第一恒磨牙局部涂氟防龋效果3年纵向研究
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摘要
目的评估对学龄儿童第一恒磨牙进行局部涂氟的防龋效果,为制定学龄儿童龋病防治策略提供依据。方法选取2014年11月广西大化县某小学一年级6～7岁儿童666例,采用整群随机抽样的方法,分为试验组与对照组。从2014年11月到2017年5月,试验组儿童每半年进行1次第一恒磨牙局部涂氟,同时进行口腔健康教育;对照组儿童仅进行口腔健康教育,并在2014、2016、2017年的11月对所有研究对象进行口腔检查,收集第一恒磨牙患龋情况数据并进行统计分析。结果干预2年后,试验组第一恒磨牙龋病发病率低于对照组,差异有统计学意义(P<0.05);干预3年后,试验组患龋率、龋均、龋面均及龋病发病率均低于对照组,差异具有统计学意义(P<0.05)。干预后,试验组上下颌第一恒磨牙龋病发病率及窝沟龋发病率均低于对照组,差异有统计学意义(P<0.05),邻面龋发病率差异无统计学意义(P>0.05)。结论局部涂氟对第一恒磨牙龋具有良好的预防效果,且涂氟时间越长,防龋效果越好。
Objective To assess the effect of topical fluoride varnish on the prevention of the first permanent molar caries of schoolage children and provide evidence for formulating caries prevention strategies. Methods Using cluster random sampling method,in November 2014,666 children of 6-7 years old in the first grade of primary school in Dahua County,Guangxi province were randomly selected and divided into two groups: the test group and the control group. From November 2014 to May 2017,the children in the test group were treated with fluoride varnish every six months,along with oral health education; whereas,children in the control group were only given oral health education. In November of 2014,2016,and 2017,oral examinations were performed on all subjects to collect data of the first permanent molars and conduct statistical analysis. Results After 2 years of intervention,the incidence of dental caries in the first permanent molar in the test group was lower than that in the control group,and the difference was statistically significant( P<0.05). After 3 years of intervention,the prevalence and incidence of caries,mean DMFT and mean DMFS in the test group were all lower than those in the control group,and there was a significant difference( P<0.05). After intervention,the incidences of maxillary and mandibular first molar,fissure and proximal surface caries of the first permanent molars in the test group were lower than those of control group,but there was no significant difference in the incidence of proximal surface caries( P>0.05). Conclusion The topical application of fluoride varnish is effective in prevention of caries of the first permanent molars,and the longer the exposure time of fluoride varnish is,the better the effect of prevention is.
Objective To assess the effect of topical fluoride varnish on the prevention of the first permanent molar caries of schoolage children and provide evidence for formulating caries prevention strategies. Methods Using cluster random sampling method,in November 2014,666 children of 6-7 years old in the first grade of primary school in Dahua County,Guangxi province were randomly selected and divided into two groups: the test group and the control group. From November 2014 to May 2017,the children in the test group were treated with fluoride varnish every six months,along with oral health education; whereas,children in the control group were only given oral health education. In November of 2014,2016,and 2017,oral examinations were performed on all subjects to collect data of the first permanent molars and conduct statistical analysis. Results After 2 years of intervention,the incidence of dental caries in the first permanent molar in the test group was lower than that in the control group,and the difference was statistically significant( P<0.05). After 3 years of intervention,the prevalence and incidence of caries,mean DMFT and mean DMFS in the test group were all lower than those in the control group,and there was a significant difference( P<0.05). After intervention,the incidences of maxillary and mandibular first molar,fissure and proximal surface caries of the first permanent molars in the test group were lower than those of control group,but there was no significant difference in the incidence of proximal surface caries( P>0.05). Conclusion The topical application of fluoride varnish is effective in prevention of caries of the first permanent molars,and the longer the exposure time of fluoride varnish is,the better the effect of prevention is.
引文
[1] Phipps KR,Ricks TL,Blahut P. Permanent first molar eruption and caries patterns in American Indian and Alaska Native children:challenging the concept of targeting second grade for school-based sealant programs[J]. J Public Health Dent,2013,73(3):175-178.
[2] Oliveira DCD,Cunha RF. Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of children with and without dental caries experience[J]. Acta Odontologica Scandinavica,2013,71(3/4):972-977.
[3]皮昕.口腔解剖生理学[M].7版.北京:人民卫生出版社,2012.
[4]唐莉红,施乐,袁爽,等.3种不同方法预防儿童恒牙龋的临床效果评价[J].上海口腔医学,2014,23(6):736-739.
[5]蒋纯蓉.窝沟封闭加局部用氟对龋高危儿童防龋效果观察[J].广东牙病防治,2014,22(11):582-584.
[6] Kucukyilmaz E,Savas S. Evaluation of different fssure sealant materials and flowable composites used as pit-and-fissure sealants:a24-month clinical trial[J]. Pediatr Dent,2015,37(5):468-473.
[7]段君兰,刘宗响,张洪永,等.氟保护漆联合窝沟封闭对第一恒磨牙防龋的效果评估[J].口腔医学,2017,37(7):629-631.
[8]张露东,周寅,朱亚琴.氟保护漆对儿童第一恒磨牙龋病的预防效果评价[J].上海口腔医学,2017,26(6):641-645.
[9]陈贝斯,刘秋林,陈柏霖,等.学龄儿童第一恒磨牙局部涂氟防龋效果分析[J].口腔疾病防治,2017,25(4):254-257.
[10] Pitts N.“ICDAS”-an international system for caries detection and assessment being developed to facilitate caries epidemiology,research and appropriate clinical management[J]. Commun Dent Health,2004,21(3):193-198.
