Development of effective clinical management of cervical lesions based on evidence

(1)最新的一步自蚀刻体系的结合强度显著高于早期的一步自蚀刻体系。然而，即使是最新的系统也不能消除技术敏感性。(2)两步自蚀（Liner Bond 2）和两步全蚀（Single Bond）系统修复的5级树脂复合材料9年来表现出优异的临床性能。(3)虽然与两步系统相比，边缘变色发生得更早，但用最新的一步自蚀蚀系统（S^3 Bond和G-Bond）修复的5级树脂复合材料在18个月内表现出可接受的临床性能。(4)不同类型树脂复合材料（混合型：Clearfil AP-X；可流动型Clearfil Flow FX）的临床表现无显著差异。(5) 5类树脂复合材料的10年生存率在操作者之间存在显著差异（主要研究者为86%，其他牙医为54%）。(6)修复体丢失是5级树脂复合材料失效的主要原因。但从牙型上看，其主要原因不同：前牙继发龋，后牙脱落。(7)宫颈非龋齿病变的平均进展率约为70 μm /年。(8)宫颈部位的龋如处于非活跃期，则已被控制了5.8年。(9)一项关于树脂复合材料再处理决策的问卷调查显示，在某些情况下，牙医之间的标准差异很大。（10）长期临床观察表明，对修复体的监测可以提供更准确的诊断和正确的决策。

(1) The latest one-step self-etch systems showed significant higher bond strengths than earlier one-step systems. However, even the latest systems could not eliminate technique sensitivity.(2) Class 5 resin composites restored with two-step self-etch (Liner Bond 2) and two-step total-etch (Single Bond) systems have demonstrated excellent clinical performances for 9 years.(3) Although marginal discoloration occurred earlier compared to the two-step systems, class 5 resin composite restored with the latest one-step self etch systems (S^3 Bond and G-Bond) have shown acceptable clinical performances for 18 months.(4) There were no significant difference in clinical performances between types of resin composite (hybrid : Clearfil AP-X ; flowable Clearfil Flow FX).(5) Significant difference in 10-year survival rates of class 5 resin composites was found between operators (principal investigator:86%, other dentists:54%).(6) Loss of restorations was the main reason for failures of class 5 resin composites. From the viewpoint of tooth types, however, their main reasons were different: secondary caries for anterior teeth and loss for posterior teeth.(7) Mean progress rate of non-carious cervical lesions was approximately 70 μm per year.(8) Caries at cervical regions has been arrested for 5.8 years if it was in non-active stage.(9) A questionnaire study on decision-making for retreatment of resin composites revealed that there were great variances in criteria among dentists in some cases.(10) Long-term clinical observation suggested that monitoring of restorations could provide more accurate diagnosis and proper decision-making.