窝沟封闭剂临床应用的护理配合

窝沟封闭剂临床应用的护理配合李洁西安第四军医大学口腔医学院（７１００３２）１９９０年，我科对窝沟封闭剂的保留率和防龋效果进行调查，对象是西安市３所小学的１００名６岁儿童，并有４个完全萌出的第一恒磨牙。对该牙合面窝沟封闭后的０．５、１、２、３年分别进行...     

7～9周岁第一恒磨牙窝沟封闭效果的分析

目的通过随访353名儿童第一恒磨牙窝沟封闭效果,探究可能导致窝沟封闭脱落的因素及各因素的作用。方法选择符合窝沟封闭适应证的362名儿童第一恒磨牙(共1 229颗)进行封闭并记录每名儿童的情况。采用前瞻设计,对窝沟封闭3、6个月的效果进行评估,使用分析性口腔流行病学方法探讨窝沟封闭剂种类、口腔卫生、龋面数、心理因素、饮食甜品及碳酸饮料频率等对窝沟封闭效果的影响。结果术后3和6个月对353名儿童(1 218颗)进行检查; 3、6个月窝沟封闭剂脱落率为10.0%、11.9%。Logistic多因素回归分析显示口腔卫生差、饮食甜品及碳酸饮料频率高、心理Ⅱ型、龋面数多是窝沟封闭剂脱落主要危险因素,窝沟封闭剂种类对窝沟封闭剂脱落有一定的影响。结论 7～9岁儿童第一恒磨牙窝沟封闭剂的脱落与口腔卫生情况、饮食习惯、心理因素、龋面数和窝沟封闭剂种类有关。     

457例维吾尔族儿童第一恒磨牙窝沟封闭2年疗效分析

目的: 探讨新疆乌鲁木齐市7~9岁维吾尔族儿童第一恒磨牙窝沟封闭2年后的临床效果, 分析窝沟封闭剂的2年保留率。方法: 对乌鲁木齐市7~9岁457名维吾尔族儿童的1499颗新萌出第一恒磨牙进行窝沟封闭, 并对封闭后6、12、24个月的封闭剂保留情况和罹患龋病情况进行观察及记录, 应用SPSS 16.0软件包对检查结果进行χ2检验和t检验。结果: 457名新疆维吾尔族儿童窝沟封闭术后6、12、24 个月的窝沟封闭剂完全保留率分别为 98.33%、92.71%和88.93%, 患龋率分别为0%、0.63%和1.15%。结论: 对新疆乌鲁木齐市7~9岁维吾尔族儿童的第一恒磨牙进行窝沟封闭 , 预防窝沟龋效果好, 值得大力推广。     

应用免冲洗酸蚀剂的窝沟封闭系统临床效果观察

目的：观察应用免冲洗酸蚀的窝沟封闭系统在临床应用的保留率和龋齿减少率。方法：选择儿童口腔门诊6－14岁儿童的完全萌出的第一或第二恒磨牙，由一位医师采用自身对照法进行窝沟封闭，术后3、6、12月复查。共复查38人136颗牙齿，并应用扫描电镜观察封闭后的离体牙封闭情况，结果：12月时免冲洗酸蚀组的完全保留率低于磷酸酸蚀组，脱落率高于磷酸酸蚀组，有统计学差异，免冲洗酸蚀组发现2例龋齿，磷酸酸蚀组4例龋齿，免冲洗酸组龋齿减少率为50％，结论：复查一年后，应用免冲洗酸冲的窝沟封闭系统，封闭剂保留率较低，脱落率较高，临床应慎重使用免冲洗酸蚀剂。     