[11]台保军,江汉.专业人员使用的局部用氟措施[J].中国实用口腔科杂志,2009,2(9):520-523.
[12] Hawkins R,Locker D,Noble J,et al. Prevention. Part 7:professionally applied topical fluorides for caries prevention[J]. Br Dent J,2003,195(6):313-317.
[13] Hawkins R,Noble J,Locker D,et al. A comparison of the costs and patient acceptability of professionally applied topical fluoride foam and varnish[J]. J Public Health Dent,2004,64(2):106-110.
[14]朱敏,周会霞,李宝莉,等.新型氟保护漆多乐氟的防龋效果观察[J].中国美容医学,2014,23(14):1191-1193.
[15] Marinho VCC,Higgins JPT,Sheiham A,et al. Combinations of topical fluoride(toothpastes, mouth rinses, gels, varnishes)versus single topical fluoride for preventing dental caries in children and adolescents[J]. Cochrane Database Syst Rev,2004,1:CD002781.
[16] Liu BY,Lo EC,Chu CH,et al. Randomized trial on fluorides and sealants for fissure caries prevention[J]. J Dent Res,2012,91(8):753-758.
[17] Moberg Sk9ld U,Petersson LG,Lith A,et al. Effect of schoolbased fluoride varnish programmes on approximal caries in adolescents from different caries risk areas[J]. Caries Res,2005,39(4):273-279.
[18] Greig V,Conway DI. Fluoride varnish was effective at reducing caries on high caries risk school children in rural Brazil[J]. Evid Based Dent,2012,13(3):78-79.
[19] Kalnina J,Care R. Prevention of occlusal caries using a ozone,sealant and fluoride varnish in children[J]. Stomatologija,2016,18(1):26-31.
[20]吴煜,蒋才谦,冯华玉.氟保护漆抗龋效果的电镜观察[J].口腔材料器械杂志,2002,11(1):24-26.
[21]蒋贤军,胡德渝,尹伟.含氟涂料预防儿童和青少年龋齿的研究进展[J].中华口腔医学研究杂志(电子版),2012,6(5):468-471.
[2] Oliveira DCD,Cunha RF. Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of children with and without dental caries experience[J]. Acta Odontologica Scandinavica,2013,71(3/4):972-977.
[3]皮昕.口腔解剖生理学[M].7版.北京:人民卫生出版社,2012.
[4]唐莉红,施乐,袁爽,等.3种不同方法预防儿童恒牙龋的临床效果评价[J].上海口腔医学,2014,23(6):736-739.
[5]蒋纯蓉.窝沟封闭加局部用氟对龋高危儿童防龋效果观察[J].广东牙病防治,2014,22(11):582-584.
[6] Kucukyilmaz E,Savas S. Evaluation of different fssure sealant materials and flowable composites used as pit-and-fissure sealants:a24-month clinical trial[J]. Pediatr Dent,2015,37(5):468-473.
[7]段君兰,刘宗响,张洪永,等.氟保护漆联合窝沟封闭对第一恒磨牙防龋的效果评估[J].口腔医学,2017,37(7):629-631.
[8]张露东,周寅,朱亚琴.氟保护漆对儿童第一恒磨牙龋病的预防效果评价[J].上海口腔医学,2017,26(6):641-645.
[9]陈贝斯,刘秋林,陈柏霖,等.学龄儿童第一恒磨牙局部涂氟防龋效果分析[J].口腔疾病防治,2017,25(4):254-257.
[10] Pitts N.“ICDAS”-an international system for caries detection and assessment being developed to facilitate caries epidemiology,research and appropriate clinical management[J]. Commun Dent Health,2004,21(3):193-198.
[11]台保军,江汉.专业人员使用的局部用氟措施[J].中国实用口腔科杂志,2009,2(9):520-523.
[12] Hawkins R,Locker D,Noble J,et al. Prevention. Part 7:professionally applied topical fluorides for caries prevention[J]. Br Dent J,2003,195(6):313-317.
[13] Hawkins R,Noble J,Locker D,et al. A comparison of the costs and patient acceptability of professionally applied topical fluoride foam and varnish[J]. J Public Health Dent,2004,64(2):106-110.
[14]朱敏,周会霞,李宝莉,等.新型氟保护漆多乐氟的防龋效果观察[J].中国美容医学,2014,23(14):1191-1193.
[15] Marinho VCC,Higgins JPT,Sheiham A,et al. Combinations of topical fluoride(toothpastes, mouth rinses, gels, varnishes)versus single topical fluoride for preventing dental caries in children and adolescents[J]. Cochrane Database Syst Rev,2004,1:CD002781.
[16] Liu BY,Lo EC,Chu CH,et al. Randomized trial on fluorides and sealants for fissure caries prevention[J]. J Dent Res,2012,91(8):753-758.
[17] Moberg Sk9ld U,Petersson LG,Lith A,et al. Effect of schoolbased fluoride varnish programmes on approximal caries in adolescents from different caries risk areas[J]. Caries Res,2005,39(4):273-279.
[18] Greig V,Conway DI. Fluoride varnish was effective at reducing caries on high caries risk school children in rural Brazil[J]. Evid Based Dent,2012,13(3):78-79.
[19] Kalnina J,Care R. Prevention of occlusal caries using a ozone,sealant and fluoride varnish in children[J]. Stomatologija,2016,18(1):26-31.
[20]吴煜,蒋才谦,冯华玉.氟保护漆抗龋效果的电镜观察[J].口腔材料器械杂志,2002,11(1):24-26.
[21]蒋贤军,胡德渝,尹伟.含氟涂料预防儿童和青少年龋齿的研究进展[J].中华口腔医学研究杂志(电子版),2012,6(5):468-471.