氟钼酸铵溶液抑制人工根面龋作用的研究

目的 :观察 10 0g/L氟钼酸铵溶液对体外形成的人工根面龋的抑制作用。方法 :3 2个正畸减数前磨牙根面开窗 ,置于致龋菌液中 48h形成初期人工龋损后随机分为 4组 ,各组从开窗区中央分为 2部分 ,一半为龋损基线 ,另一半开窗区 ,分别用 10 0 g/L氟钼酸铵、3 80g/L氟化氨银、2 0g/L氟化钠溶液及去离子水处理 2min× 3 ,再次放入新鲜菌液中 48h。标本磨片拍摄显微放射照片并测定龋损深度及脱矿量。结果 :氟钼酸铵组形成的人工龋损深度浅 ,脱矿量变化小 ,与氟化钠组和对照组存在显著性差异 (P <0 .0 5) ,与氟化氨银组无差异 (P >0 .0 5) ;氟钼酸铵和氟化氨银处理组龋损深度及脱矿量前后无显著性差异 (P >0 .0 5)。而氟化钠溶液及去离子水处理组处理前后有差异 (P <0 .0 5)。结论 :10 0g/L氟钼酸铵有抑制根面龋损作用 ,其作用与 3 80 g/L氟化氨银相似 ,优于 2 0 g/L氟化钠     

五倍子水提取物处理早期人工釉质龋后表面结构的扫描电镜观察

目的观察五倍子水提取物处理早期人工釉质龋后的表面形态。方法采用化学人工龋制备法,将釉质块随机分成六组,分别用1、10、30mg/mL五倍子溶液,380mL/L氟化氨银,20mL/L氟化钠以及去离子水处理,进行体外pH循环,扫描电镜观察釉质表面结构。结果经五倍子与氟化氨银处理后的釉质表面形成致密均匀、形状不规则的指状结构,长约0.08~0.6μm;氟化钠处理后釉质表面形成大小不一,散在的小球状结构,直径约0.02~2μm;去离子水处理的釉质表面成蜂巢状结构。结论1、10、30mg/mL五倍子溶液处理后釉质表面结构与氟化氨银组相似;1mg/mL可能是五倍子水提取物的有效浓度,但不一定是最低有效浓度;从表面形态上看,五倍子所生成的结构可能与抑制脱矿、促进再矿化有关。     

氟化钠-壳聚糖凝胶对乳牙釉质早期龋再矿化实验观察

目的:探讨氟化钠壳聚糖凝胶促进乳牙釉质早期龋模型再矿化的可行性.方法:乳前牙试件使用乳酸羧甲基纤维素凝胶预处理,制备早期龋模型;早期龋的乳前牙试件随机分成4组(n=6),3组分别进行氟化钠壳聚糖凝胶、壳聚糖空白凝胶、多乐氟处理,1组作为空白对照,处理完成后进行pH循环,SEM、EDS检测循环完成后的试件表面.结果:SEM观察,氟化钠壳聚糖凝胶能更好的保护釉质表层结构不受破坏,而多乐氟和空白对照组,则表现出釉质表层的崩解.同时氟化钠壳聚糖凝胶有更多的矿化物结晶在釉质表面形成.EDS检测钙离子的沉积比例,氟化钠壳聚糖凝胶组明显多于其余各组(P＜0.05).结论:氟化钠壳聚糖凝胶可以提高乳前牙早期龋的再矿化水平.     

绿茶多酚涂膜临床防龋效果观察

本研究将含绿茶多酚涂膜（0.078g/L）用于乳牙，观察其对乳牙的防龋作用，并分析其作用特点。实验组107名儿童的第一乳磨牙和乳中切牙涂布绿茶多酚涂膜，隔6个月后重复涂布一次，一年后复查患龋情况，记录dmft和dmfs。另110名儿童作为对照。结果涂布牙新患龋率与对照组相比下降66％；实验组非涂布牙新患间牙、新患龋牙面和新患龋率均显著低于对照组；绿茶多酚涂膜对后牙防龋作用大于前牙；从不同牙面看，涂膜对面作用最强，颊舌面次之，近远中面较小。表明绿茶多酚涂膜对涂布牙和口腔中其它非涂布牙具有显著防龋作用。     

