引导再生术用于下颌第三磨牙拔除后牙槽骨再生的疗效评估

目的观察联合应用Bio-oss骨代材料和Bio-gide胶原膜的引导骨再生术(guided bone regeneration,GBR)治疗下颌阻生第三磨牙拔除后邻牙远中牙槽骨缺损的疗效。方法将24例下颌阻生第三磨牙拔除患者随机分为GBR组和对照组,GBR组12例,对照组12例。GBR组拔牙后行Bio-oss、Bio-gide引导骨再生术。对照组拔牙后常规处理拔牙创。分别记录术前、术后3个月拔牙区域牙槽骨再生情况,邻牙远中牙周探诊深度(probing depth,PD)、牙槽嵴顶到釉牙骨质界的距离、松动度及敏感度。结果与术前相比两组术后拔牙区域均存在牙槽骨再生,X线片显示,GBR组疗效优于对照组,且有显著性差异。GBR组新骨形成量较多,牙周探诊深度减小,邻牙远中牙槽嵴顶到釉牙骨质界的距离减小。无邻牙松动和敏感病例,对照组新骨形成量较少,牙周探诊深度和邻牙远中牙槽嵴顶到釉牙骨质界的距离变化不明显,存在部分邻牙松动和敏感病例。结论联合应用Bio-oss骨代材料和Bio-gide胶原膜行引导骨再生术可促进拔牙区域牙槽骨再生和邻牙远中牙槽骨高度的改善。     

北京市海淀区部分幼儿园36～42月龄儿童龋齿流行趋势及牙面分布的抽样调查

目的:调查北京市海淀区部分幼儿园36～42月龄儿童龋齿的患病情况和牙面分布情况,以了解该年龄阶段龋齿的分布特点,为指导早期预防幼儿龋提供依据。方法:选取北京市海淀区12所幼儿园,所有36～42月龄儿童为研究对象,2名经验丰富的儿童口腔医师依据WHO龋齿诊断标准进行口腔检查。结果:本研究共取样本630个,患龋儿童296名,患龋率47%。龋均(dmft index)2.17±3.31;龋面均(dmfs index)2.91±5.19。6≤dmft≤20的有90名,1≤dmft≤5的有206名。患龋牙面以乳磨面和上颌乳切牙邻面多见。结论:患龋牙大部分集中在患龋较重的儿童中,对于36～42月龄婴幼儿上颌乳切牙的邻面、上下颌乳磨牙的面是龋齿的高发牙面。对于患龋高危的患儿应早期干预,阻断龋齿的早期发生,并对重点好发患龋牙面应重点预防。     

双氟硅烷保护漆预防乳磨牙邻面龋的临床效果和经济评价

目的：评价氟保护漆（fluor protector，含1g／L氟）预防学龄前儿童乳磨牙邻面龋的效果，并进行经济学评价。方法：787名3．5岁儿童参与试验，分为试验组（n=516）和对照组（n=271）。对试验组儿童乳磨牙邻面应用氟保护漆，对照组用安慰剂。试验期两年，每年第一季度隔周1次，连续应用3次，之后每季度各用1次。结果：2年后氟保护漆组乳磨牙dmfsappr比对照组降低52．7％（P〈0．05）。结论：该方法能够有效预防乳磨牙黯面龋，但成本一效果分析显示成本较高。目前用于患龋高危儿童以及诊室内防治乳磨牙邻面龋更为适宜。     

乳磨牙龋非创伤性充填疗效观察

非创伤性充填技术(ART)适用于恒牙和乳牙无牙髓病变的中、小龋洞充填。我们对ART充填乳磨牙He面龋(Ⅰ类洞)和邻He面龋(Ⅱ类洞)的临床效果进行评价,现报告如下。     

