自酸蚀粘结剂联合流体树脂修复楔状缺损的疗效观察(1)
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[摘要]目的：探讨自酸蚀粘结剂联合流体树脂修复楔状缺损的疗效。方法：对21例患者共126颗牙髓活力正常的牙颈部楔状缺损分别进行充填治疗，随机分成实验组和对照组，每组63颗牙。实验组使用CLEARFIL S3 BONDTM自酸蚀粘结剂和流体树脂进行充填；对照组常规酸蚀，涂布粘结剂和复合树脂充填。评价两组6个月、1年、2年的保留成功率。结果：两组在治疗后6个月，成功率差异无统计学意义；治疗后2年，自酸蚀粘结剂联合流体树脂充填成功率为95%，对照组为76.6%，两组差异有统计学意义(P<0.01)。结论：自酸蚀粘结剂和流体树脂充填楔状缺损牙髓刺激性小，可明显提高修复充填体的固位率，值得推广应用。
[关键词]流体树脂；自酸蚀粘结剂；楔状缺损；修复
[中图分类号]R783 [文献标识码]A [文章编号]1008-6455(2011)09-1444-03
Effect research of clinical dental wedge-shaped defects be fulled byself-etching adhesive and flowable resin
SHI Chun-mei,TANG Ji-wei,OU Xiao-li,FANG Ping,LI Yan
(Department of Stomatology,People's Hospital of Guangxi Zhuang Autonomous Regien,Nanning 530021,Guangxi,China)
Abstract:ObjectiveTo study the clinical effect of self-etching adhesive(CLEARFIL S3 BONDTM) and flowable resin on restoring dental wedge-shaped defects. Methods A total of 126 teeth with wedge-shaped defect were divided into 2 groups randomly.Test group was treated by CLEARFIL S3 BONDTM and flowable resin while the control was restored by 3M FiltekTM Z350 compomer.The clinical effects after two years were compared. Results There was nosignificant difference between two groups of success rate (P>0.05) after 6 months. But two years later,the success rate of flowable resin was 95.0%,while the control group was 76.6%.There was significant difference between two groups(P<0.01).ConclusionCLEARFIL S3 BONDTM and Flowable resin exhibited better clinical efect than 3M FiltekTM Z350 compomer during our study period，which makes it a good choice for treating dental wedge-shaped defects.
Key words:flowable resin;self-etching adhesive;wedge-shaped defects;restoring
楔状缺损(wedge-shaped defect)是牙齿唇、颊侧颈部硬组织发生缓慢消耗所致的缺损，因形态呈窄端向内的楔形而得名。目前其确切病因不明，多认为与不正确刷牙、牙颈部组织结构薄弱、局部酸的作用及牙体疲劳等原因有关。早期症状不明显，病变累及牙本质后可出现牙本质敏感症状，进一步发展可造成牙髓根尖周病变，因此对楔状缺损的早期处理十分重要。楔状缺损最有效的治疗方法即是采用树脂和玻璃离子类材料进行充填修复。由于其特殊形态，缺乏固位性，传统的复合树脂修复楔状缺损存在脱落率高，术后敏感发生率高等缺点。因此，充填材料的正确选择对于提高楔状缺损的治疗成功率很重要。
流动性树脂充填材料是20世纪90年代末开发出的新型材料，它具有一定的渗透性和流动性，可以方便地封闭充填体边缘，并允许用于小面积龋损的充填。而传统的复合树脂修复楔状缺损存在脱落率高，术后敏感发生率高等缺点。本研究采用自酸蚀粘结剂联合流体树脂修复楔状缺损与常规光固化复合树脂修复比较，观察其临床疗效。现报道如下。
1资料和方法
1.1 临床资料：选择2009年2月～2011年2月口腔门诊就诊的楔状缺损患者21例(男12例，女9例)，年龄20～45岁。共126颗患牙，其中前牙24颗，尖牙22颗，前磨牙56颗，磨牙24颗。所有牙均无龋、无牙周病，牙髓活力测试正常。将每一患者的左右同名患牙随机分为实验组和对照组 ......
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