窝沟封闭剂防治龋病的循证病案讨论

为评价窝沟封闭剂防治牙齿窝沟点隙龋病的临床效果,作者检索了从1991~2005年的OVID-EBMReviews(包括ACP Journal Club、Cochrane图书馆)和MEDLINE的随机对照试验、Meta分析和系统评价。结果发现,窝沟封闭剂防龋有效,并且两种不同窝沟封闭剂的疗效略有区别,树脂型窝沟封闭剂具有明显防龋效果,且流动型复合树脂保存率较理想,而玻璃离子窝沟封闭剂防龋效果还有待确认。临床中应用酸蚀技术有助于减少产生微渗漏和提高保存率;机械空气喷磨结合酸蚀技术有可能会获得最好的边缘封闭;而其它的技术如ErYAG laser激光、牙钻预备和粘接技术等临床效果还不能肯定,还需要更进一步临床研究。据以上证据,我们对患者制定了治疗方案,尚未获得随访资料。

Evidence-based Practice of Pit and Fissure Sealants

We searched randomized controlled trials,meta-analysis and systematic reviews from OVID-EBM Reviews which included ACP Journal Club,The Cochrane Library, and MEDLINE( 1991 to 2005) to evaluate clinical effectiveness of pit and fissure sealants for caries. The results showed that pit and fissure sealants were recommended to prevent caries of the occlusal surface. The effectiveness varied between the two types of sealants. In general, flowable resin composite had a more satisfactory retention than glass ionomer composite. Acid etch was helpful for less microleakage and more satisfactory retention. Mechanical air-abrasion with acid etch may have the best border seal. However, we were not sure of the effectiveness of Er:YAG laser, technique of dental drill preparation and splicing. More high quality clinical trials on pit and fissure sealants are still needed.