咬合调整对非龋齿性宫颈病变树脂复合修复体临床性能的影响：一项随机、对照、双盲临床试验。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-02 DOI:10.1016/j.jdent.2025.106084

Jullyana Mayara Preizner Dezanetti Hermeling , Brenda Giselle Sanchez Leyton , Sergio Aparecido Ignacio , Rodrigo Nunes Rached , Evelise Machado de Souza

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引用次数: 0

摘要

目的：在长达18个月的时间里，本研究旨在评估一种常规和可流动的复合树脂在有和没有咬合调节的非龋齿宫颈病变（ncls）修复中的临床表现。方法：选取18例有抽脱性病变和咬合干扰的受试者。将145颗NCCL牙分为4组：FWA（可流动复合牙合调整）、FNA（可流动复合牙合不调整）、CWA（常规复合牙合调整）和CNA（常规复合牙合不调整）。根据修改后的USPHS和FDI标准，两名独立审查员分别在7天、6个月、12个月和18个月对修复进行评估。采用Mann-Whitney U、Kruskal-Wallis、Dunn和Friedman检验（α=5%）。结果：2个CWA修复体在18个月后由于失去固位而被认为是临床不可接受的。在6个月时，与遵循USPHS标准的CNA （p=0.000）、FNA （p=0.001）和CWA （p=0.015）相比，FWA的边缘染色指数明显更高。使用FDI，在6个月时，FWA组的边缘染色评分明显高于CNA （p=0.000）、FNA （p=0.001）和CWA (p=0.001)，在12个月时，FNA和CWA的边缘染色评分明显高于CWA （p=0.005）。与CWA （p=0.004）、FWA （p=0.005）和FNA （p=0.031）相比，CNA在18个月时用FDI评估的抽瘤复发率显著更高。结论：18个月后，常规树脂和可流动树脂复合材料临床表现良好，但可流动树脂的边缘变色率较高。当咬合不能完全达到平衡时，应避免使用常规复合材料，以尽量减少复发性抽脱病变的风险。临床意义：咬合干扰的诊断和治疗可能影响常规复合树脂在抽脱性病变中修复的临床寿命。

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Effects of occlusal adjustment on the clinical performance of resin composite restorations in non-carious cervical lesions: A randomized, controlled, double-blind clinical trial

Objective

This study aimed to evaluate the clinical performance of a conventional and flowable composite resin in the restoration of non-carious cervical lesions (NCCLs), with and without occlusal adjustment, over a period of up to 18 months.

Methods

Eighteen participants with abfraction lesions and occlusal interferences were recruited. A total of 145 teeth with NCCL were divided into four groups: FWA (flowable composite with occlusal adjustment), FNA (flowable composite without occlusal adjustment), CWA (conventional composite with occlusal adjustment), and CNA (conventional composite without occlusal adjustment). Two independent examiners evaluated the restorations at 7 days, 6, 12, and 18 months, according to the modified USPHS and the FDI criteria. Mann-Whitney U, Kruskal-Wallis, Dunn and Friedman tests were used (α=5%).

Results

Two restorations of CWA were considered clinically unacceptable due to loss of retention after 18 months. At 6 months, FWA showed a significantly higher index of marginal staining compared to CNA (p=0.000), FNA (p=0.001), and CWA (p=0.015) following USPHS criteria. Using FDI, in 6 months, marginal staining scores were significantly higher in the FWA group compared to CNA (p=0.000), FNA (p=0.001), and CWA (p=0.001), and at 12 months between the FNA and CWA (p=0.005). Abfraction recurrence assessed with FDI at 18 months was significantly higher in the CNA compared to CWA (p=0.004), FWA (p=0.005), and FNA (p=0.031).

Conclusions

After 18 months, both conventional and flowable resin composites performed clinically well, although the flowable resin showed higher marginal discoloration rates. Conventional composites should be avoided when occlusal balance cannot be fully achieved, to minimize the risk of recurrent abfraction lesions.

Clinical Relevance

The diagnosis and treatment of occlusal interferences may influence the clinical longevity of restorations with conventional composite resin in abfraction lesions.

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.