依据牙槽嵴和根尖周牙槽骨骨状况进行牙槽骨分类法

如果治疗前能对牙槽嵴顶和根尖周的牙槽骨情况及其厚度有一定了解,那么对于满足美观和功能的风险评估将会有所帮助,尤其是在上下前牙区发育异常及想要达到前牙保护耠时。本文介绍了一种牙槽骨（表型phenotype）的新分类法,该分类方法将牙槽嵴顶和根尖周区牙槽骨分开考虑,并依据每个区域的唇颊侧牙槽骨厚度进行分类,从而有助于跨学科治疗的风险评估。牙槽嵴顶区被定义为从釉牙骨质界向根尖方向4mm范围内的牙槽骨区。根尖周区牙槽骨范围取决于每个牙的牙根长度,它从釉牙骨质界根尖方向4mm处（牙槽嵴顶区止点）延伸至根尖区为止。每个区域的牙槽骨（牙槽嵴顶区和根尖周区）都可以归为厚型或薄型。唇颊侧骨质厚度≥1mm称为厚型,而厚度〈1mm则称为薄型。     

南京市449例乳牙期儿童龋面分布特点

目的 了解南京市乳牙列期儿童龋病的牙面分布规律.方法 抽取南京市449位2～6岁儿童进行口腔检查并记录,分析不同牙面的患龋差异.结果 龋齿牙面分布左右对称,龋面主要集中于上颌乳中切牙近中邻面,其次为乳磨牙邻面和上颌乳前牙唇面及邻面.乳前牙区牙面龋风险向中线递增,乳磨牙区下颌龋风险大于上颌,(牙合)面龋以第二乳磨牙为主,...     

3M流动树脂与3M玻璃离子修复乳磨牙Ⅱ类洞的临床疗效比较

目的:探索儿童口腔科2种常用充填材料用于乳磨牙邻牙合面龋洞(Ⅱ类洞)充填治疗的临床疗效。方法:将178名4~6岁儿童266颗乳磨牙Ⅱ类洞随机分为2组,即3M流动树脂组(实验A组)、3M玻璃离子组(对照B组),对乳磨牙进行充填治疗后1、2年复查比较2种材料治疗的临床疗效。结果:采用3M流动树脂和3M玻璃离子对Ⅱ类洞进行充填治疗后1年成功率分别为96.00%和87.80%,充填治疗后2年成功率分别为95.76%和86.61%,差异有统计学意义(P<0.05)。结论:3M流动树脂用于乳磨牙邻牙合面龋洞充填治疗的临床效果优于3M玻璃离子。     

第一恒磨牙患龋与乳磨牙患龋相关性的研究

目的 探讨6～10岁儿童第一恒磨牙患龋与乳磨牙患龋的相关性,以期为临床提供参考.方法 采用整群、分层、随机抽样的方法,抽取济南市10个区(县)40所小学,对6 ～ 10岁符合纳入标准的3680名儿童进行患龋情况调查,并分析第一恒磨牙患龋率与年龄、性别及乳磨牙患龋之间的相关性,对第一恒磨牙龋失补牙数(decayed-missed-filled teeth,DMFT)、龋失补牙面数(decayed-missed-filled surfaces,DMFS)及乳磨牙龋失补牙数(decayed-missed-filled teeth,dmft)、龋失补牙面数(decayed-missed-filled surfaces,dmfs)进行相关分析.结果 6～10岁第一恒磨牙DMFT为1440,龋均0.39(1440/3680);患龋率20.7％ (763/3680),女性患龋率[28.9％ (509/1762)]显著高于男性[13.2％ (254/1918)] (P ＜0.01)；第一恒磨牙患龋率随年龄增长呈上升趋势.第一恒磨牙DMFT与乳牙dmft呈显著正相关关系(r=0.31,P＜0.01),DMFS与dmfs呈显著正相关(r=0.35,P＜0.01).当dmft＞3、dmfs＞ 19时第一恒磨牙患龋率成倍增长.结论 第一恒磨牙患龋率与性别、年龄及乳磨牙患龋指数有关,对乳磨牙高龋患者应早期对第一恒磨牙采取必要的防龋措施.     