氟化钠护齿剂在预防上海市学龄前儿童龋齿中的效果评价

目的通过对上海市3岁学龄前儿童全口乳牙列涂布氟化钠护齿剂,实施群体性预防干预措施,分析评价氟化钠护齿剂预防儿童乳牙龋齿的效果。方法在上海市3个行政区内,随机选取1 905名符合涂氟防龋指征的3岁幼儿园儿童,随机分为3组,分别给予每年2次涂氟(试验A组)、每年1次涂氟(试验B组)和空白对照,对所有入组儿童进行口腔卫生指导,连续跟踪观察2年,记录患龋状况,采用Spss17.0软件进行统计学分析。结果 3组儿童的龋齿发病率和龋均值有显著性差异,实验组儿童龋齿发病率和龋均值显著低于对照组儿童,差异有统计学意义(P<0.05)。结论在学龄前儿童中应用氟化钠护齿剂能够有效降低乳牙龋齿发病率。     

五倍子水提取物对正常釉质及去有机质釉质脱矿影响的实验研究

目的：探讨五倍子水提取物影响牙釉质脱矿的机理。方法：建立去有机质釉质模型,分别以30mg／ml五倍子水提取物、2％氟化钠、38％氟化氨银、10％硝酸银及去离子水处理去有机质釉质及正常釉质,采用化学法制备釉质人工龋。分别收集各组脱矿液,以原子光谱法检测脱矿液中钙、磷含量。脱矿后釉质进行显微放射照相分析,比较其脱矿量及龋损深度。结果：与氟化氨银及硝酸银组相同,五倍子水提取物对正常釉质抑制脱矿的效果显著优于去有机质釉质。氟化钠及去离子水对正常釉质及去有机质釉质抑制脱矿效果无显著性差异。结论：有机质在一定条件下可抑制釉质脱矿;五倍子通过作用于釉质有机质达到抑制釉质脱矿的作用。     

学龄前儿童乳牙局部加氟抑龋研究

目的 :利用局部加氟方法抑制乳上前牙龋病进展。方法 :选用同一生活区内有上前牙乳牙龋的 779名 3～6岁学龄前儿童 ,经基线检查、记录结束后 ,分成实验组和对照组。第一、二组每日氟水含漱 (0 .0 5 %) ,第三、四组每3个月一次含氟涂料涂布 ,其中第二、四组处理前去除软龋 ,1年后复查抑龋效果。结果 :各组抑龋牙面龋为 0 .91±1.88、1.0 2± 2 .11、2 .47± 1.90、2 .75± 1.90、0 .75± 2 .34。结论 :局部加氟抑龋效果确定 ,实施前是否去除龋坏组织对抑龋效果无明显影响。     

幼儿猛性龋病原菌的分离鉴定

目的:确定幼儿猛性龋的优势病原菌,为其防治提供依据。方法:采用细菌分离培养、形态学、生理生化学和 DNAG+C mol%测定方法,对30名2~5岁猛性龋患儿牙菌斑菌丛进行分离鉴定,采样部位为上颌患龋乳切牙龋损部位及邻近健康釉质表面,对照组的非猛性龋和无龋儿童则采集上颌乳前牙唇面颈1/3处的菌斑。结果:猛性龋儿童龋损部位变链菌和远缘链球菌的检出率及两个采样部位菌斑标本中变链菌和远缘链球菌的检出水平均显著高于非猛性龋和无龋儿童(P<0105)。结论:变链菌和远缘链球菌为幼儿猛性龋的优势病原菌。关键词 幼儿猛性龋变链菌远缘链球菌。     

氟化钠壳聚糖凝胶对乳牙釉质抗酸能力的影响

目的 本实验通过研究氟化钠壳聚糖温敏凝胶对乳牙牙釉质表面抗酸蚀的作用,初步探讨氟化钠壳聚糖温敏凝胶在防治早期龋中的应用可能性。方法 配制氟化钠壳聚糖温敏凝胶,观察其基本性能,使用氟离子选择电极检测壳聚糖氟化钠凝胶氟离子的释放速率。制备乳前牙试件,随机分成4组,分别为多乐氟组、氟化钠壳聚糖凝胶组、壳聚糖空白凝胶处理组和空白对照组,进行乳酸脱钙实验,离子火焰法测试洗脱出的钙离子浓度。SPSS19.0对不同组钙离子浓度进行方差分析,统计结果。结果 壳聚糖氟化钠凝胶,常温下为淡黄色清亮黏稠液体,37 ℃时转变为乳白色的果冻状凝胶。壳聚糖氟化钠凝胶4 h氟离子的释放率为70.22%。氟化钠壳聚糖凝胶处理的乳前牙釉质试件,其脱出的钙离子浓度为4.29 mg/L,低于壳聚糖空白凝胶组(7.20 mg/L)及空白对照组(7.34 mg/L),有统计学差异;但和多乐氟组(4.22 mg/L)没有统计学差异(P>0.05)。结论 氟化钠壳聚糖凝胶可以提高乳前牙的釉质抗酸能力,有应用于预防乳前牙早期龋的可能性。     

