氟化氨银溶液对人工脱矿牙本质粘接强度的影响

目的：评价氟化氨银溶液（silver diammine fluoride,SDF）对人工龋牙本质和玻璃离子粘固剂（glass ionomer cement,GIC）之间的微拉伸粘接强度的影响。方法：将12颗人离体磨牙制备成脱矿牙本质和未脱矿牙本质2组标本,均分为对照组、氟化氨银组及氟化氨银与光固化联合处理组（n ＝20）,将处理完成的牙本质与 GIC 富士 IX 粘接,24 h 后对标本进行切割及微拉伸强度试验,最后用扫描电镜观察牙本质与 GIC 之间的超微结构,并进行数据统计分析。结果：脱矿后牙本质的粘接强度显著高于未脱矿的牙本质（P ＜0．01）。经过光固化 SDF 处理的人工龋牙本质的粘接强度数值显著高于只经 SDF 处理的人工龋牙本质的粘接强度（P ＜0．01）。结论：SDF 处理的人工脱矿牙本质与 GIC 之间的微拉伸粘接强度得到显著提高。     

ART和传统充填技术30个月的临床观察与研究

目的评价2种ART专用玻璃离子水门汀(GIC)充填恒磨牙He面龋的效果。方法ART和传统窝洞预备方法，Fuji IX GP和Ketac-Molar为观察组，银汞为对照组。结果ART备洞时间是传统方法的2倍。30月后，2种GICS充填体He面磨损重，窝沟封闭材料缺损大，但无材料差异，无窝沟的龋坏；材料的颜色早期变化明显。银汞充填体表面着色和边缘破损情况随时间的推移而加重。结论改良的GIC适用于有选择的恒磨牙He面龋的充填。     

ART技术充填第一恒磨牙浅、中龋的近期疗效观察

目的 比较非创伤修复治疗（atraumatic restorative treatment,ART）与传统银汞合金充填第一恒磨牙He面、颊面浅中龋的治疗效果。方法 对初一学生203颗第一恒磨牙浅中龋进行ART修复，对199颗同年龋组的第一恒磨牙标准备洞后进行银汞合金充填。结果 ART修复10个月后复查，成功率为94.08%；传统银汞合金充填10个月后成功率为97.47%，两组间无显著差异（P＞0.05）。结论 ART是一种较好的龋病治疗方法，可避免汞污染，不受诊疗条件的限制，利于社区、农村、学校推广，提高龋病充填率。     

非创伤性修复技术治疗老年根面龋的临床疗效

牙根龋病是老年人最常见的牙病,严重影响老年人口腔及全身健康,对老年人的龋病治疗已受到广泛重视。大多数老年人对口腔疾病的治疗恐惧,对钻牙时机器发出的噪音及钻牙时的酸痛感等难以承受。非创伤性修复治疗技术(atraumatic restorative treatment,ART),是采用手动器械去除龋坏组织,再用与牙体组织有粘接性的材料修复。这种修复治疗可以避免钻牙时的痛苦,易于被老年人接受。作者采用ART技术治疗老年根面龋,观察治疗后3个月、1年的疗效,并对ART技术治疗老年根面龋的效果进行评价。     

乳牙龋损无损伤性修复技术的临床应用

目的 选择适合儿童的无损伤性修复(atraumatic restorative tractment,ART)技术,评价ART技术修复乳牙龋损的效果。方法 89例118颗乳牙龋洞,采用ART技术修复,用玻璃离子水门汀充填窝洞。1年后复查充填物情况。结果 根据标准判断105颗牙为成功,成功率为88.98％;失败13颗,占11.02％,主要见于充填物边缘缺损、磨损及脱落。结论 ART技术是一种只用手动器械去除龋坏组织,并用黏接性修复材料修复龋洞的治疗技术,在预防和治疗早期龋损中具有实用价值。     

