A long-term evaluation of alternative treatments to replacement of resin-based composite restorations Results of a seven-year study
A long-term evaluation of alternative treatments to replacement of resin-based composite restorations Results of a seven-year study
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DOI：
10.14219/jada.archive.2009.0098
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发表时间：
2009-12-01
影响因子：
3.9
通讯作者：
Mjoer, Ivar A.
中科院分区：
文献类型：
--
作者：
Gordan, Valeria V.;Garvan, Cynthia W.;Mjoer, Ivar A.
Objective.在一项为期7年的前瞻性队列研究中，作者评估了未经治疗或通过修复、密封、修整或完全更换进行治疗的有缺陷的树脂基复合材料（RBC）修复的寿命。他们还旨在确定和量化临床医生诊断为缺陷的主要原因。37名患者-19名女性和18名男性-年龄在27至78岁之间（平均值= 57岁，标准差[SD] = 13岁），共有88个有缺陷的矫正参与了这项研究。两位作者根据患者的治疗需求将每个修复体分配到五个治疗组之一：修复（n = 25），封闭缺陷边缘（n = 12），修复（n = 19），更换（n = 16）和无治疗（n = 16）。作者在基线和治疗后6个月、1年、2年和7年进行了生存分析（根据美国公共卫生服务标准）。作者确定，临床医生诊断88个矫正缺陷的主要原因是边缘变色（n = 53，60.2%），边缘退化（n = 18，20.5%）和颜色不匹配（n = 17，19.3%）。作者在六个月后检查了69例（78%），一年后68例（77%），两年后62例（70%），七年后53例（60%）。7年后，每种治疗的失败率分别为：修复0%，封闭缺陷边缘0%，修补18%，更换21%，未治疗23%。这些组的对数秩检验的P值为0.36。修复退化。在所有的标准中有不同程度的差异，不同的治疗方法之间的生存率也不同。7年来收集的纵向数据支持所有非置换修复治疗策略的可行性。
Objective. In a seven-year prospective cohort study, the authors assessed the longevity of defective resin-based composite (RBC) restorations that were not treated or were treated by means of repair, sealing, refinishing or total replacement. They also aimed to identify and quantify the main reasons clinicians diagnosed restorations as defective.Methods. Thirty-seven patients-19 women and 18 men-who were aged 27 through 78 years (mean = 57 years, standard deviation [SD] = 13 years) and had a total of 88 defective restorations participated in the study. Two of the authors assigned each restoration to one of five treatment groups, depending on the patient's treatment need: repair (n = 25), sealing of defective margins (n = 12), refinishing (n = 19), replacement (n = 16) and no treatment (n = 16). The authors conducted a survival analysis (according to modified U.S. Public Health Service criteria) at baseline and again at six months, one year, two years and seven years after treatment.Results. The authors determined that the main reasons clinicians diagnosed the 88 restorations as being defective were marginal discoloration (n = 53, 60.2 percent), marginal degradation (n = 18, 20.5 percent) and color mismatch (n = 17, 19.3 percent). The authors examined 69 (78 percent) restorations at six months, 68 (77 percent) after one year, 62 (70 percent) after two years and 53 after seven years (60 percent). The percentages of failed restorations for each treatment after seven years were 0 percent for repair, 0 percent for sealing of defective margins, 18 percent for refinishing, 21 percent for replacement and 23 percent for no treatment. The P value for the log-rank test of equality for these groups was .36.Conclusions. Restorations degraded. to varying degrees in all criteria, and the survival of restorations differed among treatment approaches. Longitudinal data collected across seven years support the viability of all nonreplacement restoration treatment strategies.