Оцінка якості реставрації постійних зубів у дітей композиційними пломбувальними матеріалами

Abstract

Мета дослідження – провести клінічну оцінку якості реставрацій постійних зубів у дітей двома композиційними матеріалами через 18 місяців спостереження. Для аналізу були доступні 17 реставрацій «Charisma» і 18 реставрацій «Ceram. X SphereTEC one». Жодна пломба не потребувала заміни і не було виявлено вторинного карієсу. «Ceram. X SphereTEC one» дещо переважав «Charisma» за показниками крайової адаптації й прилягання, кольорової стабільності реставрації, дискомфорту після пломбування й шорсткості поверхні, проте невірогідно. Доцільно проводити більшу кількість досліджень і триваліше спостереження для доведення переваги одного з композиційних пломбувальних матеріалів над іншим при реставрації постійних зубів у дітей.

A paradigm shift in dental caries treatment in paediatric dentistry is viewed towards a wide using of composite resins. This prospective clinical trial are evaluated and compared during 18 months of clinical performance of a microhybrid composite with a nanoceramic resin composite placed in сlass I and II cavities in permanent teeth in children. Thirty one children aged between 7 and 15 years were investigated during this study. About 40 restorations were performed, 50% for each material: a nanoceramic resin composite “Ceram. X Sphere TEC one” and a microhybrid resin composite “Charisma”. The restorations have been estimated by investigators immediately after complete polishing a filling. Clinical evaluation was performed 18 months after replacement by two other investigators using modified USPHS criteria. In addition to hand instruments, a magnifier was used for investigation of the restoration margins. Eighteen fillings with “Ceram. X Sphere TEC one” and 17 fillings with “Charisma” were available. The USPHS parameters were analyzed with the Chi-square test in18 months. The level of significance was p<0.05. Also Green-Vermillion index was used for oral hygiene estimation. There are no failed restorations and secondary caries during the studied period. There were no statistically significant differences among the materials used (p>0.5) regarding the clinical performance. GreenVermillion hygienic index was 1.48. Thirteen children (43.42%) showed satisfactory level of oral hygiene, 10 children (35.71%) demonstrated good level and 7 children (20.87%) – unsatisfactory level. According to the marginal discoloration and surface roughness criteria, there were no significant differences among the restorative materials (p>0.5). Marginal discoloration was seen in children with unsatisfactory oral hygiene that corresponds to the data of recent study. Marginal adaptation rate was 94.95% for nanoceramic, and 82.35% for the microhybrid restorations. The marginal defects recorded had small detectable defects at the enamel margin of the restorations. According to the anatomic form criterion, there were no significant differences among the restorative materials (p>0.5). Postoperative sensitivity of one nanoceramic and two microhybrid restorations was scored as Bravo at baseline examination, but it disappeared by the 18-months evaluation. For color match criterion, the slight differences were observed in microhybrid restoration in 18 months. This shade mismatch was clinically acceptable (Bravo), with no significant differences noted between the materials studied (p>0.5). The nanoceramic and microhybrid composites have provided acceptable clinical performance over 18- months period. The research pertaining to bigger size of a studied sample and longer observation period is considered advisable to ensure the higher clinical success rate of nanoceramic than microhybrid composite in restoration of permanent teeth in children.