李贺

[摘要]目的：比较大块充填复合树脂和传统复合树脂对后牙邻牙合面牙体缺损修复的临床效果。方法：选择60例患者，120颗患牙自身对照，将每位患者的两颗GV BlackⅡ类缺损患牙随机分为Ⅰ、Ⅱ两组。Ⅰ组：Tetric N-Ceram Bulk Fill充填树脂整层充填;Ⅱ组：FiltekTM Z350传统复合树脂分层充填，临床随访观察2年，依据改良的美国公共卫生署的直接临床评价系统（USPHS），分别在修复体边缘着色、边缘密闭性、继发龋、表面形态、填充术后敏感及充填体脱落6个方面评价两种充填技术的临床效果。结果：随访2年内，两种树脂粘接修复后的临床效果接近，两组比较均无统计学差异（P>0.05）。结论：大块充填复合树脂与传统复合树脂修复后牙GV Black Ⅱ類洞缺损均显示出了很好的临床效果，2年的随访中，疗效相当。

[关键词]充填复合树脂;整层充填;复合树脂;分层充填;后牙

[中图分类号]R783.3    [文献标志码]A    [文章编号]1008-6455（2021）04-0133-03

Clinical Effection of Bulk Fill and Nanofill Composite Restorations in Posterior Lesions

LI He

（Department of Stomatology， the Fifth Affiliated Hospital of Xinjiang Medical University，Urumqi 830000， Xinjiang，China）

Abstract： Objective  To evaluate the clinical effect of bulk fill and nanofill composite restorations in posterior lesions. Methods  Sixty patients with 120 premolars or molars with equivalent posterior lesions. Two posterior lesions teeth of each patient were randomly divided into two groups： Group Ⅰ was treated with Tetric N-Ceram Bulk Fill， GroupⅡwas treated universal nano?hybrid resin composite FiltekTM Z350. The patients were followed up 2 years. The results were evaluated by modified USPHS criteria and statistically analyzed using the Fishers exact test. Results  Follow up for 2 years showed that there were no significant differences in sensitivity evaluation， material loss， marginal discolor， marginal adaptation， secondary caries and surface texture between the three groups （P>0.05）. Conclusion  The bulk-fill composite resin and nanofill composite showed similar clinical performances in the restoration of posterior lesions

Key words： bulk fill resin; bulk -filling; composite resin ; incremental filling; posterior

光固化复合树脂充填材料因其物理、机械性能及材料美学性能的逐渐完善，已成为后牙充填的首选[1]。但传统复合树脂（Resin-based composites， RBCs）因聚合收缩产生收缩应力易导致修复体边缘着色、边缘微渗漏、釉质折裂、牙尖变形、术后敏感等[2-3]，影响修复效果，故临床上多采用水平或斜向的分层充填方法减小粘接面的聚合收缩应力[4-5]。然而，分层充填方式应用于较深窝洞时，固化深度不足，固化距离较远、转化率降低。近年来，大块充填复合树脂（Bulk-fill resin-based composites， Bulk-fill RBCs）逐渐在临床上开展使用，固化深度4mm以上，具有低聚合收缩量和低边缘微渗漏，同时具备高强度及流动性[6-7]。本研究用……