楔状缺损治疗失败的原因分析

Analysis of the failure of the restoration for teeth with wedge-shape defects

[目的]通过远期疗效的观察,分析楔状缺损治疗失败的原因.[方法]79例518颗楔状缺损牙分别用光固化复合树脂和进口玻璃离子修复,于修复后1、2年及4年根据一定指标评价其疗效.[结果]楔状缺损修复后的临床成功率从2年时的85.3%,下降为4年时的27.6%,并发现1.7%(修复后2年)和6.6%(修复后4年)的患牙原楔状缺损修复体颈缘下方出现的新"楔状缺损".疗效受多种因素影响,有咬合因素患牙组的临床失败率明显高于无咬合因素组.[结论]楔状缺损修复治疗失败率受患牙承担咬合力的大小和修复材料物理性能的影响,提示在楔状缺损的治疗中,一定要考虑咬合因素的祛除.

[Objective] To evaluate the failure reason of the treatment for teeth with wedge-shaped defects on long-term.[Method] A hundred and eighteen teeth of serenty-nine cases with wedge-shape were randomly divided into two groups. One group was restored by 3M Z100,the other was restored by GC Fuji Ⅱglass ionomer cement. After 1 year,2 or 4 years, the successful rate was evaluated according to the defect of the filling.[Results] The result is that:ithe successful rate dropped from 2 year 85.3% to 4 year 27.6% .ii the new wedge shape defects were presented at the cervical margin of the original restoration in 1.7% (2 year later ) and 6.6% (4 years later ). The curative effect influenced by many factors. The failure rate in the group with occlusal interference was significantly higher than that without occlusal interference. [Conclusions] The clinical failure rate is affected by the value of occlusal force on the restored teeth and the physical properties of the restorative materials. It is suggested that the process of restoration of dental wedge-shaped defect should include obviating occlusal factors as well as improving the properties of restorative materials.