Repair or replacement of restorations A prospective cohort study by dentists in The National Dental Practice-Based Research Network
Repair or replacement of restorations A prospective cohort study by dentists in The National Dental Practice-Based Research Network
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DOI：
10.1016/j.adaj.2015.05.017
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发表时间：
2015-12-01
影响因子：
3.9
通讯作者：
Gilbert, Gregg H.
中科院分区：
文献类型：
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作者：
Gordan, Valeria V.;Riley, Joseph L., III;Gilbert, Gregg H.
背景进行了一项前瞻性队列研究，包括国家牙科实践为基础的研究网络中的牙医，以量化12个月的修复或更换基线失败。该研究验证了一个假设，即12个月后修复和更换的支架之间的故障百分比没有显着差异。它还测试了假设，即某些牙医，患者和修复特征与修复失败的发生率显着相关。牙医记录了50个或更多连续缺陷牙列的数据。12个月后，对修复或更换的假体进行召回，并对缺陷进行表征。牙医（N = 195）记录了5，889个牙齿矫正的数据; 378个牙齿矫正需要额外的治疗（74个修复，171个替换，84个牙齿接受牙髓治疗，49个被拔出）。多变量逻辑回归分析表明，与替换（5%）相比，修复（7%）更容易发生额外的治疗（比值比[OR]，1.6; P <0.001; 95%置信区间[CI]，1.2-2.1），如果与前磨牙或前牙相比，磨牙修复（7%）（分别为5%和6%）（OR，1.4; P = 0.010; 95%CI，1.1-1.7），如果主要原因是骨折（8%），与其他原因（6%）相比（OR，1.3; P = 0.033; 95%CI，1.1-1.6）。如果最初的修复体已经修复（7%），与被替换（5%）相比，在第一年内更有可能发生额外的治疗。然而，修复后的牙列比替换后的牙列更不需要积极的治疗（替换、根管治疗或拔牙）。修复或更换有缺陷的修复体一年后，失败率很低。然而，修复后的包皮环切比替换后的包皮环切需要积极治疗的可能性更小。
Background. A prospective cohort study that included dentists in The National Dental Practice-Based Research Network was conducted to quantify 12-month failures of restorations that were repaired or replaced at baseline. The study tested the hypothesis that no significant differences exist in failure percentages between repaired and replaced restorations after 12 months. It also tested the hypothesis that certain dentist, patient, and restoration characteristics are significantly associated with the incidence of restoration failure.Methods. Dentists recorded data for 50 or more consecutive defective restorations. The restorations that were either repaired or replaced were recalled after 12 months and characterized for developing defects.Results. Dentists (N = 195) recorded data on 5,889 restorations; 378 restorations required additional treatment (74 repaired, 171 replaced, 84 teeth received endodontic treatment, and 49 were extracted). Multivariable logistic regression analysis indicated that additional treatment was more likely to occur if the original restoration had been repaired (7%) compared with replaced (5%) (odds ratio [OR], 1.6; P < .001; 95% confidence interval [CI], 1.2-2.1), if a molar was restored (7%) compared with premolars or anterior teeth (5% and 6%, respectively) (OR, 1.4; P =.010; 95% CI, 1.1-1.7), and if the primary reason was a fracture (8%) compared with other reasons (6%) (OR, 1.3; P =.033; 95% CI, 1.1-1.6).Conclusions. An additional treatment was more likely to occur within the first year if the original restoration had been repaired (7%) compared with being replaced (5%). However, repaired restorations were less likely to need an aggressive treatment (replacement, endodontic treatment, or extraction) than replaced restorations.Practical Implications. One year after repair or replacement of a defective restoration, the failure rate was low. However, repaired restorations were less likely to need an aggressive treatment than replaced restorations.