瓦努阿图儿童乳牙龋病发病情况调查

目的了解瓦努阿图桑托岛居住的3～6岁儿童乳牙龋齿患病情况,为该地区制定学龄前儿童龋病防治措施提供基线资料。方法505名该地区居住的儿童,在室外条件下检查乳牙患龋情况,并记录dmft值,经统计学分析各年龄组之间及各牙位之间的患龋情况。结果儿童乳牙的患病率为35.7%～48.4%,龋均0.57～1.66。各年龄组和性别间乳牙的患龋率和龋均没有显著性差异。患龋最多的为上颌乳切牙,其次为下颌乳磨牙和上颌乳磨牙。发病率最低的是下颌乳切牙、下颌乳尖牙及上颌乳尖牙。乳牙龋坏充填率0.6%。结论瓦努阿图桑托岛居住的儿童乳牙龋齿的患病率较低,可能与当地的生活习惯有关。龋齿充填率很低,应当加大口腔保健的服务力度。     

下颌第三磨牙萌出状态与第二磨牙远中邻面龋坏的相关性研究

目的:研究下颌第三磨牙萌出状态与第二磨牙远中邻面龋坏的相关性。方法 :临床收集因下颌第三磨牙不适而就诊的患者204例,运用锥形束CT分析下颌第二磨牙远中邻面龋坏与第三磨牙阻生类型(高位、中位、低位)、阻生角度以及两磨牙的釉牙骨质界距离(cementoenamel junction,CEJ)等因素是否存在相关性。结果:在下颌第三磨牙存在的情况下,第二磨牙远中邻面龋坏发生率高达78.4%;性别差异无统计学意义(P=0.165);高位、中位和低位阻生的龋坏发生率差异无统计学意义(P=0.646);而当第三磨近中阻生角度为40~80°时,第二磨牙远中邻面最易发生龋坏,与其他阻生角度组的差异有统计学意义(P<0.001);当第二磨牙与第三磨CEJ距离在6~9 mm时,第二磨牙远中邻面龋坏高于其他组,差异有统计学意义(P<0.001)。结论:下颌第三磨牙近中阻生角度、第三磨牙与第二磨牙的CEJ距离与第二磨牙远中邻面龋坏的发生密切相关。当第三磨近中阻生角度在40~80°间,且两磨牙间的CEJ距离在6~9 mm时,第二磨牙远中邻面更容易发生龋坏,此类阻生齿建议尽早拔除。     

Frequency of alveolar bone loss adjacent to proximal caries in the primary molars and healing due to restoration of the teeth.

The frequency of alveolar bone loss adjacent to extensive proximal caries, and the effect of dental restorations on alveolar bone loss and healthy alveolar bone were examined in human primary molars. Proximal caries, contact loss, mesial drift and the presence of alveolar bone loss were recorded from 190 bite-wing radiographs from 60 boys and 46 girls. Proximal caries was evident in 297 quadrants. In 63.0% of quadrants, both primary molars had proximal caries. Contact loss was evident in 38.4% of the quadrants with proximal caries. Bone loss was found in 12.1% of the quadrants with proximal caries or 31.6% of those with contact loss. Analysis of variance for the presence of bone loss indicated statistically significant values (P less than 0.05) for one or two teeth with caries by quadrant, the presence or absence of contact loss, and age. A second examination was available for 41 children. Among these, eight out of the 36 bone defects disclosed at the first examination were present. At the second examination, after tooth restoration, healing of five bone defects was evident. These findings indicate a connection between the presence and treatment of extensive proximal caries and alveolar bone health in the primary dentition.     

