玻璃离子窝沟封闭剂的应用研究

窝沟封闭是预防点隙沟裂龋发生的一种有效方法。近年来．玻璃离子材料作为封闭剂使用受到很大关注，本文就玻璃离子封闭剂的发展．特点，临床效果．适用指征，国内研究状况等方面作一介绍,以供参考。     

Retention of resin-based pit and fissure sealants: A systematic review

The aim of the present study was to perform a systematic review on the retention of resin-based sealants (RBSs) according to the material used and the clinical procedure. An electronic search in MEDLINE, EMBASE, Cochrane library and SCOPUS was completed by a hand search in conference proceedings. One hundred and twenty-four studies were identified, 31 of which were included. The retention rate of auto-polymerized and light-cured RBSs did not differ significantly. Light-cured RBSs had a significantly higher retention rate than fluoride-containing light-cured RBSs at 48 months (RR = 0.80, 95% CI: 0.72-0.89) and more. Concerning the clinical procedure, the scarcity of well-conducted studies made judgement difficult, except for the isolation stage. If using a rubber dam did not affect retention of auto-polymerized RBSs, it did for fluoride-containing light-cured RBSs (RR = 2.03, 95% CI: 1.51-2.73).     

Nigerian dentists' knowledge and attitudes towards mouthguard protection

Abstract –  The objective of this study was to assess the knowledge and attitudes of Nigerian dentists towards mouthguard protection. A pre-tested 15-item, one-page questionnaire was distributed to 185 dentists practising in different parts of the country with government hospitals or private establishments, by 'hand-delivery' system. Filled and returned forms were 170 (response rate of 92%). The period of the survey was between April and August 2003. Dental graduates from the different dental schools in the country responded to this survey. About 49% of the respondents indicated having only classroom lectures on mouthguards during their undergraduate trainings, 11% said they had some laboratory sessions in addition while no form of education on mouthguards was received by 40%. About 82% had never recommended mouthguard protection for athletic patients, and the major reason was no formal training in the subject. Only 58.5% were familiar with the different types of mouthguards, 75.9% would not be able to supervise or fabricate mouthguards and 50.6% would prefer custom-made mouthguard for their athletic patients. About 84% felt the current training on mouthguards in Nigerian dental schools is inadequate. Over 98% agreed that mouthguard usage in contact sports should be encouraged with the involvement of the dentists. The knowledge and attitudes of the respondents towards mouthguard protection did not vary significantly across years of postqualification from dental schools as well as the professional status of the dentists ( P  > 0.05). Although Nigerian dentists support mouthguard protection in contact sports and want to be involved in the provision of mouthguards for athletes, their knowledge of the protective device is inadequate. There is need for attention to be given to this subject in the undergraduate curricula of our dental schools.     

Evaluation of the retention of two types of pit and fissure sealants

The aim of this study was to statistically compare the retention of a chemically polymerized sealant (Delton, Johnson & Johnson Co., East Windsor, N.J.) with a widely tested UV-polymerized system (Nuva-Seal, L.D. Caulk Co., Milford, Del.) Two hundred children aged 5-16 years who resided in Fairfax County, Virginia (a fluoridated community) and who had one or more pairs of homologous permanent posterior teeth free of decay or fillings were admitted to the study. Posterior teeth on one side of the mouth of each subject were randomly assigned to receive Nuva-Seal; teeth on the other side were treated with Delton. Treated teeth were examined for sealant loss approximately every 6 months for a period of 2 years. Scores for complete retention of Nuva-Seal were 86% after 6 months and 78% at the end of 2 years. The corresponding values for Delton-treated teeth were 96% and 92%. For both sealants, scores of total retention were highest in mandibular first premolars and lowest in mandibular second molars. The greatest rate of sealant loss occurred within the first 6 months after placement. A comparison of overall retention scores (net gain) for Delton and Nuva-Seal revealed that Delton scores were significantly higher than Nuva-Seal at each semi-annual examination. The McNemar test was used to compare the retention of the two sealants for each tooth type. The test showed that the retention scores for Delton were significantly higher than those for Nuva-Seal only on maxillary and mandibular first molars.     

