Çocuklarda Aşırı Madde Kayıplı Daimi Molarların Rezin Restorasyonlarının 3 Yıllık Sağ Kalımı

Amaç: Bu retrospektif çalışmanın amacı, aşırı madde kayıplı daimi birinci büyük azılara uygulanan direkt kompozit rezin (DKR) restorasyonların 3 yıl sonundaki sağ kalım oranlarının belirlenmesidir. Gereç ve yöntem: Araştırmaya aynı hekim tarafından daimi birinci büyük azılarına 3 yüzlü DKR restorasyon uygulanmış 7-14 yaş aralığındaki çocuklar dahil edilmiştir. Restorasyonların 3 yıl sonundaki sağ kalım değerlendirmesinde United States Public Health Service (USPHS) kriterleri kullanılmış ve ilgili dişlerde spontan ağrı, perküsyon hassasiyeti, apse gibi geri dönüşümsüz pulpa hasarını işaret eden semptomların varlığı incelenmiştir. Verilerin istatistiksel analizinde Ki-kare ve Kruskal Wallis analizleri kullanılmıştır. Bulgular: Üç yıl sonundaki kontrol randevusuna gelmeyi kabul eden toplam 34 hastanın daimi birinci büyük azı dişlerine yapılmış 58 DKR restorasyon klinik ve radyografik olarak incelenmiştir. Restorasyonların sağ kalım oranı %70.69’dur. İncelenen restorasyonların %15.5’inde geri dönüşümsüz pulpa hasarını ve kök kanal tedavisi ihtiyacını gösteren bulgular saptanmıştır. Sonuç: Aşırı madde kayıplı daimi birinci büyük azı dişlerine uygulanan DKR restorasyonların 3 yıl sonundaki sağ kalım oranının tatmin edici olmadığı ancak, adeziv sistemler ve kompozit rezinlerdeki gelişmeler sayesinde aşırı madde kayıplı genç daimi posterior dişlerde DKR uygulamalarının devam edeceği düşünülmektedir. Bu nedenle konuyla ilgili uzun vadeli, randomize, kontrollü klinik çalışmalar sürdürülmelidir.

Anahtar Kelimeler:

Kompozit Dental Rezin, Diş Çürükleri, Diş Restorasyonu, Kalıcı

3-Year Survival of Resin Restorations of Severely Damaged Permanent Molars in Children

Objective: Aim of this retrospective study was to determine survival rates of direct composite resin (DCR) restorations of permanent first molars (PFMs) with excessive material loss at the end of 3 years. Material and Methods: Children between the ages of 7-14 whose PFMs had 3-surfaced DCR restoration were included. Survival rates of the restorations after 3 years were evaluated using The United States Public Health Service criteria and the presence of symptoms indicating irreversible pulp damage such as spontaneous pain, percussion, abscess in the related teeth were examined clinically and radiographically. Chi-square and Kruskal Wallis analyzes were used for the statistical analysis. Results: Totally 58 DCR restorations of 34 patients who agreed to come for the control after 3 years were examined. The survival rate of restorations was 70.69%. Findings indicating irreversible pulp damage were found in 15.5% of the restorations examined. Conclusion: Survival rate of DCR restorations applied to PFMs with excessive material loss is not satisfactory after 3 years, however it is thought that DCR applications will continue in PFMs with excessive material loss thanks to the developments in adhesive systems and composite resins. Therefore, long-term randomized controlled clinical studies on this subject should be continued.

Keywords:

Composite Resins Dental Caries, Dental Restoration, Permanent, Severely Damaged Molars,