磷酸酸蚀结合流动树脂对年轻恒牙窝沟封闭的疗效分析

目的比较3M流动树脂和3M窝沟封闭剂为第一恒磨牙行窝沟封闭术,2种材料窝沟封闭的保留率及龋病发生率情况。方法选择7~9岁120例240颗窝沟较深无龋的下颌第一恒磨牙,采用自身半口对照方法,掷币法随机选择一侧为3M流动树脂组,另一侧则为3M窝沟封闭剂组。于术后3、6、12、24个月复查,检查两组窝沟封闭材料的保留率和封闭后牙齿的患龋状况。结果第3、6个月两组第一恒磨牙的窝沟封闭材料保留率、龋病发生率及龋降低率有差异但是无统计学意义(P>0.05)。第12、24个月流动树脂组封闭材料的保留率、龋降低率高于窝沟封闭剂组,龋患病率低于窝沟封闭剂组,差异有统计学意义(P<0.05)。结论表面处理法相同的情况下,流动树脂组远期疗效优于窝沟封闭剂组,提高了封闭材料的保留率,降低了龋病的患病率。     

第一恒磨牙窝沟封闭3年临床效果观察

目的通过3年随访观察窝沟封闭技术预防8岁儿童第一恒磨牙龋的临床效果。方法试验组805人,对照组245人,分别进行口腔检查,对试验组符合适应证的2 190颗第一恒磨牙进行窝沟封闭,分别于1、2、3年后复查试验组封闭剂保留情况和两组第一恒磨牙患龋状况,计算封闭剂保留率和比较两组第一恒磨牙患龋率。结果试验组3年随访封闭剂保留率分别为78.35%、69.56%、69.31%,第一恒磨牙患龋率分别为9.45%、9.91%、10.87%,龋均分别为0.10、0.11、0.12,而对照组3年随访第一恒磨牙患龋率分别为14.29%、17.26%、18.95%,龋均分别为0.15、0.20、0.21。对3年的患龋率分别进行比较,两组间差异均有统计学意义,第2、3年龋均两组间差异有统计学意义。结论窝沟封闭在第一恒磨牙防龋应用中效果好。     

光固化流体树脂窝沟封闭防龋疗效的评价

目的比较光固化流体树脂与光固化窝沟封闭剂在儿童新生恒牙窝沟封闭预防龋坏的临床效果。方法临床选取150名7~10岁,双侧下颌第一恒磨牙无龋坏的儿童。每个儿童随机选取一侧作为试验组,用光固化流体树脂进行窝沟封闭,另一侧为对照组,用传统光固化窝沟封闭剂进行封闭。封闭治疗后6、12、24个月复查,检查封闭剂在牙面的保留率及龋病发生率,并进行统计学分析。结果 2年后试验组光固化流体树脂脱落率和龋病发生率分别为7.80%和2.13%,对照组传统窝沟封闭剂的脱落率和龋病发生率分别为21.43%和7.09%,两组封闭剂脱落率和龋病发生率均有显著性差异(P<0.05)。结论光固化流体树脂在窝沟封闭预防龋坏治疗效果确切,值得临床推广。     

358个乳恒牙窝沟封闭的疗效观察

目的:验证窝沟封闭术在儿童第二乳磨牙、第一恒磨牙中的临床防龋效果.方法:随机选取105名3～12岁儿童,其第二乳磨牙、第一恒磨牙无龋病或釉质发育不全等疾病,并随机选取一侧第二乳磨牙、第一恒磨牙进行光固化窝沟封闭为实验组;另侧同名牙不做封闭为对照组, 进行1～4年的随访观察.结果:封闭358个牙,4年后复查, 第二乳磨牙、第一恒磨牙封闭剂完全保留率分别为45.07 %、46.39%,龋齿降低相对有效率分别为65.22%、57.17%(P=0.000),龋牙降低实际有效率分别为21.13%、12.05%(P=0.000),实验组患龋率18.31%、16.87%,明显低于对照组50.70%、44.58%(P＜0.05).结论:窝沟封闭能有效地预防窝沟龋的发生,是目前预防窝沟龋的较好方法之一.     

应用Prime＆Bond NT粘接剂封闭儿童第一恒磨牙窝沟的临床观察

目的 探讨Prime & Bond NT粘接剂对第一恒磨牙窝沟封闭剂保留率的临床疗效.方法 采用双侧自身对照的研究方法,选择同一受试对象,一侧上下牙采用Prime&Bond NT粘接剂作为试验组,对侧上下牙采用磷酸酸蚀作为对照组.结果 试验组保留率显著高于对照组,两组封闭剂保留率差异有统计学意义(x2 =8.628,P =0.013).结论 Prime & Bond NT粘接剂对第一恒磨牙窝沟封闭剂保留率高于37％磷酸凝胶窝沟封闭剂保留率.     