In vivo bisphenol-A release from dental pit and fissure sealants: A systematic review

ObjectiveTo search the literature and assess the short- and long-term release of bisphenol-A (BPA) in human tissues after treatment with dental sealants.DataTwo review authors performed data extraction independently and in duplicate using data collection forms. Disagreements were resolved by discussion with an arbiter.SourcesElectronic database searches of published and unpublished literature were performed. The following electronic databases with no language and publication date restrictions were searched: MEDLINE (via Ovid and Pubmed), EMBASE (via ovid), Cochrane Trials Register and CENTRAL. The reference lists of all eligible studies were hand-searched.Study selectionIn the absence of RCTs, six interventional and two observational studies, examining in vivo BPA release in human salivary, blood and urinary samples, were included. Due to the heterogeneity in methodology and reporting, the main synthesis of the results was qualitative. The quantitative synthesis based on the weighted Z-test could only include two studies. BPA levels identified in saliva ranged from traces below the method's detection limit to 30 μg/ml. In urine, BPA quantities spanned from 0.17 mg/g to 45.4 mg/g. BPA was not traced in any blood sample at any point of time in the relevant studies. The quantitative analysis showed evidence of BPA release one hour after sealant placement compared to the amount traced before restoration (Stouffer's z trend: <0.001).ConclusionsThe available evidence on this topic derived from studies that represent a moderate level of evidence. Nevertheless, the available evidence supports that BPA is released in saliva after sealant placement.Clinical significanceFrom the qualititative and quantitative synthesis of studies, it is reasonable to conclude that BPA is released after placement of some dental pit and fissure sealants in the oral cavity. The biggest quantities are detected in saliva immediately after or one hour after their placement.     

The retention of pit and fissure sealants placed in primary school children by Dentl Health Services, Victoria

The benefit of a public sector sealant programme for children in Australia is yet to be established. This study evaluated sealants placed by therapists of the School Dental Service in Victoria, between 1989 and 1994, on permanent teeth of children in 15 primary schools in Melbourne. Seven hundred and seventy four children aged 6–12 years were examined in school dental clinics by six calibrated examiners. A total of 5363 sealants placed on 2875 permanent teeth (including 2616 first molars, 91 per cent of sample) up to four and a half years previously was examined. Values for complete and partial sealant retention were highest for premolars (86 per cent, 9 per cent respectively, total 95 per cent); similar for occlusal surfaces of maxillary and mandibular first molars (63 per cent, 30 per cent; 62 per cent, 32 per cent respectively) and buccal pits of mandibular molars (66 per cent); and low for pits/fissures of Carabelli's cusps of maxillary molars (44 per cent). Cross-sectional examination up to 24 months for both maxillary and mandibular first molars indicated average values of 67 per cent complete retention, 27 per cent partial retention, 6 per cent missing; thereafter complete retention decreased and partial retention increased. Sealant failures in the six months post-placement were attributed to technique failure. Regardless of sealant retention, caries experience was low under partially retained or missing sealants (4.5 per cent) and completely retained sealants (0.4 per cent). It is concluded that the SDS sealant programme is a sound preventive dental public health approach.     

自酸蚀黏结系统对窝沟封闭剂黏结强度的影响

目的:评价自酸蚀黏结系统对3种窝沟封闭剂剪切黏结强度的影响。方法:选取前磨牙36个,随机分为实验组与对照组,每组18个。实验组分为3小组,经自酸蚀黏结系统(XenoⅢ)处理后,分别与3种窝沟封闭剂(Estiseal F,Concise,Ionosit Seal)黏结。对照组分为3小组,用GLUMA牙釉质酸蚀凝胶酸蚀后分别与3种窝沟封闭剂黏结。37℃水浴保存24h,万能材料试验机检测剪切黏结强度,扫描电镜(SEM)观察断裂面形态。结果:实验组的剪切黏结强度(SBS)明显高于对照组(P<0.05);SEM观察结果表明,断裂形式取决于酸蚀系统的类型。结论:自酸蚀黏结系统可以提高窝沟封闭剂与釉质的剪切黏结强度。     

Pit and fissure sealants: Another major cornerstone in preventive dentistry

Despite dramatic reductions in caries in fluoridated communities, the disease continues to occur during childhood and adolescence and there is a sustained caries susceptibility of pits and fissures. Pit and fissure sealants have been available to the dental profession for the past two decades. Closely following community water fluoridation, this use of adhesive technology is now recognized as a major cornerstone of modern preventive dentistry. However, the technique appears to have been slow in implementation by the dental profession. Recent expanded utilization of sealants in the public sector, particularly in Victoria, has increased the awareness of the procedure amongst the public and is heightening demand. A review of the pertinent literature and current trends in utilization of sealants is presented. The case is made for expanded utilization of sealants in both the public and private sectors of dental health care delivery in Australia.     

