防龋涂膜的作用机制与临床应用

防龋涂膜作为一种局部应用的防龋方法,在国际上已广泛使用,并取得良好防龋效果。本文对两大类防龋涂膜(氟化物涂膜和洗必太涂膜)的防龋机制、临床应用情况,以及使用它们的安全性和可接受性进行介绍和讨论。     

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提要：牙齿防龋用氟化物涂膜是一种用于牙齿表面的含氟涂膜材料，一般由成膜材料、氟化物和挥发性溶剂组成， 分为稀糊剂型、悬浮液型和溶液型3种类型。涂于牙齿表面后，氟化物涂膜能在牙齿表面附着一段时间，期间能缓慢释放氟离子。释放的氟离子能进入釉质内，形成氟磷灰石，同时在釉质表面形成氟化钙沉积层，从而提高牙釉质抗酸蚀能力。     

氟化物涂膜的应用

氟化物是一种被公认的有效防龋剂，目前有多种氟化物制剂可供使用，如氟化物溶液、含氟牙膏、氟凝胶、含氟水门汀以及含氟树指等。作为一种局部应用的氟化物，氟化物涂膜（Fluoride Varnish）是为了克服其它氟化物制剂的缺点发展起来的，已被欧洲国家广泛应用。在许多国家氟化物涂膜已取代了氟化物凝胶的应用。本文就氟化物涂膜及其应用作一简要综述。     

使用氟化泡沫前后晨尿含氟量临床对比观察

氟可以保护牙齿、预防龋齿，安全第一、效果第二是我国开展氟防龋工作的基本原则。如何安全有效地应用氟化物防龋，在氟剂型的改进和应用方法方面仍然是一个需要不断探讨和解决的问题，本文试图对一种新的局部使用氟化物剂型———氟化泡沫使用前后晨尿氟量的观察，分析评...     

防龋涂膜的作用机制与临床应用

防龋涂膜作为一种局部应用的防龋方法，在国际上已广泛使用，并取得良好防龋效果，本文对两大类防龋涂膜的防龋机制、临床应用情况，以及使用它们的安全性和可接受性进行介绍和讨论。     

氟化物涂膜对乳牙防龋疗效观察

目的:观察氟化物涂膜 Duraphat 对儿童乳牙的防龋效果.方法:选择同一社区的 3-4 岁儿童 348 名,随机分为2组,氟化物涂膜组 175 人,每半年使用一次氟化物涂膜 Duraphat 进行防龋;对照组 173 人不作任何处理;3 年后进行患龋状况检查.结果:实验前涂膜组与对照组龋患率,龋均都较低,差异无显著性(p>0.05).3年后涂膜组龋患率和龋均上升幅度均显著低于对照组(P<0.01).新生龋龋均对照组显著高于涂膜组(P<0.01).结论:氟化涂膜对乳牙有显著的防龋作用.     

氟化物涂膜治疗齿感觉过敏症的疗效观察

临床上治疗牙齿感觉过敏的方法有750 g/L氟化钠甘油糊剂,碘化银等,这些方法虽都有一定疗效,但远期效果不确切.氟化物涂膜Duraphat是一种防龋用的窝沟封闭剂,笔者自2004年将其应用于牙齿感觉过敏症的治疗,取得了满意的效果.     

WHO促进中国有效应用氟化物研讨会纪要

中国正处于经济飞速发展和社会变革的转型阶段，18年来中国的牙病防治工作也取得了令人瞩目的成绩，引起了国际同行的广泛关注。2006年3月13至15日,WHO总部口腔卫生办公室与北京的世界卫生组织预防牙医学研究与培训合作中心等组织合作共同举办了促进中国有效应用氟化物研讨会，共有来自不同国家和地区的29位专家参加，会议议题：从临床、生物学和公共卫生的视角讨论使用氟化物的方法；不同国家使用氟化物的经验；在中国开展各种应用氟化物防龋项目的可行性；公众对氟化物的意识和社会对氟化物的接受程度；国家卫生部、疾病预防控制中心、WH0总部及其合作中心等在促进氟化物应用中的作用；在中国开展各种氟化物防龋项目的困难及制约因素；政策制定的意义；根据21世纪健康促进的曼谷宣言（www．who．int／en）和21世纪口腔健康促进的利物浦宣言（www’who．int．／oral_health），如何将推广应用氟化物纳入到全国非传染性疾病的综合预防策略中。本次研讨会汇集了全球的经验和专家意见，其内容对我国有效应用氟化物防龋政策的制定有很好的借鉴及指导作用，对我国氟化物防龋研究工作的进一步深入开展有重要的推动作用。[编者按]     

氟与龋病——龋病学研究百年回顾与展望之十一

在龋病预防中,氟化物的应用已有60余年历史.本文对氟化物在预防龋病中的多种应用方式,氟化物防龋的机理以及氟化物在防龋应用中对人体带来的毒副作用进行了全面的回顾.同时也对多年来应用氟防龋引发的争议给以论述.     

