玻璃离子和流体树脂修复楔状缺损的疗效比较

Comparation of the Clinical Effects of Glass Ionomer Cement and Flowable Composite Resin on the Restoration of Dental Wedge-Shaped Defects

目的:探讨玻璃离子和流体树脂用于楔状缺损的修复的临床效果。方法:选择105例中型楔状缺损患者(376颗患牙),楔状缺损深度大于1 mm且小于2 mm、仅出现牙本质过敏症状、无牙髓炎症状。将患者左右两侧同名牙采用自身对照法随机分为玻璃离子衬垫组(A组)和流体树脂衬垫组(B组),A组以玻璃离子和复合树脂充填;B组以流体树脂和复合树脂充填。采用Ryge和USPHS评价标准,比较术后1周、1个月、1年、3年的敏感发生率及充填体脱落率。结果:失访18例70牙,复查87例306牙,复查率为81.4%。A组楔状缺损充填修复后1周、1个月的术后敏感发生率分别为18.3%(28/153)、9.2%(14/153),B组分别为35.9%(55/153)、28.1%(43/153),差异均有统计学意义(P均<0.01);修复后1年和3年2组术后敏感发生率差异无统计学意义。A组患牙术后1年、3年充填体脱落率分别为9.8%(15/153)、11.8%(18/153),B组分别为2.6%(4/153)、3.3%(5/153),差异均有统计学意义(P<0.05和0.01);修复后1周、1个月差异均无统计学意义。结论:采用玻璃离子和流体树脂作为夹层技术中的衬垫材料修复楔状缺损,对于预防术后敏感和降低充填体脱落率均有理想的疗效。但是玻璃离子作为衬垫材料在预防术后敏感方面要优于流体树脂,而流体树脂作为衬垫材料在修复体固位力方面则优于玻璃离子。

Objective：To compare the clinical effects of glass ionomer cement（GIC） and flowable composite resin（FCR） on the restoration of dental wedge-shaped defects as liners.Methods：A total of 376 teeth from 105 patients with wedge-shaped defects were studied and divided into Group A and Group B randomly with self-contrasted method.The depth of wedge-shaped defects was more than 1 mm and less than 2 mm,and the patients were with dentin hypersensitiveness and without pulpitis.Group A was restored with composite resin after applying flowable composite as a liner in one side,and Group B was filled with composite resin after lined with GIC.The Ryge criteria and United States Public Health Service（USPHS） criteria were used to evaluate postoperative sensitivity and cumulative loss rates of the treatment effects after 1 week,1 month,1 year and 3 years.Results： Postoperative sensitivity after 1 week and 1 month in Group A were 18.3 %（28/153） and 9.2 %（14/153）,respectively;and they were 35.9 %（55/153） and 28.1 %（43/153） in Group B,respectively.There was significant difference between the two groups（P all0.01）.There was no significant difference between two groups after 1 year and 3 years.Postoperative cumulative loss rates after 1 year and 3 years in Group A were 9.8 %（15/153）,and 11.8 %（18/153）,respectively;they were 2.6 %（4/153） and 3.3 %（5/153） in Group B,respectively.There was significant difference between the two groups（P0.05 and 0.01）.But there was no significant difference between the two groups after 1 week and 1 month.Conclusions： Both GIC and FCR are ideal materials for restoration of dental wedge-shaped defects as liners,but GIC has its advantages in anti-postoperative sensitivity,while the FCR has good retention.