光固化封闭剂与光固化流体树脂窝沟封闭临床效果评价

目的:比较光固化流体树脂与光固化封闭剂在实施窝沟封闭方面防龋成本及保留率的差异。方法:选择上海市7～10岁儿童256名,口腔内至少有1对第一恒磨牙无龋。每名儿童一侧的恒磨牙用光固化流体树脂进行窝沟封闭,另一侧用传统光固化封闭剂进行窝沟封闭,使用便携式牙科椅吸取唾液,并用棉卷隔湿。使用2种方法操作时记录每个牙封闭所用去的棉卷数和操作时间。1a后,检查2种材料在牙面上的保留情况。所有操作均在学校内施行,检查由2名医师用镰形探针进行,采用SPSS10.0软件包对数据进行统计学分析。结果:使用传统光固化封闭剂进行窝沟封闭操作时间每牙需3.53min,而光固化流体树脂组需3.32min(P<0.05)。在封闭剂的保留率方面,光固化流体树脂组显著高于传统的窝沟封闭组(P<0.05)。结论:应用光固化流体树脂进行窝沟封闭,能用较短操作时间达到防龋目的,适合在学校推广应用。     

Meta-analysis of the longevity of commonly used pit and fissure sealant materials

ObjectiveThis systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials.MethodsA search of the MEDLINE, EMBASE and CENTRAL databases identified 3707 abstracts published prior to 12/31/2017, of which 335 clinical publications were analysed in detail. A total of 67 studies included information about sealant retention after 24, 36, or 60 months of follow-up. A meta-analysis using a random effects model was conducted to calculate the pooled estimate of the retention rates for the five groups of sealants. Subgroup moderator analysis was performed to compare the pooled retention rate estimate (RRE) of primed sealants against those of the other groups.ResultsPrimed sealants had a 2-year pooled RRE of 43.2% (95% CI: 30.5–55.8), which was significantly inferior to those of auto-polymerizing (80.8%, 95% CI: 72.2–89) and light-polymerizing sealants (68.4%, 95% CI: 60.2–76.7). Fluoride-releasing and light-polymerizing sealants had the highest 3-year pooled RREs (86.4%, 95% CI: 73.4–99.3 and 83.1%, 95% CI: 75.6–90.7, respectively).SignificaneThe results of this meta-analysis suggest that primed sealants cannot be fully recommended for clinical practice due to their moderate survival rates. Auto-polymerizing, light-polymerizing and fluoride-releasing sealants continue to be considered the reference standards for pit and fissure sealants. However, future generations and developments of primed sealant materials may change this position.     

Twenty-four month clinical evaluation of fissure sealants on partially erupted permanent first molars: glass ionomer versus resin-based sealant

BackgroundGlass ionomer sealants are an alternative to resin-based sealants, especially for use in partially erupted permanent molars. The authors conducted a study to compare the retention, marginal staining and cariostatic properties of a glass ionomer sealant with those of a resin-based sealant during a 24-month period.MethodsWe included in this study 39 patients aged 5 through 9 years who had bilateral partially erupted first permanent molars. One of us (S.B.) placed a resin-based sealant (Delton Plus FS+, Dentsply Professional, York, Pa.) (group D) on a partially erupted first molar in one quadrant of the maxilla or mandible and a glass ionomer sealant (GC Fuji Triage White, GC America, Alsip, Ill.) (group T) in the other quadrant. Two masked and calibrated investigators (S.A.A., J.C.) evaluated the sealants for retention, marginal staining and carious lesions at three, six, 12 and 24 months. The authors used a multinomial regression for statistical analysis (P < .05).ResultsThe recall rate was 69.2 percent at 24 months. Two sealants from group D and three from group T were lost completely. Complete retention rates at 24 months were 40.7 and 44.4 percent for groups D and T, respectively. The authors found no statistically significant difference in retention rates between groups at each recall examination (P > .05). For marginal staining, sealants in the resin-based group exhibited statistically higher marginal staining than did sealants in the glass ionomer group (P < .05). Although the authors detected no caries in teeth in group T, teeth in group D in which the sealant was lost completely experienced demineralization.ConclusionsResin-based and glass ionomer sealants exhibited similar retention rates at 24 months. However, marginal staining was lower in the glass ionomer group, and the authors found no caries in teeth in this group. Consequently, glass ionomer sealants may be a better choice when salivary contamination is expected.Clinical ImplicationsSealing during tooth eruption presents a particular challenge owing to difficulty in isolating the tooth. Glass ionomers may be a better material for sealing partially erupted molars.     

