Long-term Clinical Evaluation on Pulp Complication of Composite Resin Restorations with Self-etching Adhesives

目的：本研究的目的是对自酸蚀粘接系统进行长期评价，并验证缺乏保护层不是该系统长期牙髓并发症的原因。方法：所有150例患者，谁收到这种类型的修复，至少2年后，从恢复的时间被召回。在47名患者中（31%），对107名2.2至6.5岁的儿童进行了牙齿敏感和牙髓活力检查。结果采用Fisher精确检验和多因素Logistic回归分析。结果如下：4例（3.7%）深窝洞牙髓保护治疗后（3例术后短期敏感）因炎症而切除牙髓。多变量logistic回归分析估计的比值比的95%置信区间为：空洞深度[1.54至∞]（p=0.020<0.05），保护层提供[0.02至∞]（p=1>0.05），术后短期敏感性[1.50至∞]（p=0.022<0.05）。结论：最初在7天评估的深腔和短期术后敏感性的存在是本研究所研究的持续时间（2.2至6.5年）内牙髓并发症发生的两个关键预测因素。自酸蚀粘结剂系统在深龋洞中的牙髓并发症与常规护髓方法的缺失无关

Objective : The aim of the present study was to make a long-term assessment on self-etching adhesive system for composite resin restoration and to test the hypothesis that the absence of protective layers was not responsible for long-term pulp complication in this system. Methods : All 150 patients, who received this type of restorations, were recalled after at least 2 years from the time of restoration. Of 47 patients responded (31%), 107 restorations, 2.2 to 6.5 years old, were examined for tooth sensitivity and pulp vitality. The results were analyzed by Fisher's exact test and multivariate logistic regression analysis. Results : No positive case was found in the assessment of tooth sensitivity, while 4 restorations (3.7%) made in deep cavities with pulp protection (3 with short-term postoperative sensitivity) resulted in pulpectomy due to inflammation. The 95% confidence intervals for odds ratio estimated by the multivariate logistic regression analysis were [1.54 to ∞](p=0.020<0.05) for cavity depth, [0.02 to ∞](p=1>0.05) for provision of protective layer, and [1.50 to ∞](p=0.022<0.05) for short-term postoperative sensitivity. Conclusion : Deep cavity and the existence of short-term postoperative sensitivity originally assessed at 7 days were the two critical predictors for the occurrence of pulp complication for the duration (2.2 to 6.5 years) investigated in the present study. The absence of conventional pulp protection was not responsible for the pulp complication in deep cavities with the self-etching adhesive system