Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial
Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial
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DOI：
10.14219/jada.archive.2007.0265
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发表时间：
2007-06-01
影响因子：
3.9
通讯作者：
DeRouen, Timothy A.
中科院分区：
文献类型：
--
作者：
Bernardo, Mario;Luis, Henrique;DeRouen, Timothy A.
背景牙科治疗失败是牙科实践中的一个主要问题。更换失效的设备构成了手术工作的主要部分。临床医生应了解直接后路置换术的寿命和失败的可能原因。在一项长期随机临床试验中，作者比较了汞合金和复合材料的寿命。作者随机分配了472名受试者中的一半，年龄从8岁到12岁不等，接受后牙银汞合金修复，另一半接受树脂基复合材料修复。研究牙医每年对受试者进行随访口腔检查并拍摄咬翼片。需要更换的修复是失败的。记录修复失败的不同原因。受试者在基线时共接受了1，748次治疗。作者跟踪了七年。总体而言，10.1%的基线预防失败。银汞合金充填成活率为94.4%，复合充填成活率为85.5%。年失效率范围为0.16%至2.83%的汞合金和从0.94%至9.43%的复合材料。继发龋是两种材料失败的主要原因。复合组继发龋的风险是对照组的3.5倍。银汞合金充填比复合充填效果好。性能的差异在大尺寸和涉及三个以上表面的情况下更加突出。临床意义。如果寿命是材料选择的主要标准，则在大后牙的多表面修复中，使用银汞合金似乎比使用复合材料更可取。
Background. Failure of dental restorations is a major concern in dental practice. Replacement of failed restorations constitute the majority of operative work. Clinicians should be aware of the longevity of, and likely reasons for the failure of, direct posterior restorations . In a long-term, randomized clinical trial, the authors compared the longevity of amalgam and composite.Subjects, Methods and Materials. The authors randomly assigned one-half of the 472 subjects,whose age ranged from 8 through 12 years, to receive amalgam restorations in posterior teeth and the other one-half to receive resin-based composite restorations. Study dentists saw subjects annually to conduct follow-up oral examinations and take bitewing radiographs. Restorations needing replacement were failures. The dentists recorded differential, rea:son for restoration failure.Results. Subjects received a total of 1,748 restorations at baseline., which the authors followed for, up to seven years. Overall, 10.1 percent of the baseline restorations failed. The survival rate of the amalgam restorations was 94.4 percent; that of composite restorations was 85.5 percent. Annual failure rates ranged from 0.16 to 2.83 percent for amalgam restorations and from 0.94 to 9.43 percent for composite restorations. Secondary caries was-the main reason for failure in both materials. Risk of secondary caries was 3.5 times greater in the composite group.Conclusion. Amalgam restorations performed better than did composite restorations. The difference-in performance was accentuated in large restorations and in those with more than three surfaces involved. Clinical implications. Use of amalgam appears to be preferable to use of composites in multisurface restorations of large posterior teeth if longevity is the primary criterion in matetial selection.