氟化物涂膜的作用机理与临床应用研究现状

氟化物涂膜的作用机理与临床应用研究现状第四军医大学口腔医学院预防科（７１００３２）李刚李振纲综述吴友农审校局部应用氟化物的目的是改善牙齿表面硬度，阻止、抑制、逆转龋病发展的一种方法。氟化物涂膜（Ｆｌｕｏ－ｒｄｅＶａｒｎｉｓｈ）作为一种氟化物局部应用的...     

含氟涂料与含氟泡沫对儿童龋病预防效果的对比研究

目的比较含氟涂料和含氟泡沫对儿童乳牙龋病的预防效果,为在我国开展乳牙龋病防治工作提供理论依据。方法随机整群抽样的方法抽取2所幼儿园的3~4岁儿童共220名,进行口腔检查,记录患龋情况。随机将这些儿童分为含氟泡沫组和含氟涂料组,分别用氟泡沫和氟保护漆进行龋齿预防,每半年1次,2年共干预4次,每年进行口腔检查,比较2组基线后1年和2年的乳牙新生龋均、新生龋面均及龋齿发病率。结果含氟泡沫组干预1年及2年后新生龋面均分别为2.58±4.36、3.85±5.15;含氟涂料组干预1年及2年后新生龋面均分别为0.95±2.28、1.94±3.32,均显著低于含氟泡沫组(P<0.01)。结论含氟涂料对儿童龋病的预防效果优于含氟泡沫。     

氟化钠护齿剂在预防学龄前儿童乳牙龋齿中的疗效观察

目的:观察氟化钠护齿剂预防儿童乳牙龋齿的效果,为全面开展学龄前儿童涂氟防龋提供依据。方法:采取随机整群抽样方法,在上海市徐汇区抽取25所公办幼儿园3~4岁小班儿童共1140名作为研究对象,在儿童家长知情同意的情况下,本着自愿原则,将研究对象分为2组。涂氟组762名,每半年涂氟1次,连续2年共涂布4次;对照组378名,不做涂氟处理。对所有入组儿童进行口腔卫生指导,比较2组儿童患龋率、龋均、龋病发病率、新增龋均的情况,采用SAS 9.4软件包进行统计学分析。结果:2年后,对照组的患龋率、龋均、龋病发生率和新增龋均均显著高于涂氟组（P<0.05）。结论:在学龄前儿童中应用氟化钠护齿剂,能有效降低乳牙龋病发生率和新增龋均,值得在学龄前儿童中推广应用。     

Fluoride varnish: a primary prevention tool for dental caries

Fluoride varnish is an effective tool that has been proven to prevent dental caries both in primary and permanent dentition. Its ease of use, acceptability and efficacy make it an important tool in the primary prevention of dental caries in high-caries-risk children. There has been an increase in third-party reimbursement for fluoride varnish applications in high-risk children and adults.     

学龄儿童第一恒磨牙局部涂氟防龋效果分析

目的 评价局部涂氟用于学龄儿童第一恒磨牙的防龋效果,为学龄儿童龋病防治提供参考依据.方法 选取广西河池市大化县某小学一年级6~7岁儿童378名(1053颗第一恒磨牙),按照随机抽样原则,分为试验组和对照组.试验组191名(542颗第一恒磨牙),对照组187名(511颗第一恒磨牙).试验组每半年涂布多乐氟1次,同时进行口腔健康教育,共计3次;对照组只进行相同的口腔健康教育.试验开始前检查两组儿童的第一恒磨牙龋患情况,试验18个月后复查.结果 试验组与对照组患龋率分别由干预前21.99%增至27.75%,24.60%增至37.43%;干预后发病率分别为5.76%及12.83%.干预后试验组患龋率、发病率、新增龋均、新增龋面均、 面患龋率、窝沟龋患龋率、邻面龋患龋率、牙面龋发病率均低于对照组,差异均有统计学意义(P<0.05).结论 局部涂氟能够有效预防第一恒磨牙龋的发生.     

Effectiveness of fluoride varnish on caries in the first molars of primary schoolchildren: a 3-year longitudinal study in Guangxi Province,China

Aims: To evaluate the effectiveness of 5% sodium fluoride varnish on caries in first permanent molars and to assess the suitability of using this method to control caries among children in rural areas of Guangxi province, China. Methods: A total of nine schools with 32 classes were selected by simple random sampling. There were 999 students in the experimental group and 1,004 in the control group. The experimental group received oral health education and topical application of 5% sodium fluoride varnish, while the control group received oral health education only. Dental examinations were performed in November 2014 and November 2017, and the modified International Caries Detection and Assessment System (ICDAS-II) was used to record the caries status of the first permanent molars. The data were entered into SPSS 22 for statistical analysis. Results: A total of 1,748 students (853 in the experimental group and 895 in the control group) completed the study. After 3 years of intervention, the experimental group had a lower prevalence of caries, a lower caries increment, a lower decayed, missing and filled teeth (DMFT) index and a lower decayed, missing and filled surfaces (DMFS) index compared with the control group (respectively: 58.9% vs 65.5%, 34.8% vs 42.1%, 1.38 vs 1.59 and 2.06 vs 2.38). All the differences were statistically significant (P < 0.05). Conclusion: In this study population, twice-yearly application of 5% sodium fluoride varnish and oral health education were more effective for preventing caries in first permanent molars than oral health education alone. The implementation of fluoride varnish application as a public health measure in schools in rural areas is recommended.Key words: Fluoride varnish, first molars, caries prevention, schoolchildren     

