不同粘接系统用于楔状缺损直接修复的临床观察  

Clinical evaluation of a two-step etch-and-rinse adhesive and a one-step self-etch adhesive in non-carious cervical lesion

作　　者：田福聪[1] 王晓燕[1] 高学军[1] 

机构地区：[1]北京大学口腔医学院.口腔医院牙体牙髓科,北京100081

出　　处：《北京大学学报（医学版）》2014年第1期58-61,共4页Journal of Peking University:Health Sciences

基　　金：卫生公益性行业科研专项(201002017)基金资助~~

摘　　要：目的:比较两步法酸蚀冲洗型粘接剂与一步法自酸蚀粘接剂用于楔状缺损直接修复的临床效果。方法:选择口内同时存在两颗楔状缺损患牙的患者50人,随机采用两步法酸蚀冲洗型粘接剂(α组)或一步法自酸蚀粘接剂(β组)粘接并用复合树脂修复缺损。所有操作由一位医师按照标准临床步骤完成,再由另外一位检查者根据改良USPHS(United States Public Health Service)评价标准在术后1周(基线)、6个月及18个月对修复体固位、边缘适合性、边缘着色、继发龋、术后敏感进行评价,采用卡方检验对复查结果进行统计分析。结果:基线两组各纳入50例修复体;6个月复查48位患者,α组与β组分别有两例修复体脱落,18个月复查44位患者,α组与β组分别累计有4例和6例修复体脱落,固位率分别为α组90.0%,β组86.4%。α和β组分别有3例和5例修复体边缘适合性评价为B,两组分别有2例和3例修复体边缘着色评价为B,所有复查修复体均未观察到继发龋及术后敏感的情况。卡方检验显示,两组之间所有评价项目差异均无统计学意义(P>0.05)。结论:一步法自酸蚀粘接剂与两步法酸蚀冲洗型粘接剂在观察时间内表现相近,能够满足临床要求,远期效果仍需进一步观察。Objective ： To compare the clinical effectiveness of the two-step etch-and-rinse with the one- step self-etch adhesive in non-carious cervical lesions. Methods： Fifty patients were selected, each with at least two wedge-shaped defects in the mouth. The paired defects were randomly bonded either with the two-step etch-and-rinse adhesive α or the one-step self-etch adhesive α and then restored with resin com- posite. The treatment was carried out by one practitioner according to standard procedures. The evalua- tion was performed by another practitioner according to modified United States Public Health Service （USPHS） criteria at one week, six months and eighteen months after treatment. Chi-square test was used for statistical analysis. Results： Fifty restorations were placed for each group. Forty-eight patients atten- ded the six months recall, with two restorations loss for each group. Forty-four patients attended the eigh- teen months recall, with accumulative four restorations loss for adhesive α and six restorations loss for ad- hesive β. The retention rate was 90.0% for group α and 86.4% for group β. Marginal adaptation of three restorations in group α and five restorations in group β were scored Bravo; while for marginal dis- coloration, two restorations in group α and three restorations in group β were scored Bravo respectively. No secondary caries and post-operative sensitivity occurred for any of the restorations after eighteen months. No significant difference was detected between the groups for any evaluation criteria （P 〉 0.05）. Conclu- sion： Within the observation period of this study, the two-step etch-and-rinse adhesive and the one-step self-etch adhesive showed similar clinical performance. The long term follow-up is still warranted.

关 键 词：牙本质粘接剂 酸蚀 牙 复合树脂类 牙粘合 

分 类 号：R781.05[医药卫生—口腔医学]