树脂水门汀类牙本质粘接剂的不良反应及其相关因素回顾性分析  

Retrospective analysis of adverse reactions and related factors of resin cement dentin adhesive

作　　者：付馨靓 孙吉宇 朱卓立[1] 甘雪琦 FU Xinliang;SUN Jiyu;ZHU Zhuoli;GAN Xueqi(State Key Laboratory of Oral Diseases,National Clinical Research Center for Oral Diseases,Department of Prosthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院修复科,四川成都610041

出　　处：《口腔疾病防治》2022年第7期491-498,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81870802);四川省药品监督管理局牙本质粘接剂不良事件重点监测项目(0040305302066)。

摘　　要：目的 探讨树脂水门汀用于牙本质粘接的不良反应发生情况及其相关因素。方法 选择使用树脂水门汀类牙本质粘接剂进行复合树脂直接修复,或全冠间接修复治疗的牙体缺损患者作为研究对象,回顾性分析其治疗后7 d、1个月、3个月、6个月及1年牙体牙髓病变、软组织不良反应、修复体松动脱落等不良反应的发生情况及原因。结果 在使用树脂水门汀类牙本质粘接剂的5 971位患者14 776例患牙中,共计发生580例次(3.93%)不良反应。单因素分析示,治疗后7 d、1个月、12个月,修复类型为“全冠(桥)”的患牙不良反应发生率最高;治疗后7 d,预备层次为“预备后近髓”的患牙不良反应发生率最高;治疗后7 d和3个月,粘接面处理方式采用“牙本质处理剂-粘接剂-树脂”的患牙不良反应发生率最高。多因素分析结果显示,治疗后7 d“牙体预备穿髓后盖髓”为不良反应发生的危险因素(OR=2.610),治疗后7 d及3个月以“牙本质处理剂-粘接剂-树脂方式处理粘接面”为不良反应发生的保护因素(OR均小于1)。结论 树脂水门汀类牙本质粘接剂用于直接或间接修复时,牙体预备层次和粘接面处理方式可影响不良反应的发生率,牙体预备穿髓后盖髓及自酸蚀粘接易导致不良反应发生。Objective To investigate the adverse reactions of resin cement used for dentin bonding and its influencing factors.Methods Patients with dental defects treated with resin cement dentin adhesive for direct composite resin repair or full crown indirect repair were selected as the research objects.The occurrence and causes of adverse reactions,such as dental pulp lesions,soft tissue adverse reactions,and restoration loosening and falling off 7 days,1month,3 months,6 months,and 1 year after treatment,were analyzed retrospectively.Results Among the 14 776teeth of 5 971 patients who used resin cement dentin adhesive,580 cases (3.93%) had adverse reactions.Univariate analysis showed that the incidence of adverse events was highest in teeth with the"full crowns (fixed partial dentures)"restoration type at 7 days,1 month,and 12 months after treatment.At 7 days after treatment,the incidence of adverse events was the highest in teeth with a preparation depth of"near pulp after preparation".At 7 days and 3 months after treatment,the incidence of adverse events was the highest in teeth with"dentin conditioner-adhesive-resin"treatment of the bonding surface.Multivariate analysis indicated that pulp perforation and pulp capping after tooth preparation were risk factors for adverse events 7 days after treatment (OR=2.610),and the“dentin primer-adhesive-resin”bonding surface treatment method was a protective factor for adverse events 7 days and 3 months after treatment (OR<1).Conclusion When resin cement dentin adhesives are used for direct or indirect restoration,the tooth preparation level and bonding surface treatment method may affect the occurrence of adverse events.pulp perforation,and pulp capping after tooth preparation,and self-etching bonding may contribute to adverse reactions.

关 键 词：树脂水门汀 牙本质粘接 牙体缺损 复合树脂修复 冠修复 不良反应 牙体牙髓病变 软组织不良反应 修复体松动 单因素分析 多因素分析 回顾性研究 

分 类 号：R78[医药卫生—口腔医学]