乳牙龋坏非创伤性充填的1年临床结果观察

目的：探索适合中小城镇及农村的非创伤性充填治疗（ART）技术,评价ART修复乳牙龋坏的效果。方法：1997年在四川省成都及周边地区小学选取6～8岁儿童198名,由经过中专口腔专业训练的医生采用ART技术对乳牙龋坏进行充填,在1个月内对该儿童作了324个充填。结果：1年议后复查297个充填体。248个根据标判断为“成功”,成功率为88．89％。结论：ART不失为一种有前途的龋病充填治疗方法,是可以在农村及中小城镇广泛采用的有前景的防治措施。     

采用ART技术封闭恒牙防龋的6年临床效果观察

目的:评价非创伤性充填(ART)技术对恒牙窝沟封闭后,封闭剂保留及新生龋损发生情况。方法:1996年在四川省德阳市4所中学选取12～13岁儿童140名作191个牙ART封闭。采用WHO的ART标准器械,德国ESPE公司生产的高强度玻璃离子材料,对选择的牙面窝沟进行封闭;操作者为经中等口腔专业训练的医生。封闭后每年对ART封闭及牙龋损情况进行评价。结果:封闭后1、2、4、6年的完整保留率分别为75.4%、62.5%、50.0%、34.6%;成功率分别为89.6%、78.8%、68.5%、57.9%。试验后1年没有新生龋牙的发生,试验后2、3年,龋患发生率分别为1.6%、2.8%。试验后4年龋病有明显增加,试验4、5、6年后,龋病发生率分别为8.5%、16.1%、15.0%。结论:ART封闭试验3年的保存率较高、新生龋发生率低;试验6年封闭剂保留率虽然有所降低,但其结果还是令人满意的,预防龋病的效果是显著的。但封闭物脱落3年后,若没有重新修复,新龋患率大幅度上升,作为恒牙龋病防治的措施是适合和可接受的;是一种适合于在学校、社区开展的有效、实用的龋病预防方法。     

无创伤性修复技术治疗恒牙龋齿的临床观察

无创伤性修复技术（AtraumaticRestorativeTreatment,简称ART）是世界卫生组织专家近年来开发的一种早期充填龋洞的方法。它是使用手动器械如挖器、斧型器等去除龋洞中的龋坏组织,然后用具有粘接性、抗压、抗磨性能较好的玻璃离子材料修复龋洞的操作技术。这项技术主要适用于缺乏牙科临床设备所需要的电能及相应牙科专业人员发展中的国家贫困地区,为生活在这些地区的人们提供一个能够修复牙龋洞的途径。１９９７年作者与荷兰有关牙科机构合作,在锡山市开展了ART临床试验研究。现将ART治疗后２年的临床观察结果报告如下：牙位龋复查…     

龋病治疗药物的研究进展

龋病被世界卫生组织列为三大重点防治疾病之一。通过再矿化手段修复受损牙体硬组织被认为是一种极具潜力的龋病治疗策略,但是当前的再矿化技术主要是基于离体牙模型研究发展起来的,忽视了天然龋的病理结构特点和生物膜的影响,缺少针对天然龋治疗效果的进一步验证和转化,尚不能精准有效地预防和治疗龋病。基于此,近期部分研究开始着重于设计具有抗菌和再矿化双功能的复合材料,从龋病的病理特点出发,采取更高效的手段以终止龋病的进展。本文综述了目前无创/微创终止龋病的临床治疗技术和相关材料学研究进展,并且展望了未来再矿化/抗生物膜双功能材料精准预防和治疗龋病的研究方向和思路。     

