从复合树脂直接粘接修复材料的发展看临床技术指南

Correspondence between advances of dental composites and adhesives and clinical guidelines for direct restorations

复合树脂直接粘接修复术核心材料的性能制约着临床操作程序，进而影响临床疗效。为克服临床上出现的问题，学者们对复合树脂基质和填料不断研发以改良其性能；在成熟的酸蚀-冲洗-粘接牙釉质的基础上，突破牙本质粘接难点研发出白酸蚀粘接系统。尚未克服的材料性能的局限性要求通过严格的临床操作表达技术目标，美国、欧洲和中国均建立了相应的临床操作技术指南。本文通过分析材料性能，重点阐述了技术指南中关于牙体组织去腐、粘接界面准备和粘接剂应用3个关键环节，并介绍了材料进入临床的准人标准和临床疗效评价系统的应用。

The longevity of direct adhesive restoration is related to the restorative materials, the patient and the professional. On one hand, dental composites / adhesives have been modified and developed to fulfill the criteria for clinical application. On the other hand, the clinical guidelines for adhesive restorations have been released and updated accordingly, which would prolong the longevity of restorations. In this commentary, the removal of carious tissues, interface preparation for bonding and application of adhesives are emphasized. The administrative measures for registration and clinical evaluation criteria for adhesive restorative material are also introduced.