Development of effective clinical management of cervical lesions based on evidence

(1)最新的一步自酸蚀系统显示出比以前的一步系统显著更高的结合强度。然而，即使是最新的系统也不能消除技术敏感性。(2)两步自酸蚀(Liner Bond2)和两步全酸蚀(Single Bond)系统修复的5类树脂复合体9年来表现出良好的临床性能。(3)虽然边缘变色发生得比两步系统更早，但用最新的一步自酸蚀系统(S^3 Bond和G-Bond)修复的5类树脂复合体在18个月的临床表现可以接受。(4)不同类型的树脂复合体(混合：Clearfi AP-X；(5)不同操作人员之间5类树脂复合体的10年存活率有显著差异(主要调查者：86%，其他牙科医生：54%)。(6)修复体失修复体是导致5类树脂复合体失败的主要原因。但从牙齿类型来看，其主要原因不同：前牙继发性龋病和后牙缺失。(7)非龋性宫颈病变的平均进展速度约为每年70μm。(8)非活动期的颈部龋阻止期为5.8年。(9)关于树脂复合体再治疗决策的问卷调查显示，在某些情况下，牙医在标准上存在较大差异。(10)长期的临床观察表明，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.