氟化钠联合半导体激光治疗牙齿面感觉过敏症94例

作者采用氟化钠联合半导体激光治疗牙合面牙齿感觉过敏症94个牙,现报道如下。1　临床资料1.1　一般资料选择后牙牙合面严重磨耗患者2 5例94个牙。男11例,女14例,年龄2 5～70岁。牙位:上颌后牙39个,下颌后牙5 5个。敏感度:Ⅰ度4个,Ⅱ度5 7个,Ⅲ度33个。所选患牙均无龋坏、隐裂,颈部无牙齿感觉过敏症。1.2　治疗方法棉球隔湿患牙,30mL/L过氧化氢液棉球涂布牙合面,吹干,用探针刮擦或冷试验判明牙合面敏感区域,中性油笔标记敏感点,用75 0mg/L氟化钠糊剂(第四军医大学配方)涂擦15s ,牙科半导体激光治疗仪(上海曼迪森公司生产)呈准接触照射标志…     

Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children

Untreated dental caries in Chinese pre-school children is common. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. Three hundred seventy-five children, aged 3-5 years, with carious upper anterior teeth were divided into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). Sodium fluoride varnish (22,600 ppm F) was applied every three months to the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. Three hundred eight children were followed for 30 months. The respective mean numbers of arrested carious tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5, and 1.3 (p < 0.001). Silver diamine fluoride was found to be effective in arresting dentin caries in primary anterior teeth in pre-school children.     

A community-based caries control program for pre-school children using topical fluorides: 18-month results.

Dental caries in Chinese pre-school children is common, and restorative treatment is not readily available. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. We divided 375 children (aged 3-5 yrs) with carious upper anterior teeth into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). NaF varnish (22,600 ppm F) was applied every three months onto the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. We followed 341 children for 18 months. The mean numbers of new caries surfaces in the five groups were 0.4, 0.4, 0.8, 0.6, and 1.2, respectively (p = 0.001). The respective mean numbers of arrested carious tooth surfaces were 2.8, 3.0, 1.7, 1.5, and 1.0 (p < 0.001).     

Microhardness of dentine in primary teeth after topical fluoride applications

OBJECTIVES: This study measured the microhardness of arrested dentinal caries on primary teeth receiving regular fluoride applications after 30 months. METHODS: Caries on primary upper anterior teeth of preschool children were randomly assigned to receive 38% silver diamine fluoride every 12 months or 5% sodium fluoride varnish every 3 months. Lesions that were hard on probing were considered arrested. At 30 months, very mobile teeth were extracted, sectioned, and polished and they underwent Knoop hardness number (KHN) measurements at sites below the surface at the center of the carious lesion every 25 microm toward the pulp. Three sets of measurements were made on parallel tracks approximately 150-200 microm apart, and the median KHN at each depth were analyzed. RESULTS: Five arrested and five soft carious lesions were examined. Within the outer 25-200 microm, the median KHN of arrested carious lesions (range, 20-46 or 196-451 MPa) were greater than those of soft carious lesions (range, 5-20, or 49-196 MPa). The difference between them, however, was not statistically significant. At a distance of 225 microm or more from the surface of the lesion, the median KHN of both groups were between 20 and 30 (196-294 MPa). CONCLUSIONS: The outermost dentinal surface of carious lesions that had been arrested by topical fluoride application was harder than that of active carious lesions. At a distance of 225 microm or more from the lesion surface, the microhardness of both arrested and soft dentinal caries was similar.     

Randomized trial on fluorides and sealants for fissure caries prevention

To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine fluoride (SDF) solution, annual application; and (4) placebo control. Follow-up examinations were conducted every 6 months by a masked examiner. After 24 months, 485 children (97%) were examined. Proportions of pit/fissure sites with dentin caries in the sealant, NaF, SDF, and control groups were 1.6%, 2.4%, 2.2%, and 4.6%, respectively. A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls (p < 0.05). We concluded that placement of resin sealant, semi-annual application of NaF varnish, and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars (ClinicalTrials.gov number CT01446107).     

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

Abstract

Purpose: This longitudinal clinic study evaluated the effect of a glass ionomer sealant (GIS) and a fluoride varnish (FV) in the prevention of dental decay on newly erupted permanent molars of children with and without caries experience. Materials and methods: Eighty children, aged 6–8 years, with all four newly erupted first permanent molars, were divided into two groups. Group 1 consisted of 53 children without caries experience and group 2 consisted of 27 children with dental caries experience. Permanent molars of the right side were sealed with GIS and the fluoride varnish was applied on the other two permanent first molars. Evaluation of GIS retention and the effectiveness of both materials in the prevention of dental caries were performed after 6, 12 and 18 months. Results: After 18 months, of the 299 teeth, 271 (91%) showed no caries lesions and 28 presented caries lesions (9%). Teeth sealed with GIS had more carious lesions (15) than teeth with fluoride varnish (13). Most of the teeth (70%) that presented carious lesions were in group 2. Of the 138 sealed teeth, only one showed GIS to be totally present, 95 were partially present and 42 teeth were absent. Conclusion: The caries-preventive effect was very similar between both treatments. The presence of dental caries prevailed in the children with caries experience.     