可见光固化窝沟封闭剂治疗磨牙窝沟龋的临床效果观察

目的：探讨可见光固化窝沟封闭剂治疗磨牙Ｈｅ面窝沟龋的临床应用价值。方法：对１２０例６￣１５岁患者的Ｈｅ面窝沟龋在去龋后用光固化窝沟封闭剂对龋损部位及窝沟进行封闭术,并采用对侧同名牙或邻牙也有窝沟龋者作对照研究。结果：随访３年发现该方法能有效阻止龋坏的进一步发展,１年内未发现一例中龋,而对照组有３２．９４％牙发现为中龋,２￣３年后中龋发生率亦有明显差异。３年后实验组继发龋发生率为４．３％,涂膜完全保     

Glass ionomer and resin-based fissure sealants: a clinical study

Abstract – The aim of this study was to compare the retention rate of a glass ionomer cement formulated for fissure sealing with two resin-based sealants. 208 occlusal fissures of permanent molars and premolars were sealed with either Fuji III, Delton or Concise WS by four dentists. Clinical assessments and a replica scoring technique were used to register the performance of the sealants at baseline, after 6–12 months, and then yearly up to 5 yr. As judged clinically, 61% of the glass ionomer sealants were lost within 6–12 months and 84% after 30–36 months. Although total loss was recorded clinically for the majority of the glass ionomer sealants, some retained sealant was observed in the tooth replicas in 93%, of them. The clinical evaluation of the resin-based sealants showed an average complete retention rate of 90% after 4.5–5 yr. The corresponding figure with the replica technique was 58%. Caries was recorded in 5% of the resin-based and in none of the glass ionomer sealed surfaces.     

Practice-based study of the cost-effectiveness of fissure sealants in Finland

OBJECTIVE: To retrospectively analyze the cost-effectiveness of sealant treatment in two health centers with different caries preventive strategies in Finland using a practice-based research protocol. MATERIALS AND METHODS: The data of digital dental records were data-mined and analyzed retrospectively in the health center in Kemi where the preventive strategy was sealing selectively only high-caries risk patients, and in Vantaa where all patients were routinely sealed. Risk group determination in Kemi was based on the presence of Streptococcus mutans in dental plaque. Supervised use of xylitol was an additional caries preventive measure in Kemi. The subjects were divided into all-sealed and non-sealed groups in the beginning of the follow-up according to the sealant treatment status of their first permanent molars. The mean cumulative cost of restorations and sealing treatment was counted in children at 12 years of age. RESULTS: Sealing of risk children in Kemi resulted in a total cost of 185euro per child whereas the respective cost of routinely sealed children in Vantaa was 235euro. The cost of restorations was 76euro in Kemi and 150euro in 5 years in Vantaa. Risk determination and the use of xylitol did not affect significantly the total treatment cost in Kemi. CONCLUSION: The significant reduction in the cost of dental treatment can be achieved by leaving non-risk subjects unsealed and sealing only high-caries risk individuals.     

Porosity of pit and fissure sealants

The aim of this study was to investigate the bulk porosity of a range of pit and fissure sealants. The following materials were included in the study: Concise White Sealant and Delton (chemically cured); Delton (visible light-cured); Helioseal, Visioseal and Prolite (visible light-cured with delivery from the bottle via cannule); Delton, Luma Seal and Prisma Shield (visible light-cured with syringe-type direct delivery systems). Five cylindrical samples, 7 mm in diameter and 1 mm in thickness, were prepared from each sealant and the following parameters were analysed in a computer-controlled mercury porosimeter: (i) total cumulative pore volume; (ii) specific surface area of pores; (iii) percentage total porosity (iv) bulk density; and (v) pore radius distribution. According to the results, the chemically cured sealants exhibited total cumulative pore volume, specific surface area of pores and total porosity. Significant differences were detected within the group of visible light-cured materials. The visible light-cured sealants with syringe-type delivery exhibited the lowest porosity.