银汞合金黏结修复术临床应用5年疗效观察

Clinical performance of bonded amalgam restorations aftter five years

目的:观察银汞合金黏结修复术修复保留部分无基釉邻面洞的疗效,为该技术的推广应用提供临床依据。方法:采用随机双盲实验,实验组和对照组分别使用一滴棒黏结剂和洞漆后银汞合金修复,分别在修复后0.5、1、2、5年复诊,评价修复体保存,边缘折裂,以及继发龋的发生情况。结果:在5年的追踪观察中,两组除了在修复体脱落情况上无明显差异外,在边缘折裂和继发龋发生情况上两组均表现出显著性差异:对照组(洞漆组)修复体边缘折裂28例(70%),修复体边缘发生继发龋20例(50%),实验组(一滴棒黏结修复组)修复体边缘折裂6例(15%),继发龋4例(10%)。结论:银汞合金黏结剂修复术用于邻面洞修复,既提高了充填后牙齿的整体强度,又降低了邻面洞对洞形预备的要求,尤其是减少了无基釉的切割,可更大程度地保存牙体硬组织。一滴棒是一种合适的银汞合金黏结剂。

AIM： To evaluate the effect of amalgam bonding applied in nonretentive class Ⅱ restorations. METHODS ： The clinical performance of bonded amalgam restorations was examined after five years of clinical service and compared it with that of nonbonded amalgam restorations. In this double - blind study, these subjects had been randomly assigned to have amalgam restorations placed with an adhesive liner （One Coat Bond） or with a drop of copal varnish placed under all restorations. The marginal adaptation, retention and the presence of secondary caries at six months, one, two and five years were evaluated. RESULTS：At five years, statistical analysis showed no significant differences between the two techniques in the retention of restorations. Restorations in adhesive preparations were successful during this period in preventing marginal fracture and secondary caries （P ≤0. 025）. CONCLUSION：Bonded amalgam restorations were clinically successful in nonretentive preparations over a five - year period. It was concluded that the bonded amalgam to tooth structure could partly restore the strength and rigidity lost by the cavity preparation. This might lead to a reduction in the incidence of tooth fracture due to fatigue. One Coat Bond is a suitable adhesive liner in amalgam bonding.