Efficacy of bonded and nonbonded amalgam in the treatment of teeth with incomplete fractures
Efficacy of bonded and nonbonded amalgam in the treatment of teeth with incomplete fractures
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DOI：
10.14219/jada.archive.2000.0203
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发表时间：
2000-04-01
影响因子：
3.9
通讯作者：
Overton, JD
中科院分区：
文献类型：
--
作者：
Davis, R;Overton, JD
背景本临床研究比较了粘结剂固位与针固位复合银汞合金充填治疗磨牙不完全骨折的疗效。在两周、三个月和一年后评估咀嚼疼痛和冷敏感性的缓解情况。作者治疗了38例以活髓磨牙咀嚼敏感为主诉的患者（研究中有40颗牙齿）。一个随机数发生器决定了每颗牙齿的治疗方法。20颗牙齿接受粘结汞合金充填。20颗牙齿接受了汞合金或螺纹钉来保持汞合金。评估牙齿的术后咀嚼敏感性。视觉模拟疼痛量表用于评估每次访视时对皮肤制冷剂浸泡的棉球的冷反应。12个月后，所有40颗牙齿都可用于评估。除了一颗牙齿外，所有牙齿的咀嚼疼痛都完全消除了。Student's t检验发现粘结组和非粘结组之间术前冷敏感性无显著差异（P > 0.05）。配对t检验比较表明，粘结组的牙齿在3个月和12个月后对寒冷的敏感性明显低于基线测量时（P < .0001）。配对t检验显示非粘结组术前和术后牙齿冷敏感评分无显著差异（P > 0.05）。无论是粘结式还是机械固位式复合银汞合金充填都能成功地解决隐裂磨牙的咀嚼敏感问题，40颗牙中有39颗在一年的随访期间咀嚼敏感没有恢复。在3个月和12个月时，粘结涂层的冷敏感性降低。在所有三个时间段，冷敏感性保持类似的基线水平的机械保留fractionations.Clinical意义。摘要用银汞合金覆盖折断的牙尖，可以成功地治疗磨牙不完全性牙折。这项研究排除了对冷刺激长期敏感的牙齿或有牙周炎证据的牙齿。通过这些排除，可以预测咀嚼敏感性的消除。用粘结剂修复的牙齿在3个月和12个月时对冷刺激的敏感性降低，但在两周时没有。非粘结修复体修复后的牙齿在基线、2周、3个月和1年时的冷敏感性相似。
Background. This clinical study compared the efficacy of adhesive-retained vs. pin-retained complex amalgam restorations in the treatment of molars with incomplete fractures. Both relief of chewing pain and cold sensitivity were evaluated at two weeks, three months and one year.Methods. The authors treated 38 patients with a chief complaint of chewing sensitivity on vital molar teeth (40 teeth in the study). A random-number generator determined the treatment method for each tooth. Twenty teeth received bonded amalgam restorations. Twenty teeth received amalgapins or threaded pins to retain the amalgam. Teeth were evaluated for postoperative chewing sensitivity. A visual analog pain scale was used to evaluate cold response to a skin-refrigerant-soaked cotton pellet at each visit. After 12 months, all 40 teeth were available for evaluation.Results. Chewing pain was completely eliminated in all but one tooth. A Student's t-test found no significant difference (P > .05) in preoperative cold sensitivity between the bonded and nonbonded groups. A paired t-test comparison indicated that the teeth in the bonded group were significantly less sensitive to cold after three months and 12 months than they were at the time of the baseline measurements (P < .0001). A paired t-test indicated no significant difference between preoperative and postoperative cold sensitivity scores for teeth in the nonbonded group (P > .05).Conclusions. Both adhesively bonded and mechanically retained complex amalgam restorations were successful in resolving chewing sensitivity in cracked molars, For 39 of 40 teeth, chewing sensitivity did not return during the one-year follow-up period. At three months and 12 months, cold sensitivity was reduced in the bonded restorations. At all three time periods, cold sensitivity remained similar to baseline levels for the mechanically retained restorations.Clinical Implications. Incomplete tooth fracture in molars can be successfully treated by covering fractured cusps with amalgam restorations. This study excluded teeth with prolonged sensitivity to a cold stimulus or those with periodontal evidence of root fracture. With these exclusions, elimination of chewing sensitivity was predictable. Teeth restored with bonded restorations experienced a decrease in sensitivity to a cold stimulus at three months and at 12 months, but not at two weeks. The cold sensitivity of teeth restored with nonbonded restorations was similar at baseline, two weeks, three months and one year.