非创伤性技术充填乳牙两年的效果比较

目的：探索非创伤性充填（ART）方法修复乳牙龋坏的效果。方法：选取患牙本质龋的乳牙共454颗，分为3组，ART充填154颗，151颗牙作为对照进行汞合金充填，149颗采用钻备油，，玻璃离子充填。1年及2年后复查。结果；大部分儿童使用ART治疗无不适感，93.02％的学生表示如果有龋坏牙，愿意使用同样的方法进行治疗。ART组第1、2年的成功率（84.7％、69.1％）与汞合金对照组（77.1％、66.2％）、牙钻玻璃离子组（87.5％，74.9％）无显著性差异。使用玻璃离子材料的ART组及牙钻组两年继发龋发生率（6.85％、9.2％与6.35％、8.62％）低于汞合金对照组（16.9％、21.5％），差异有显著性。结论：ART技术简单易学，效果较好，对于乳牙龋坏是一种有效的治疗方法。     

Chemical exchange between glass-ionomer restorations and residual carious dentine in permanent molars: an in vivo study

OBJECTIVE: To evaluate the remineralization of carious dentine following the restoration of an extensive lesion in a permanent molar with a high strength glass-ionomer cement (GIC). MATERIALS AND METHODS: Thirteen first permanent molars, which were scheduled for extraction because of the presence of extensive caries lesions, were selected for this study. They were first restored, according to the ART technique, using encapsulated Fuji IX(GP), which contains a strontium glass rather than the traditional calcium glass. The cavities were prepared with a clean enamel margin and minimal removal of the carious dentine around the walls. After a period of 1-3 months they were harvested and subsequently sectioned and examined using an electron probe microanalysis (EPMA) and scanning electron microscopy (SEM). RESULTS: EPMA demonstrated that both fluorine and strontium ions had penetrated deep into the underlying demineralized dentine. The only possible source of these ions was the GIC restoration. CONCLUSION: The pattern of penetration of the fluorine and strontium ions into the dentine was consistent with a remineralization process.     

The physical and adhesive properties of dental cements used for atraumatic restorative treatment

Atraumatic Restorative Treatment (ART), a recently reported field dentistry technique, involves removal of carious debris using only hand instruments and placement of a glassionomer cement (GIC) restoration. While small ART-GIC restorations are effective short-term replacements for lost tooth form, many larger ART-GIC restorations are defective after two years. Presently, resin-modified GICs (R-M GIC) are available which require no special activation equipment and handle easily in field settings. This study measured the com- pressive, tensile, and shear bond strengths to enamel and dentin of a conventional ART-GIC (Fuji IX) and two R-M GICs (Fuji Plus and Advance) at a powder-to-liquid ratio of 3.6:1. The compressive strengths of the GICs tested were significantly different. Fuji IX had the highest compressive strength, and Advance had the lowest strength (p < 0.05). The tensile strength of the R-M GICs was greater than that of the ART-GIC. Fuji Plus showed the highest shear bond strength to enamel and dentin and was significantly different from both Fuji IX and Advance. A clinical protocol is presented followed by case reports where the ART technique was used for management of acute caries in a modern dental setting.     

Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement

Several recent studies have demonstrated the success of the ART (atraumatic restorative treatment) technique under field conditions in developing countries. The ART technique involves removal of caries using only hand instruments, and placing a glass ionomer cement (GIC) restoration.
Objectives. To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia.
Design . Clinical field trial.
Setting . One high school in rural Cambodia.
Sample and methods . 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate. Subjects were randomly assigned to a dental nurse student for cavity preparation and placement of ART restorations (without cavity conditioning).
Results . 92·1% of the carious lesions required class I or class V restorations, and 85·4% were in the lower molars. 89 teeth were filled. At 1 and 3 years 86·4% and 79·5% of restorations were still present. Restorations were assessed by one dentist according to standard criteria. 76·3% of the restorations were judged to be successful at 1 year, and 57·9% at 3 years.
Conclusions . Factors which may have affected the success rates included: the material used, technical factors, failure to condition the cavity prior to restoration, and inexperience of the operators. The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years. Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements.     

