氟化氨银和氟化钠涂料对乳牙龋治疗作用

目的 :观察 3 8mL/L氟化氨银液和 50mg/L氟化钠涂料对乳前牙龋的治疗作用。 方法 :来自 8所幼儿园的 3 75名 3～ 5岁患有上颌前牙龋的儿童参加了该项研究 ,他们被随机分配到 5个组。各组处理分别为去腐和每年涂布 1次氟化氨银 ;每年涂布 1次氟化氨银 ;去腐和每 3个月涂布 1次氟化钠 ;每 3个月涂布 1次氟化钠 ;涂布水。结果 :2 4个月后各组儿童上颌前牙平均静止龋牙面数分别为 3 .52、3 .54、1.93、1.95和1.67(P <0 .0 0 1)。结论 :1年 1次涂布 3 8mL/L氟化氨银对乳前牙龋有治疗作用 ,涂氟前是否去腐对治疗效果无影响     

2种复合树脂修复前牙龋损的临床效果评估

目的 探讨2种复合树脂修复前牙龋损的临床效果。方法 选取100例前牙龋损患者，依据随机数字法将其分为实验组与对照组，每组各50例。实验组应用复合树脂多层充填技术和3 M-Z350（A2/A3）纳米复合树脂充填，对照组选用卡瑞斯玛光固化复合树脂充填， 1年后比较2组的修复成功率、不良反应及患者满意度。结果 实验组的美观满意度、治疗成功率均高于对照组（P<0.05） ；实验组不良反应发生率低于对照组（P<0.05）。结论 纳米复合树脂材料可大大提高前牙龋损患者美观满意度，提高修复成功率，减少不良反应的发生情况，值得临床推广应用。     

窝沟封闭剂联合涂氟预防儿童第一恒磨牙龋病效果的临床研究

目的 研究窝沟封闭剂联合涂氟对儿童第一恒磨牙的防龋效果。方法 选取2020年6月上海浦东新区宣桥镇3所小学450名一年级学生作为研究对象。按照自身半口对照方法分为对照组和实验组。对照组为左侧上下颌第一恒磨牙，共900颗，采用窝沟封闭剂；实验组为右侧上下颌第一恒磨牙，共900颗，采用窝沟封闭剂联合涂布含5%氟化钠的多乐氟，两组均随访2年。观察并记录两组牙齿预防后6个月、1年和2年后的封闭剂保存情况及龋病、邻面龋发生率。结果 预防后6个月、1年、2年，实验组牙齿封闭剂保存完整率（100.00%、100.00%、94.90%）显著高于对照组（100.00%、82.40%、74.70%），差异具有统计学意义（P<0.05）。实验组第一恒磨牙龋病和邻面龋的发病率为7.30%和2.40%，显著低于对照组的11.10%和8.00%，差异具有统计学意义（P<0.05）。结论 应用窝沟封闭剂联合涂氟可显著降低封闭剂脱落率，降低儿童第一恒磨牙龋病及邻面龋的发生率，用于儿童第一恒磨牙龋病的预防中具有显著作用。     

龋齿、牙周炎患牙和健康牙的菌斑生物膜特征

目的研究牙面菌斑生物膜特征与口腔疾病的关系。方法选择牙周健康而牙冠严重龋坏的龋齿5颗、无龋损而极度松动的牙周炎患牙6颗及正畸原因拔除的健康牙4颗,在扫描电镜下,观察分析龈上、龈下及移行生态区的菌斑生物膜特征。结果龋齿、牙周炎患牙和健康牙的牙面均观察到细菌混合物组成的菌斑生物膜,健康牙菌斑生物膜以球菌为主,放线菌和短杆菌少量;龋齿牙的龋坏处为坏死组织和细菌,龋边缘及龈沟处的球菌和短杆菌较健康牙多;牙周炎患者牙菌斑生物膜的细菌种类多,在龈上、龈下移行处可见典型的玉米棒状菌斑或以杆菌为主的紧密附着菌斑,龈下可见球菌、杆菌、梭菌及螺旋体等构成的复杂菌斑。结论龋齿、牙周炎患牙和健康牙菌斑生物膜细菌组成、集聚秩序和立体结构不同,菌斑生物膜的形成与细菌的附着、集聚、生长有关,也与局部病变密切相关。     