Alveolar bone loss in 5-year-old New Zealand children: its prevalence and relationship to caries prevalence, socio-economic status and ethnic origin

Abstract This study investigated the prevalence of alveolar bone loss (ABL) in 5-year-old New Zealand children. The relationship of bone loss with the prevalence of caries, socio-economic status and ethnic origin was examined. Standardized bite-wing radiographs from 317 children were used to examine the alveolar bone in 1784 sites. Questionable bone loss (QBL) was evident in 8.5% of the children and definite bone loss (DBL) in 2.1%. The children with suitable radiographs had a mean dmft of 1.8. ± 2.9. and mean dmfs of 2.7. ± 5.0. When the children were divided into 3 groups having no bone loss (NBL), QBL only or DBL, analysis of variance on the logarithmic transformation of both the dmft and dmfs scores showed significant differences among the groups. Post hoc tests showed that the means for the DBL group were significantly different from those of the other 2 groups for both dmft and dmfs scores. Logistic regression analysis indicated that the odds ratio for having definite alveolar bone loss was slightly increased in children with a dmft of ≥9.     

Caries experience in the primary dentition of Tanzanian and Finnish 3–7-year-old children

Caries experience of primary teeth in relation to age, sex, ethnic group, socioeconomic status and frequency of consuming sweet snacks and drinks was studied among groups of Tanzanian and Finnish 3-7-yr-olds, a total of 1118 children. In all age groups the Tanzanian children had higher mean dmft scores than Finnish children did. In the Finnish group the mean dmft score was higher at age 7 than at age 3, while in the Tanzanian group no statistically significant difference in dmft scores was found between age groups. In both groups maxillary incisors and molars were the main teeth affected by caries. Frequent consumption of sweet snacks and drinks increased the risk for caries in Tanzanian but not in Finnish children. High socioeconomic status decreased the risk for caries in Finnish children but among Tanzanian children high SES was not associated significantly with the risk of developing caries. According to these results, caries experience in Tanzanian urban nursery school children was significantly higher than in Finnish children of the same age, the differences being especially high among the youngest age groups.     

Dental caries prevalence in early Polynesians from the Hawaiian Islands

We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.     

儿童乳牙龋和乳牙黑色素沉着关系研究

目的　评价学龄前儿童乳牙色素沉着患病率以及色素沉着与乳牙龋之间的关系。方法　选取上海市5个公立幼儿园的1 012名学龄前儿童进行调查,1名口腔医师采用WHO推荐的方法进行龋齿的检查,另1名口腔医师检查颊舌面色素沉着。采用SPSS软件对数据进行统计分析。结果　乳牙色素沉着的患病率为12.7%,色素沉着最常见的部位是下颌前牙的舌侧。乳牙色素沉着与年龄和性别无关。城区幼儿园儿童乳牙色素沉着患病率为16%,明显高于郊区儿童6.4%的患病率（P<0.001）。有色素沉着的儿童患龋率和龋失补牙数、龋失补牙面数分别为56.6%、2.94和4.41,明显低于无色素沉着儿童（72.1%,dmft:4.25; dmfs:7.06,P<0.001）。但两组龋齿的牙面分布比例无明显区别。结论　乳牙色素沉着和乳牙龋之间存在负相关关系。     

Primary dentition caries trends, 1976–1981, in four South African populations

Abstract— This paper is a comparison of cross-sectional data on dental caries in the primary dentition undertaken between 1976 and 1981 in the Transvaal Province, South Africa, on 690 rural Black, 1463 urban Black, 870 Indian and 1622 White children aged 2–5 yr. There was a decrease in percentage dental caries prevalence in the urban White children and an increase in the other three groups, the fastest rate being seen among urban Indian children. Similar trends were noted for mean dmft. Dental caries in incisor and canine teeth remained fairly static but caries in molar teeth increased in the groups of Black and Indian children and decreased in the White children. Ratios d/dmft, m/dmft and f/dmft indicated that minimal treatment was received by all the children.     