放射性龋齿充填治疗的临床效果评估

目的　评估放射性龋充填治疗的临床疗效。方法　对 1 5例放射性龋患者的 1 4 6个龋洞分别采用Ketac Molar和FujiIX充填 ,各充填 73个龋洞。临床观察 2年后 ,用美国公共健康部制定的评定系统 (USPHS)进行疗效评估。结果　①Ketac Molar和FujiIX 2年的完好率分别为 51 7%和52 3 % ,差异无显著性 (P >0 0 5)。②治疗失败及缺陷主要发生在术后 1年和 2年 ,失败的主要原因是充填体脱落 ,边缘着色是两组材料共有的缺陷。③两组材料除在固位情况方面差异极显著外 (P <0 0 1 ) ,其他项目差异均无显著性 (P >0 0 5)。结论　放射性龋使用上述两种材料充填治疗 ,完好率较高 ,有较好的实用性 ,其中FujiIX更优于Ketac Molar。     

Microtensile bond strengths to caries-affected dentine treated with Carisolv

BACKGROUND: Little information is available regarding the bonding performance of adhesive restorative materials to caries-affected dentine after the use of Carisolv. The aim of this study was to compare the microtensile bond strengths of two resin-based adhesives, a conventional glass ionomer cement and resin modified glass ionomer cement to 'normal' dentine and caries-affected dentine after Carisolv treatment. METHODS: Specimens were prepared using molar teeth with small carious lesions. Caries was removed with the Carisolv solution and the whole surface was bonded with either SE Bond, One Coat Bond, Fuji IX or Fuji II LC. After 24 hours, specimens were prepared for the microtensile bond strength test and stressed in tension at 1 mm/min until rupture of the bond. Mean bond strengths and mode of failure were determined and analysed with the LSD test and chi square test respectively. RESULTS: The results showed no statistical difference for SE Bond, One Coat Bond or Fuji IX, but a difference was observed for the resin-modified GIC, Fuji II LC. CONCLUSIONS: It was concluded that carious dentine treated with Carisolv did not affect the adhesion of the adhesive restorative materials tested in this study with the exception of Fuji II LC.     

Compressive strength of glass ionomer cements with dental antibacterial agents.

Glass ionomer cements have been suggested for obturating carious teeth that have been prepared with dental hand instruments. In such cases, carious dentine may be inadvertently or deliberately left in situ. The residual bacteria may, over time, lead to secondary caries and restoration failure. Benefit may be gained from combining antibacterial agents with the glass ionomer cement to control residual bacteria. The aim of this study was to investigate the effects on the compressive strength of glass ionomer cement combined with oral antibacterial agents. Cationic antibacterial agents; chlorhexidine hydrochloride, cetylpyridinium chloride and cetrimide were added to the powder and benzalkonium chloride, a liquid, to the liquid of Fuji IX glass ionomer cement. These were prepared to concentrations of 1, 2 and 4 per cent by weight of the glass ionomer cement and compared to Fuji IX with no antibacterial agent. Test specimens were subjected to a compressive force to failure. Multiple analysis of variance showed highly significant reductions in compressive strength (p < 0.01) between the test materials and control group apart from one per cent benzalkonium chloride. Increasing concentration of the antibacterial agent had increasing adverse effects on the physical properties. The addition of the antibacterial agents tested to Fuji IX reduces the seven-day compressive strength which may affect the clinical performance of the material.     

Clinical effects of glass ionomer restorations on residual carious dentin in primary molars

PURPOSE: To evaluate the mineralization and morphology of residual (infected and affected) carious dentin following the restoration of vital primary molars with viscous glass-ionomer cement (GIC). METHODS: Encapsulated Fuji IX GP and Ketac-Molar Aplicap GICs were placed in cavities that were prepared using the atraumatic restorative treatment (ART) approach. Four suitable exfoliated teeth with intact restorations were sectioned and then examined by electron probe microanalysis (EPMA) and scanning electron microscopy (SEM). RESULTS: EPMA demonstrated the presence of fluorine and strontium that had penetrated into the underlying residual carious dentin from the adjacent GIC. The concentrations of these two elements, and those of calcium and phosphorous, varied with distance from the GIC/dentin interface. SEM showed varying degrees of dentin tubule destruction and intratubular (peritubular) dentin present immediately subjacent to the GIC/dentin interface. Incomplete removal of carious dentin was observed in all specimens, and GIC remained adherent to the tissue.     