氟保护漆对青少年固定正畸中釉质脱矿的影响

目的 探讨氟保护漆对青少年正畸患者固定矫治后釉质脱矿发生率的影响。方法 将80例16岁以下青少年固定正畸矫治患者随机分成2组：对照组40例（721颗）,对患者及家长进行口腔健康教育,不涂氟;实验组40例（742颗）,除了对患者和家长宣教外,戴用固定矫治器时及正畸期间每6个月用氟保护漆处理牙面。临床观察2年,对粘接托槽的牙齿观察其脱矿程度。结果 实验组中706颗牙脱矿指数为0,出现脱矿的有36颗,脱矿率为4.85%,未出现脱矿指数大于1的患牙。对照组中有604颗牙脱矿指数为0,出现脱矿的有117颗,脱矿率为16.23%,其中脱矿指数大于1的患牙有18颗。两组间差异有统计学意义（P<0.05）。结论 固定正畸患者戴用固定矫治器时及矫治期间使用氟保护漆能有效预防正畸牙釉质脱矿。     

变性梯度凝胶电泳分析氟化泡沫对牙菌斑微生物的影响

目的 观察临床应用1.23％氟化泡沫对儿童牙面菌斑微生物组成的影响.方法 选取北京市海淀区幼儿园的10名学龄前儿童,平均年龄3.7岁;常规口腔检查,记录龋失补牙面数;样本采自1.23％氟化泡沫干预前后1个月内不同时间(基线及涂氟后第1、2、3、4、7、10、15、21、30天)相同牙面的菌斑;应用PCR-变性梯度凝胶电泳技术表达菌斑微生物DNA图谱,通过GelComparⅡ分析软件解析菌斑微生物的群体相关性,采用Mann-Whitney U检验分析微生物多样性指数(ShannonWeiner指数),通过聚类统计分析样本微生物群落不同时间点的相似性及种群聚类分析.结果 10名儿童基线菌斑微生物DNA的条带数为26.9±2.9,使用氟化泡沫干预3d后菌斑微生物DNA条带数下降至20.1 ±3.8,与基线相比差异有统计学意义(P＜0.05);Shannon-Weiner指数在基线为3.18±0.31,干预3d后为2.92 ±0.28,二者差异有统计学意义(P=0.04).10名儿童的微生物电泳图谱戴斯系数(Dice coefficient)和个体微生物群落聚类分析表明,氟化泡沫干预后菌斑微生物种群结构发生变化,但1个月后菌斑结构与基线相似.结论 1.23％氟化泡沫对儿童牙面菌斑微生物在一定时间内有明显的抑制作用;应用氟化泡沫后菌斑微生物种群结构经历了复杂的变化后还能恢复至原有状态.     

两种镍钛锉在儿童乳磨牙根管治疗中的临床效果

目的 比较M3乳牙专用镍钛锉和M2镍钛锉在乳磨牙根管治疗中的应用效果。方法 选择3 ～ 8岁儿童90例,分成实验组2组和对照组1组,每组30例,实验组分别在乳牙根管治疗中使用M3乳牙镍钛锉和M2镍钛锉,对照组使用不锈钢K锉。分别记录3组的根管预备时间以及疼痛评估值、以及术后X线片检查充填效果。所有的根管治疗操作均为同一医生进行。结果 实验组中的两组平均每根根管预备时间均比对照组短,X线片显示恰充根管数量均高于对照组,患儿术后第1天和第3天的疼痛反应评分值均低于对照组,差异均有统计学意义（P< 0.05）,而实验组中的M3组和M2组比较,根管预备时间、充填效果、术后第1天和第3天的疼痛反应评分值差异没有统计学意义（P> 0.05）。术后第7天3组间疼痛评分值差异无统计学意义（P> 0.05）。结论 M3乳牙专用镍钛锉和M2镍钛锉在乳牙根管治疗时操作时间短、术后疼痛反应低,充填效果佳,均可用于乳牙根管治疗,但是M3乳牙镍钛器械更适用于儿童。     

菌斑微生物群落构成变化与儿童龋病相关研究进展

龋病作为多因素影响的疾病,细菌是龋病发生的始动因素,生态菌斑学说的提出以及现代分子生物学手段的应用,使得学者们能够从微生物角度对菌斑生物膜中细菌的种群分布、菌群多样性、菌斑微生物群落变化与儿童龋病之间的联系进行了更深入的探讨。菌群多样性的降低与龋病发生密切相关,早于龋病发生前的6个月就可以检测到菌群多样性水平的降低,这为龋病监测和患龋风险评估提供了重要依据;差异菌属如乳酸杆菌、韦荣球菌等有可能作为儿童龋病生物标记物,判断儿童患龋风险。目前研究表明在龋病发生发展的不同进程中菌斑微生物群落结构中优势菌属不同,各菌群间的相互作用仍未清晰,菌斑微生物群落在龋病发生发展过程中的具体致龋机制尚未阐明。探究龋病发展过程中微生物多样性和微生物群落构成的变化,筛选特异性的龋病生物标记物,仍是进一步研究的重点。本文针对相关研究进行综述。     