PDF

___

1. Fejerskov, O., Josephsen, K., & Nyvad, B. (1984). Surface ultrastructure of unerupted mature human enamel. Caries research, 18(4), 302–314. https://doi.org/10.1159/000260781
2. Carvalho, J. C., Ekstrand, K. R., & Thylstrup, A. (1989). Dental plaque and caries on occlusal surfaces of first permanent molars in relation to stage of eruption. Journal of dental research, 68(5), 773–779. https://doi.org/10.1177/00220345890680050401
3. Carvalho, J. C., Thylstrup, A., & Ekstrand, K. R. (1992). Results after 3 years of non-operative occlusal caries treatment of erupting permanent first molars. Community dentistry and oral epidemiology, 20(4), 187–192. https://doi.org/10.1111/j.1600-0528.1992.tb01713.x
4. ADA Council on Scientific Affairs (2003). Direct and indirect restorative materials. Journal of the American Dental Association (1939), 134(4), 463–472. https://doi.org/10.14219/jada.archive.2003.0196
5. Statement on posterior resin-based composites. ADA Council on Scientific Affairs; ADA Council on Dental Benefit Programs. (1998). Journal of the American Dental Association (1939), 129(11), 1627–1628.
6. Denehy, G., & Cobb, D. (2004). Impression matrix technique for cusp replacement using direct composite resin. Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 16(4), 227–234. https://doi.org/10.1111/j.1708-8240.2004.tb00040.x
7. Deliperi, S., & Bardwell, D. N. (2006a). Direct cuspal-coverage posterior resin composite restorations: A case report. Operative dentistry, 31(1), 143–150. https://doi.org/10.2341/04-177
8. Hickel, R., & Manhart, J. (2001). Longevity of restorations in posterior teeth and reasons for failure. The journal of adhesive dentistry, 3(1), 45–64.
9. Gruythuysen, R. J., van Strijp, A. J., & Wu, M. K. (2010). Long-term survival of indirect pulp treatment performed in primary and permanent teeth with clinically diagnosed deep carious lesions. Journal of endodontics, 36(9), 1490–1493. https://doi.org/10.1016/j.joen.2010.06.006
10. Fuks A. B. (2000). Pulp therapy for the primary and young permanent dentitions. Dental clinics of North America, 44(3), 571–7.
11. Fagundes, T. C., Barata, T. J., Prakki, A., Bresciani, E., & Pereira, J. C. (2009). Indirect pulp treatment in a permanent molar: case reort of 4-year follow-up. Journal of applied oral science : revista FOB, 17(1), 70–74. https://doi.org/10.1590/s1678-77572009000100014
12. Cvar, J. F., & Ryge, G. (2005). Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clinical oral investigations, 9(4), 215–232. https://doi.org/10.1007/s00784-005-0018-z
13. Leprince, J. G., Palin, W. M., Hadis, M. A., Devaux, J., & Leloup, G. (2013). Progress in dimethacrylate-based dental composite technology and curing efficiency. Dental materials : official publication of the Academy of Dental Materials, 29(2), 139–156. https://doi.org/10.1016/j.dental.2012.11.005
14. Jang, J. H., Park, S. H., & Hwang, I. N. (2015). Polymerization shrinkage and depth of cure of bulk-fill resin composites and highly filled flowable resin. Operative dentistry, 40(2), 172–180. https://doi.org/10.2341/13-307-L
15. Sonkaya, E., Akbıyık, S. Y., Bakır, E. P., & Bakır, Ş. (2021). Posterior Direkt Restorasyonlarda Nerede Başarısızlık Yaşıyoruz?. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 11(2), 242-249.
16. Demarco, F. F., Corrêa, M. B., Cenci, M. S., Moraes, R. R., & Opdam, N. J. (2012). Longevity of posterior composite restorations: not only a matter of materials. Dental materials : official publication of the Academy of Dental Materials, 28(1), 87–101. https://doi.org/10.1016/j.dental.2011.09.003
17. Heintze, S. D., & Rousson, V. (2012). Clinical effectiveness of direct class II restorations - a meta-analysis. The journal of adhesive dentistry, 14(5), 407–431. https://doi.org/10.3290/j.jad.a28390
18. Manhart, J., Chen, H., Hamm, G., & Hickel, R. (2004). Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. Operative dentistry, 29(5), 481–508.
19. Brunthaler, A., König, F., Lucas, T., Sperr, W., & Schedle, A. (2003). Longevity of direct resin composite restorations in posterior teeth. Clinical oral investigations, 7(2), 63–70. https://doi.org/10.1007/s00784-003-0206-7
20. Gaengler, P., Hoyer, I., & Montag, R. (2001). Clinical evaluation of posterior composite restorations: the 10-year report. The journal of adhesive dentistry, 3(2), 185–194.
21. Kuijs, R. H., Fennis, W. M., Kreulen, C. M., Roeters, F. J., Verdonschot, N., & Creugers, N. H. (2006). A comparison of fatigue resistance of three materials for cusp-replacing adhesive restorations. Journal of dentistry, 34(1), 19–25. https://doi.org/10.1016/j.jdent.2005.02.010
22. Pallesen, U., & Qvist, V. (2003). Composite resin fillings and inlays. An 11-year evaluation. Clinical oral investigations, 7(2), 71–79. https://doi.org/10.1007/s00784-003-0201-z
23. Thordrup, M., Isidor, F., & Hörsted-Bindslev, P. (2001). A 5-year clinical study of indirect and direct resin composite and ceramic inlays. Quintessence international (Berlin, Germany : 1985), 32(3), 199–205.
24. Deliperi, S., & Bardwell, D. N. (2006b). Clinical evaluation of direct cuspal coverage with posterior composite resin restorations. Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 18(5), 256–267. https://doi.org/10.1111/j.1708-8240.2006.00033.x
25. Ravasini, F., Bellussi, D., Pedrazzoni, M., Ravasini, T., Orlandini, P., Meleti, M., & Bonanini, M. (2018). Treatment Outcome of Posterior Composite Indirect Restorations: A Retrospective 20-Year Analysis of 525 Cases with a Mean Follow-up of 87 Months. The International journal of periodontics & restorative dentistry, 38(5), 655–663. https://doi.org/10.11607/prd.3471
26. Koyutürk, A. E., Ozmen, B., Tokay, U., Tuloglu, N., Sari, M. E., & Sonmez, T. T. (2013). Two-year follow-up of indirect posterior composite restorations of permanent teeth with excessive material loss in pediatric patients: a clinical study. The journal of adhesive dentistry, 15(6), 583–590. https://doi.org/10.3290/j.jad.a30897
27. Manhart, J., Neuerer, P., Scheibenbogen-Fuchsbrunner, A., & Hickel, R. (2000). Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth. The Journal of prosthetic dentistry, 84(3), 289–296. https://doi.org/10.1067/mpr.2000.108774
28. Heidari, A., Shahrabi, M., Hosseini, Z., & Sari, N. M. (2019). Periodontal Assessment of Permanent Molar Teeth Restored with Stainless Steel Crown in Terms of Pocket Depth, Bleeding on Probing, Gingival Color and Inflammation. International journal of clinical pediatric dentistry, 12(2), 116–119. https://doi.org/10.5005/jp-journals-10005-1607
29. Sigal, A. V., Sigal, M. J., Titley, K. C., & Andrews, P. B. (2020). Stainless steel crowns as a restoration for permanent posterior teeth in people with special needs: A retrospective study. Journal of the American Dental Association (1939), 151(2), 136–144. https://doi.org/10.1016/j.adaj.2019.10.002