改良窝沟封闭术的临床效果评价

目的探讨一种改良窝沟封闭术的临床应用效果。方法选择50例学龄儿童的双侧第一恒磨牙,分别以改良窝沟封闭术(改良组)和传统窝沟封闭术(传统组)进行窝沟封闭,随访2年,观察2组窝沟封闭剂保留率和龋病发生率。结果 2年后封闭剂保留率改良组(92.55%)高于传统组(84.04%),差异有统计学意义(χ2=8.199,P<0.05);龋病发生率改良组(2.13%)低于传统组(9.57%),差异有统计学意义(χ2=4.731,P<0.05)。结论改良窝沟封闭术较传统窝沟封闭术能明显提高封闭剂保留率,从而增强防龋效果。     

733颗六龄牙窝沟封闭4年后效果评价

目的：评价儿童六龄牙窝沟封闭4年后的效果。方法对广州市海珠区南石头街5所小学二年级学生进行入校检查,并为符合适应证的儿童六龄牙实行诊室内窝沟封闭,4年后入校回访,检查其封闭剂保留情况和患龋情况。结果受试儿童508人,共检查六龄牙1231颗,其中符合窝沟封闭适应证1012颗,符合适应证中未行封闭的279颗,已封闭的733颗,应封未封率为27.57%。窝沟封闭4年后,六龄牙的封闭剂保留率为57.16%;患龋率比较,已封闭组为9.82%,未封闭组为15.77%,2组比较差异具有统计学意义（c2=7.045, P=0.008）,已封闭组龋降低率为37.73%;另外,浅窝沟组的患龋率为7.76%,已封闭组与之比较其差异无统计学意义（c2=0.844,P=0.358）。结论六龄牙窝沟封闭4年后观察,其龋降低率明显。     

Retention of pit and fissure sealant on the primary molars of 3- and 4-year-old children after 1 year

An investigation of pit and fissure sealant retention in 1,871 children in the Head Start program was conducted in Tennessee in September 1985 to determine the retention of the sealant after application to the occlusal surfaces of primary molars of 3- and 4-year-old children. The investigation shows pit and fissure sealants are retained on primary molars at a rate comparable to that expected on permanent molars.     

Effectiveness of a pit and fissure sealant in the prevention of caries: three-year clinical results.

With use of the half-mouth technique, a pit and fissure sealant was applied to the permanent first molars of 200 children between 6 and 8 years of age in a community with fluoridated water in Colombia, South America. Complete retention of sealant at 12, 24, and 36 months after application was 91.6%, 88.9%, and 87.5%, respectively. Partial retention of sealant was 5.8%, 7.1%, and 8.5% at the same intervals. The incidence of caries in all sealant-treated teeth at 36 months was 8% vs 53% in untreated paired teeth. Of the 238 teeth that completely retained sealant, only one tooth had occlusal caries at 36 months. No statistically significant difference in complete retention between maxillary and mandibular molars was noticed at any examination. The study confirms that this cold-cured pit and fissure sealant is effective in protecting the occlusal surfaces of teeth against caries for at least three years.     

Retention and effectiveness of a chemically polymerized pit and fissure sealant after 12 months

The aim of the present study was to evaluate the retention and effectiveness of a bis-GMA type of fissure sealant which polymerizes after conventional mixing of the two catalyst/activator components (Concise Enamel Bond System). Unilateral sealing of homologous pairs of permanent first molars was carried out by a dental hygienist. Of the 451 sealed sites sealant was present in 73%, partly missing in 8%, and completely missing in 18% after 1 year. The effectiveness of the treatment in preventing occlusal caries was highly significant and the caries reduction was found to be about 70%. A strong relationship between status of sealant and occlusal decay was demonstrated. The shortcomings of the half-mouth design when evaluating sealants as a caries-preventive measure in public dental health programs are discussed.     