两种局部用氟方法对托槽粘接性能的实验研究

目的 :测定含氟自酸蚀粘接系统和牙面酸蚀后涂氟对托槽粘接剪切强度和托槽脱落后牙面粘接剂残留量的影响。方法 :将 3 0个因固定正畸需拔除的健康前磨牙随机分为对照组、自酸蚀组和酸蚀后用氟组。将粘接完托槽的三组牙齿置于 3 7℃恒温水浴中保持 2 4h ,然后测定托槽的剪切强度及粘接剂残留指数。结果 :三组托槽剪切强度及粘接剂残留指数有显著性差异 ,但都达到临床需要的最小粘接强度。自酸蚀组剪切强度最高 ,且牙面粘接剂残留量最多。而酸蚀后用氟组的剪切强度最低 ,牙面粘接剂残留量最少。结论 :使用含氟酸蚀粘接系统和牙面酸蚀后涂氟的方法可预防牙釉质表面脱矿和龋坏     

学龄前儿童乳牙局部加氟抑龋研究

目的 :利用局部加氟方法抑制乳上前牙龋病进展。方法 :选用同一生活区内有上前牙乳牙龋的 779名 3～6岁学龄前儿童 ,经基线检查、记录结束后 ,分成实验组和对照组。第一、二组每日氟水含漱 (0 .0 5 %) ,第三、四组每3个月一次含氟涂料涂布 ,其中第二、四组处理前去除软龋 ,1年后复查抑龋效果。结果 :各组抑龋牙面龋为 0 .91±1.88、1.0 2± 2 .11、2 .47± 1.90、2 .75± 1.90、0 .75± 2 .34。结论 :局部加氟抑龋效果确定 ,实施前是否去除龋坏组织对抑龋效果无明显影响。     

Comparison of the caries-preventive effect of a glass ionomer sealant and fluoride varnish on newly erupted first permanent molars of children with and without dental caries experience

Abstract

Purpose: This longitudinal clinic study evaluated the effect of a glass ionomer sealant (GIS) and a fluoride varnish (FV) in the prevention of dental decay on newly erupted permanent molars of children with and without caries experience. Materials and methods: Eighty children, aged 6–8 years, with all four newly erupted first permanent molars, were divided into two groups. Group 1 consisted of 53 children without caries experience and group 2 consisted of 27 children with dental caries experience. Permanent molars of the right side were sealed with GIS and the fluoride varnish was applied on the other two permanent first molars. Evaluation of GIS retention and the effectiveness of both materials in the prevention of dental caries were performed after 6, 12 and 18 months. Results: After 18 months, of the 299 teeth, 271 (91%) showed no caries lesions and 28 presented caries lesions (9%). Teeth sealed with GIS had more carious lesions (15) than teeth with fluoride varnish (13). Most of the teeth (70%) that presented carious lesions were in group 2. Of the 138 sealed teeth, only one showed GIS to be totally present, 95 were partially present and 42 teeth were absent. Conclusion: The caries-preventive effect was very similar between both treatments. The presence of dental caries prevailed in the children with caries experience.     

绿茶多酚涂膜临床防龋效果观察

本研究将含绿茶多酚涂膜（0.078g/L）用于乳牙，观察其对乳牙的防龋作用，并分析其作用特点。实验组107名儿童的第一乳磨牙和乳中切牙涂布绿茶多酚涂膜，隔6个月后重复涂布一次，一年后复查患龋情况，记录dmft和dmfs。另110名儿童作为对照。结果涂布牙新患龋率与对照组相比下降66％；实验组非涂布牙新患间牙、新患龋牙面和新患龋率均显著低于对照组；绿茶多酚涂膜对后牙防龋作用大于前牙；从不同牙面看，涂膜对面作用最强，颊舌面次之，近远中面较小。表明绿茶多酚涂膜对涂布牙和口腔中其它非涂布牙具有显著防龋作用。     