四川省6岁儿童乳恒牙患龋状况及相关性研究

目的了解四川省6岁儿童患龋情况,探讨乳磨牙患龋与第一恒磨牙患龋之间的相关性。方法参照第三次全国口腔健康流行病学抽样调查方案,在四川省3个城市、3个农村随机抽样选取调查点,共调查714名6岁儿童的患龋情况,并分析乳磨牙患龋情况与第一恒磨牙患龋情况之间的相关性。结果四川省6岁儿童乳牙患龋率为74.37%,龋均为3.94±3.93,龋齿充填率为4.96%。乳牙患龋率和龋均在男性和女性、城市和农村儿童间无统计学差异（P>0.05）,城市乳牙龋齿充填率高于农村（P<0.05）。已萌的第一恒磨牙中有2.98%患龋,充填率为7.69%。乳磨牙患龋是第一恒磨牙患龋的危险因素[P=0.001,r=0.175,OR=5.756,95%CI（1.733,19.121）],乳磨牙与第一恒磨牙的龋均呈弱相关（P<0.001,r=0.194）。结论四川省6岁儿童乳牙患龋情况较重,乳磨牙龋坏可作为临床及预防工作中预测第一恒磨牙龋坏的因素之一。     

唐山市7~9岁儿童第一恒磨牙患龋状况及相关性研究

目的 了解唐山市7~9岁儿童患龋情况,探讨第一恒磨牙患龋与乳牙患龋之间的相关性。方法 参照WHO《口腔健康调查基本方法》和《第三次全国口腔健康调查方案》,采用分层整群随机的抽样方法,在唐山市51所小学中随机选取10所小学作为调查点,对被调查的1 794名7~9岁学生进行患龋情况检查。结果 第一恒磨牙患龋率为47.49%（852/1 794）,龋均为1.30±1.59,龋面均为1.96±3.40,龋齿充填率为2.35%（20/852）。第一恒磨牙患龋率和龋均在不同性别及年龄组间有统计学差异（P<0.05）,龋面均仅在年龄组间有统计学差异（P<0.05）。乳牙患龋率为83.11%（1 491/1 794）,龋均为4.82±3.55,龋面均为6.51±5.61,充填率为12.41%（185/1 491）。乳牙患龋是第一恒磨牙患龋的危险因素[r=0.277,OR=5.736,P=0.00,95%CI（4.175,7.881）],乳牙患龋与第一恒磨牙患龋呈显著相关（r=0.274,P<0.001）。结论 唐山市7~9岁儿童第一恒磨牙患龋情况严重,乳牙龋可作为临床及预防工作中预测第一恒磨牙龋坏的危险因素。     

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。     

Histological comparison of pulpal inflammation in primary teeth with occlusal or proximal caries

Objective.  A number of clinical and histological studies have investigated caries-related changes in the primary tooth pulp, but the effect of caries site, as a clinical variable, has not been previously considered. This study sought to compare inflammatory changes within the pulp of primary molars according to the location of the caries lesion (occlusal or proximal).
Methods.  Eighty-three primary molars were extracted under general anaesthesia for caries and/or orthodontic reasons, and were split immediately after removal and fixed in 10% formalin. Teeth were then decalcified, sectioned, and stained with haematoxylin and eosin for histological examination using light microscopy. Caries depth was measured using a graticle, and the site of the caries lesion noted as occlusal or proximal. Samples were further classified into one of five subgroups according to the observed degree of pulpal inflammation.
Results.  Key findings were that where caries depth was less than 50% of the total dentine thickness, there were no significant differences in inflammatory status according to caries site. In contrast, marked inflammatory changes were significantly more likely throughout the coronal pulp of teeth with proximal caries compared to teeth with occlusal caries where caries depth was equal to, or greater than, 50% of the total dentine thickness ( P  = 0.017, Fisher's exact test).
Conclusion.  Primary teeth with proximal carious lesions extending more than 50% through the dentine thickness appear to have more extensive inflammatory pulpal changes than teeth with occlusal caries of a similar depth. This finding has clinical implications and may help inform treatment decisions in the management of primary teeth with deep carious lesions.