Pit and fissure sealants: results at five and ten years.

AIM: This was to evaluate the efficacy of pit and fissure sealant (FS) using two different application techniques for caries prevention assessed at five and ten years. METHODS: The study was conducted using Delton(R) pit and fissures sealant applied with either rubber dam (RD) (Group A: 50 children, 200 first permanent molars, 120 second permanent molars) or cotton wool rolls (CR) (Group B: 50 children, 200 first permanent molars, 112 second permanent molars). At five and ten years FS were evaluated for retention, loss and incidence of occlusal and proximal carious lesions recorded. STATISTICS: The data were analysed with the Chi- square test comparing the results obtained for first permanent molars and second permanent molars at five and ten years. RESULTS: There was no statistical difference between results in the two groups (p< or =0.05). The highest retention rate, 81.7%, was found for second permanent molars sealed under RD at the five year assessment. The lowest, 64.3% also for second molars sealed under CR humidity control at ten years. CONCLUSIONS: Pit and fissure sealants are a valid preventive approach that can be applied with similar results with rubber dam or cotton rolls.     

两种光固化材料行窝沟封闭术后3年临床效果

目的 比较2种光固化材料用于第一恒磨牙窝沟封闭的临床效果.方法 6～8岁的儿童150例600颗健康的第一恒磨牙分为2组:试验组用光固化Filtek Z350流动纳米树脂进行一侧窝沟封闭术;对照组用光固化窝沟封闭剂Estiseal F作为自身对照.随诊3年.结果 术后1、 2、 3年复查,试验组的封闭材料完全保留率分别为95.71%、 89.83%、 80.56%,对照组分别为87.50%、 80.51%、 69.44%,试验组术后1、 2、 3年的封闭材料完全保留率高于对照组(P<0.01),差异有统计学意义.术后1、 2年龋病发生率,差异无统计学意义(P>0.05),但术后3年试验组龋病发生率为1.67%,对照组为6.67%,差异有统计学意义(P<0.05).结论 光固化Filtek Z350流动纳米树脂是一种可靠的恒牙窝沟封闭材料,值得临床推广使用.     

卓美流动聚合体和光固化窝沟封闭剂3年临床效果评估

目的 评估卓美流动聚合体作为窝沟封闭剂的临床疗效和应用价值.方法 选择360例6～10岁患儿的720颗上下颌第一恒磨牙,用卓美流动聚合体行窝沟封闭,采用可见光固化窝沟封闭剂作自身对照.结果 随访3年后,卓美流动聚合体的涂膜保留率较可见光固化剂高(P＜0.01).龋病患病率低于对照组(P＜0.05).结论 卓美流动聚合体是一种可靠的窝沟封闭剂,值得临床推广应用.     

Occlusal wear of a resin-modified glass ionomer cement following three surface treatments

Unacceptable occlusal wear has been report- ed for resin-modified glass ionomer cements (RMGICs) placed in permanent molar teeth. Three different surface treatments of a RMGIC were evaluated over periods of up to 2 years for their effects on restoration wear behaviour: (a) sealing with a thin layer of low viscosity unfilled resin (sealed restoration), (b) sealing with a thicker layer of a lightly-filled pit and fissure sealant (sealant restoration), and (c) co-curing the RMGIC with a posterior resin composite (co-cured restoration). After 2 years the cumulative median (quartiles) wear was for (a) 100 (50–150) μm, (b) 25 (0–50) μm, and (c) 25 (25–38) μm. Although method (b) effectively reduced the surface wear of the RMGIC, this treatment required frequent re-sealing, involving 52% of the restorations. Sealing the surface of a RMGIC placed in permanent molars was not a satisfactory method for reducing occlusal wear. However, co-curing the RMGIC with a posterior resin composite reduced occlusal wear significantly (P<0.0001), without the need for frequent re-applications of a pit and fissure sealant to the RMGIC. Received: 23 May 2000 / Accepted: 26 September 2000