应用新一代高通量测序技术探讨含氟涂料对患龋乳前牙菌斑微生物的影响

目的 应用新一代高通量测序技术,了解含氟涂料处理患龋乳前牙前后菌斑微生物的变化。方法 选取20名乳前牙患龋的学龄前儿童,菌斑生物膜样本采自含氟涂料处理前和处理后3天、7天和30天的乳前牙患龋牙面;抽提全基因组DNA后,用16S rRNA基因V4-V5高变区为引物扩增后,运用MiSeq测序平台测序并分析。结果 4个时间点菌斑生物膜微生物多样性Shannon指数的比较表明,涂氟后3天、后7天比涂氟前的Shannon指数更低（P=0.011;P=0.016）,提示菌斑生物膜的微生物多样性降低;涂氟后30天和涂氟前的Shannon指数持平（P>0.05）,提示涂氟后菌斑生物膜的微生物多样性恢复至涂氟前的状态;PCA分析也进一步表明和Shannon指数一致;4个时间点优势菌属的比较表明涂氟后3天、后7天、后30天和涂氟前优势菌属的种类和相对丰度均没有差异,说明含氟涂料对菌斑生物膜的多样性的抑制作用没有特异性。结论 含氟涂料对患龋乳前牙牙面菌斑微生物在一定时间内有明显的抑制作用,抑制作用无特异性,微生物多样性经过一段时间还能恢复至原有状态。     

Fluoride varnish application: a new prophylactic method in Albania. Effect on enamel carious lesions in permanent dentition

AIM: The aim of this study is to assess the effects of fluoride varnishes on enamel caries lesions on permanent dentition. MATERIALS AND METHODS: 92 children from primary school (Vasil Shanto, Tirana, Albania) aged 11-12 years were divided into varnish (experimental) and control group. The experiment group received the first fluoride varnish application (Fluoridin, Voco) at baseline, the second application after 3 months and the third application at 6 months from baseline, while the children in the control group received no professional fluoride application. Examinations were performed at baseline and after 7 months. RESULTS: We observed a slight increase in caries prevalence in the control group compared with the varnish group at the 7 month interval (P <0.1 for DMFT and P <0.5 for DMFS and DS). When enamel lesions were included the mean of DeMFT, DeMFS, DeS the caries prevalence was significantly lower in the varnish group after 7 months (P <0.001 for DeMFT, DeMFS). CONCLUSION: Fluoride varnish is an effective mean for arresting early enamel lesions. It is a safe, convenient and well accepted method by patients.     

A review of sodium fluoride varnish

Fluoride varnish was incorporated into clinical dentistry to reduce caries; its use in the U.S. has increased progressively since it was approved by the FDA in 1994. This paper reviewed clinical studies and found that fluoride varnish's effectiveness in caries prevention, ease of application, and safety give it an advantage over other types of topical fluoride treatments (such as gels and rinses) or other caries management methods. As a result, it is regarded as one of the superior topical fluoride agents for young children.     

Prevention. Part 7: professionally applied topical fluorides for caries prevention

This paper reviews the use of professionally applied topical fluorides (PATF) in caries prevention. PATFs are indicated for children and adults with one or more decayed smooth surfaces and/or those who are at high caries risk. Frequency of administration depends on the patient's caries risk, and is usually every 6 months. The effectiveness of fluoride varnish and gel applications has been well established in caries prevention trials involving permanent teeth. Although both types are effective, varnish may be preferred because it is easier to apply, reduces the risk of fluoride over-ingestion, and has greater patient acceptance. Fluoride foams are similar products to gels, but have not been tested clinically. The use of in-office two-part rinses is not recommended because they have not been proven effective. A cleaning, or prophylaxis, is not necessary before the application of topical fluoride for caries prevention. In conclusion, when used appropriately, PATFs are a safe, effective means of reducing caries risk among high-risk populations.     

Fluoride in the prevention of caries in the preschool child

The use of fluorides has benefited greatly the dental health of preschool children. Water fluoridation cuts caries by half in the deciduous dentition as it does in the permanent dentition. In the absence of water fluoridation, fluoride dietary supplements can be used and are effective. For practical reasons it may be useful to limit their use to those at risk from caries and those seen to be prone to caries. There has been some concern over links between early use of fluoride toothpastes and the occurrence of very mild fluorosis. Although this is not perceived as a problem by parents or the community, it is prudent to recommend that parents clean their children's teeth with a pea-size amount of toothpaste. Fluoride varnishes are effective and are useful for preventing caries in young children.