Posterior composite restoration update: focus on factors influencing form and function.
Posterior composite restoration update: focus on factors influencing form and function.
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DOI：
10.2147/ccide.s42044
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Spencer P
中科院分区：
文献类型：
--
作者：
Bohaty BS;Ye Q;Misra A;Sene F;Spencer P
用树脂基复合材料修复后牙在临床医生中继续受到欢迎，并且对这种美学修复的需求正在增加。事实上，牙科汞合金最常见的美学替代品是树脂复合材料。然而，中到大的后牙复合体修复失败率较高，龋齿复发率较高，更换频率也较高。地球仪的研究人员正在研究新的材料和技术，以改善复合树脂修复材料的临床性能、处理特性以及机械和物理性能。尽管如此，大到中度的后牙复合材料修复的临床寿命仍然是牙科汞合金的一半。虽然有许多关于准备设计，修复体放置和聚合技术的建议，但目前的研究表明，修复体寿命取决于牙医可能难以控制的几个变量。这些变量包括患者的龋齿风险，牙齿位置，患者习惯，修复表面的数量，牙齿修复粘结的质量，以及修复材料产生密封牙齿修复界面的能力。尽管临床医生在评价后牙复合体充填的成功和失败时倾向于关注牙形，但重点必须仍然是提高我们对影响充填-牙齿界面持久密封形成的临床变量的理解。本文介绍了现有技术的更新，并强调了对恒牙后牙复合体修复耐久性产生负面影响的机制。
Restoring posterior teeth with resin-based composite materials continues to gain popularity among clinicians, and the demand for such aesthetic restorations is increasing. Indeed, the most common aesthetic alternative to dental amalgam is resin composite. Moderate to large posterior composite restorations, however, have higher failure rates, more recurrent caries, and increased frequency of replacement. Investigators across the globe are researching new materials and techniques that will improve the clinical performance, handling characteristics, and mechanical and physical properties of composite resin restorative materials. Despite such attention, large to moderate posterior composite restorations continue to have a clinical lifetime that is approximately one-half that of the dental amalgam. While there are numerous recommendations regarding preparation design, restoration placement, and polymerization technique, current research indicates that restoration longevity depends on several variables that may be difficult for the dentist to control. These variables include the patient’s caries risk, tooth position, patient habits, number of restored surfaces, the quality of the tooth–restoration bond, and the ability of the restorative material to produce a sealed tooth–restoration interface. Although clinicians tend to focus on tooth form when evaluating the success and failure of posterior composite restorations, the emphasis must remain on advancing our understanding of the clinical variables that impact the formation of a durable seal at the restoration–tooth interface. This paper presents an update of existing technology and underscores the mechanisms that negatively impact the durability of posterior composite restorations in permanent teeth.