Glass-ionomer and calcium silicate-based cements interactions with human dentine in health and disease: Two-photon fluorescence microscopy and Raman spectroscopy analysis.

ObjectivesTo investigate the potential mineralising effects of calcium silicate-based dentine replacement material (Biodentine?) in comparison with glass-ionomer cement (GIC) (Fuji IX?) on different human dentine substrates using a multimodal non-invasive optical assessment.MethodsCements were applied on artificially demineralised or naturally carious dentine and stored for 4 weeks in phosphate-rich media +/- tetracycline used for mineralisation labelling. Interfacial dentine was examined from the same sample and location before and after aging using two-photon fluorescence microscopy, fluorescence lifetime imaging (FLIM) and second harmonic generation (SHG) imaging. Additionally, Raman spectroscopy was used to detect changes in the mineral content of dentine.ResultsSignificant changes in the fluorescence intensity and lifetime were detected in partially demineralised dentine and caries-affected dentine underneath both tested cements, after storage (p < 0.001). This was associated with a significant increase in the mineral content as indicated by the increased intensity of the phosphate Raman peak located at 959 cm^?1 (p < 0.0001). Caries-infected dentine showed significant fluorescence changes under Biodentine? after storage (p < 0.001), but not under GIC (p = 0.44). Tetracycline binding induced a reduction in the fluorescence lifetime with comparable increase in the fluorescence intensity in both cements’ groups within the affected dentine (p < 0.001). SignificanceTwo-photon fluorescence microscopy can be used efficiently for non-destructive in-vitro dentine caries characterisation providing a technique for studying the same dentine-cement interface over time and detect changes. Biodentine? demonstrated comparable remineralising potential to GIC, in addition to inducing remineralisation of caries-infected dentine. This may suggest using Biodentine? as part of minimally invasive operative dentistry (MID) in caries management.     

Spreadability of two glass ionomer cements used in atraumatic restorative treatment (ART).

'Press finger' in atraumatic restorative treatment (ART) is used to spread a glass ionomer cement (GIC) to seal the restoration margin and adjacent pits and fissures. This study compared the spreadability of Fuji IX and Ketac-Molar to establish which was best suited for this purpose. Twenty equally spaced cavities (35 mm apart) were machine-cut in each of two Perspex slabs 200 x 100 x 20 mm. Each cavity was 3 mm deep with a 4 mm diameter. Two V-shaped grooves 1 mm deep were cut to traverse the cavities: one 0.5 mm wide, the other 0.25 mm wide. Equal amounts (0.25 ml) of GIC were dispensed, 20 cavities for Fuji IX and 20 for Ketac-Molar and condensed under light finger pressure using a 20 mm diameter cork thinly coated with petroleum jelly. This allowed the GIC to be condensed into the cavity and spread into the differently sized grooves. The samples were stored in deionised water for 24 hours whereafter the length to which the GIC had spread along each groove from the cavity edge was measured to the closest 0.01 mm. The data were analysed using ANOVA and the unpaired Student's t-test (P < 0.05). There was a statistically significant difference between the length of spread of the two GICs (t = 2.534; P = 0.013) which was confined to the 0.25 mm width groove (t = 2.83; P = 0.007) with Fuji IX spreading much further along the groove (10.25 +/- 1.17 mm) than Ketac-Molar (7.66 +/- 4.21 mm). Fuji IX appears to be the better sealant material when selecting for spreadability in ART.