Bayesian analysis of clustered interval-censored data

The recording of multiple interval-censored failure times is common in dental research. Modeling multilevel data has been a difficult task. This paper aims to use the Bayesian approach to analyze a set of multilevel clustered interval-censored data from a clinical study to investigate the effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting active dentin caries in Chinese pre-school children. The time to arrest dentin caries on a surface was measured. A three-level random-effects Weibull regression model was used. Analysis was performed with WinBUGS. Results revealed a strong positive correlation (0.596) among the caries lesions' arrest times on different surfaces from the same child. The software WinBUGS made the above complicated estimation simple. In conclusion, the annual application of silver diamine fluoride on caries lesions, and caries removal before the application, were found to shorten the arrest time.     

The Efficiency of Semiannual Silane Fluoride Varnish Applications: a Two-year Clinical Study in Preschool Children

Objective : The aim of this two-year community demonstration trial was to study the caries inhibitory effects of semiannual applications of a fluoride varnish in preschool children. Methods : Twenty-four public dental health clinics in the county of Halland, Sweden, with 5,137 preschool children, 4 and 5 years of age, were matched and equally allocated to a fluoride varnish group ( n =2,535) and a reference group ( n =2,602). The children in the fluoride varnish group were treated every six months with topical applications of a silane fluoride varnish, Fluor Protector (0.1% F), while no fluoride varnish was used in the reference group. Both groups received a basic preventive program at annual checkups consisting of dietary counseling and instructions to parents to brush their children's teeth at least once daily with fluoridated dentifrice. Caries data were collected by clinical examinations at baseline and after one and two years. Results : Caries prevalence at baseline did not differ significantly between the groups. After two years, the mean caries incidence was low and no statistical difference was found in the total number of carious and filled surfaces (dfs) between the two groups. However, the incidence of approximal lesions (dfsa) was significantly lower ( P <.05) in the fluoride varnish group than the reference group. Children in the fluoride varnish group with dfs scores of 1–4 and ≥5 at the start of the study exhibited a statistically significant ( P <.05) reduction in approximal caries incidence of 19 percent and 25 percent, respectively, when compared with the reference group. Conclusion : Preschool children 4 and 5 years of age with clinical caries who receive semiannual applications of a silane fluoride varnish containing 0.1 percent F experience a reduced incidence of approximal caries over two years.     

Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement ('atraumatic' technique)

A bstract — Histological assessment of the dental pulps of 55 carious primary teeth was carried out 3 to 56 months after treatment by the 'atraumatic' technique involving application of 40 per cent silver fluoride to residual caries followed by restoration with glass ionomer cement. Fifty of the 55 teeth examined showed a favourable pulpal response, including presence of abundant reparative dentine and a wide odontoblast layer. Histological comparisons were made between these teeth and others not treated with silver fluoride but restored with glass ionomer cement, amalgam or zinc oxide and eugenol.
Possible mechanisms of the action of silver fluoride in arresting residual caries are discussed. The question of whether or not treatment of carious dentine with silver fluoride represents a biologically acceptable clinical procedure cannot be answered on the basis of pulpal histology alone. The very high concentration of fluoride in commercial preparations of silver fluoride raises several questions concerning its clinical safety.     

Caries management for institutionalized elders using fluoride and chlorhexidine mouthrinses

OBJECTIVES: The effectiveness of either a 0.2% neutral sodium fluoride (NaF) solution or a 0.12% chlorhexidine (CHX) solution as a daily mouthrinse for controlling caries was tested against a placebo rinse in this 2-year randomized clinical trial among elders in long-term care (LTC) facilities. METHODS: At baseline, 369 recruits were examined clinically for caries and allocated randomly to one of the mouthrinse groups. RESULTS: After 2 years, 116 participants remained in the trial. The prevalence of caries and the dental status of the groups were similar at baseline and after 2 years. On average, each group lost less than one tooth per person, but the fluoride group compared with the others had significantly less caries and significantly more reversals from carious to sound dental surfaces at the end of the trial. CONCLUSIONS: We conclude that 0.2% neutral NaF mouthrinse every day does reduce the incidence of caries among elders in LTC facilities.