行长达17年的长期随访情况。

结果

88例患者中的81例（92.1%）和117个修复体中的106个（90.6%）可进行随访。平均观察时间163.4个月后，累积成功率为62.0%（95%可信区间：47.3 - 76.2，年失败率2.79%）；平均观察时间179.1个月后，累积存留率为74.7%（95%可信区间：59.8 - 89.6%，年失败率：1.70%）。前磨牙替换牙尖的数量对修复体的成功率和存留率有统计学显著影响（风险比分别为2.974和3.175，p = <0.0005）。替换两个牙尖的前磨牙失败几率比替换一个牙尖的前磨牙高297%。