全酸蚀与自酸蚀结合流动树脂窝沟封闭的疗效观察

目的:应用全酸蚀粘结系统和自酸蚀粘结系统结合流动树脂对第一恒磨牙行窝沟封闭，比较2年内窝沟封闭剂的保留率和龋病预防情况。方法:选择140例6～8岁儿童已完全萌出第一恒磨牙560颗，采用自身对照方法。每名儿童随机选择一侧为A组，采用磷酸酸蚀法结合流动树脂进行窝沟封闭；另一侧为B组，采用自酸蚀粘结剂结合流动树脂进行窝沟封闭。随访2年，复查封闭剂保留情况和患龋情况。结果:所有患儿术后6、12、24个月复查，封闭剂保留率A组均高于B组，12、24个月两组间的差异有统计学意义（P＜0.05）；术后6个月两组均未发现龋齿，12、24个月龋病发生率A组低于B组，差异具有统计学意义（P＜0.05）。结论:自酸蚀粘结系统结合流动树脂进行窝沟封闭,可以简化操作步骤,降低儿童依从性的要求,但对于材料远期保留率、预防窝沟龋的发生率，磷酸酸蚀法结合流动树脂疗效优于自酸蚀粘结剂结合流动树脂。

Clinical efficacy of the combination of total acid etching and self-etching bonding system with flow resin in the treatment of the young permanent teeth with fossa and fissure closure

Objective: To compare the retention rate and caries prevention of the first permanent molar in two years by using the total acid etching bonding system and the self-etching bonding system combined with flowing resin to seal the first permanent molar. Methods: 560 first permanent molars from 140 children aged 6-8 years were selected and self-controlled method was used. One side of each child was selected as group A, and the other side was used as group B, which was sealed by phosphoric acid etching method combined with flowing resin, and the other side was treated with self-etching binder combined with flowing resin to seal the pit and groove. Follow up for 2 years , review the retention of sealant and caries. Results: The retention rate of sealant in the group A was higher than that in the group B at 6, 12 and 24 months after operation, and the difference was statistically significant between the two groups at 12 and 24 months (P＜0.05). No caries was found in the two groups at 6 months postoperatively. The incidence of caries in the group A was lower than that in the group B at 12 and 24 months postoperatively.The difference was statistically significant (P＜0.05). Conclusion: The self-etching bonding system combined with flowing resin can simplify the operation procedure and reduce the requirement of children’s compliance, but for the long-term retention rate of materials, the incidence of fissure caries can be prevented. The effect of phosphoric acid etching combined with flowing resin is better than that of self-etching binder.