西安市新城区学龄儿童第一恒磨牙窝沟封闭干预效果评估

目的评估窝沟封闭项目预防学龄儿童第一恒磨牙龋病效果。方法采用回顾性队列研究方法,以班为单位随机整群抽取760名10~12学龄儿童,按是否接受一次性窝沟封闭干预分为干预组(n=464)和对照组(n=296),以既往学生龋病检查资料判定儿童患龋风险。比较两组第一恒磨牙患龋情况。干预组检查干预前后患龋情况和窝沟封闭剂保留情况。结果采用一次性窝沟封闭干预策略,干预时间(2.63±0.09)年,咬合面封闭剂完全保留率(62.9%)高于颊/腭面(18.8%),差异有统计学意义(χ2=184.64,P=0.000),颊/腭面新发龋病(10.4%)高于咬合面(6.2%),差异有统计学意义(χ2=7.89,P0.01)。未封闭咬合面牙齿与封闭咬合面牙齿患龋风险比较OR值为6.11(95%CI为4.28~8.73)。非条件Logistic回归分析显示,有窝沟封闭剂保留对第一恒磨牙有明显的保护作用。(AOR:0.07,95%CI:0.03~0.17)。用直接标化法去除两组人群风险构成差异,标化后干预组和对照组第一恒磨牙患龋率分别为12.4%和17.6%,降低第一恒磨牙患龋率29.6%。结论西安市新城区以学校为基础的窝沟封闭干预活动减少了第一恒磨牙龋病的发生。

Effect evaluation of the first permanent molars sealant program for schoolchildren in Xincheng district of Xi'an,China.

Ojective To evaluate the prevention effects of a school-based pit and fissure sealant program to the dental caries of the first permanent molar of the schoolchildren in Xincheng district of Xi'an,China. Methods By the method of retrospective cohort study,the class took as a whole group to make random cluster sample and 760 children aged 10~12 years old,were divided into sealant group (464 children) and control group (296 children) according to whether or not to participate in pit and fissure sealant program,their general demographic information,oral hygiene habits,knowledge,attitude,etc were surveyed.History oral examination results of them were used to evaluate the risk of dental caries.The FPM caries situation was compared between two groups,and the pit and fissure sealants reserved were checked in the sealant group. Result With the one-time sealant application,follow-up time was (2.63±0.09) years,The complete sealant retention rate of occlusal surfaces was significantly higher than that of buccal/lingual surfaces (62.9% vs 18.8%,χ²=184.64,P=0.000).The caries/restored rate on buccal/lingual surfaces was significantly higher than that of occlucal surfaces (10.4% vs 6.2%,χ²=7.89,P＜0.01).The odds ratio for dental caries was 6.11(95%CI=4.28～8.73)compared between no sealed occlucal surface and sealed ones.Unconditional logistic regression analysis showed that sealant retention was a remarkable protect factor for the FPM(AOR:0.07,95%CI:0.03～0.17).Using direct standardization to control the different caries risk ratio of children in two groups,the caries rate of the first permanent molar in sealant group and in control group was 12.4% and 17.6% respectively,the reduction of attack rate was 29.6%. Conclusion The school-based pit and fissure sealant program had prevent effects on dental caries of schoolchildren in Xincheng district of Xi'an.