欧卡芙氟保护漆A型与多乐氟氟化钠护齿剂预防学龄前儿童龋病的效果对比

目的:比较欧卡芙氟保护漆A型与多乐氟氟化钠护齿剂预防学龄前儿童龋病的效果。方法:选取我市3岁儿童520名,随机分为3组,欧卡芙氟保护漆A型组(176名)和多乐氟氟化钠护齿剂组(174名)分别给予全口乳牙涂布该药物,空白对照组(170名)仅进行口腔卫生宣教。对比分析3组儿童干预前后患龋情况。结果:干预前3组儿童的患龋率及龋齿数差异均无统计学意义(P>0.05)。干预1年后,欧卡芙氟保护漆A型组患龋率、新增患龋人数均低于多乐氟氟化钠护齿剂组和空白对照组(P<0.05)。结论:两种药物均能防龋,欧卡芙氟保护漆A型防龋效果优于多乐氟氟化钠护齿剂。     

Effect of diode laser and fluoride varnish on initial surface demineralization of primary dentition enamel: an in vitro study

Summary. Introduction. Previous investigations have demonstrated improved enamel caries resistance after laser irradiation. The purpose of this in vitro study was to assess the caries‐preventive potential of 809 nm diode laser treatment of the enamel of primary teeth compared to topical fluoride application. Methods. Eighty samples of sound primary teeth were embedded in plastic and stored in saline solution. The enamel surface of 80 samples was polished in an area of 2 × 2 mm. These tooth specimens were randomly assigned to one control and three test groups: (1) no treatment/control; (2) application of 0·1 mg of fluoride varnish (Duraphat^®) for 6 h; (3) diode laser application (809 nm, 140 mJ, 50 Hz, Ø 600 µm fibre, contact mode, absorber, 1 min; ORA‐LASER01^® I.S.T.); and (4) combined application – laser/fluoride varnish. Caries‐like lesions were created by pH‐cycling. After lesion formation, longitudinal sections were taken and examined by polarized light microscopy. Results. In the control group, all samples showed lesions up to 30 µm in depth. After laser application, lesions could be identified in 15 out of 20 samples. Topical fluoride treatment in groups 2 (varnish) and 4 (laser/varnish) completely inhibited the development of caries‐like lesions in all samples. Conclusion. In this in vitro investigation, topical fluoride treatment enhances the resistance of sound enamel of primary teeth more effectively than diode laser application.     

Effect of Cervitec on mutans streptococci in plaque and on caries formation on occlusal fissures of erupting permanent molars

The aim of this study was to evaluate the effect of Cervitec on the abundance of mutans streptococci (MS) in occlusal dental plaque and on 2-year caries increment of partly erupting first permanent molars. Sixteen healthy schoolchildren aged 6-8 years, with at least 2 sound contralateral partly erupted permanent molars, received diet counselling and daily parental supervised toothbrushing with a fluoride dentifrice. Stimulated saliva samples were collected at baseline and after 1 year to evaluate MS levels. In a split-mouth design, Cervitec varnish was applied to one of the teeth at baseline and after 3 and 6 months, while the other tooth in the same jaw was a control. At the 9-month follow-up the teeth were in occlusal contact. At this time, varnish was not applied. At 3 and 6 months after the first application of varnish a significant suppression of MS was observed in plaque. Caries investigations, performed at baseline and every 3 months during the 2 years after the start of the study, showed that all the teeth treated with the varnish were free of caries after 2 years, whereas 8/16 control teeth developed incipient caries. In conclusion, our results suggest that treatment with Cervitec reduces MS in plaque on erupting permanent molars and can lead to a significant decrease in caries incidence.     

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。     

Caries increment in primary teeth after application of Duraphat® fluoride varnish

Abstract In order to evaluate the possible cariostatic effect of a fluoride varnish in the primary dentition, Duraphat® varnish was applied twice yearly for 2 years to the teeth of 195 3¹/₂-year-old children of both sexes attending nine preparatory schools in the Warsaw area. A control group of 127 children attending nine other preparatory schools was also examined. For each child a dmfs₁ index (including “caries without macroscopic defect”) and a dmfs₂ index (“caries without macroscopic defect” excluded) were determined as well as a dmft₁ and a dmft₂ index. After 2 years the difference between the test and the control groups regarding the mean dmfs₁ and dmft₂ index increments was 9.39% (P > 0.1) and 24.09% (P < 0.05) respectively. No significant differences were found, however, concerning the dmft₂ and dmfs₂ indices, the percentage children with new gingival caries, the number of teeth extracted on account of caries and the number of remaining teeth. A test group of 46 children treated with fluoride varnish in which a complete radiological examination could be carried out before and after the experimental period and which was treated with fluoride varnish was compared with a similar group of 27 children, which was not treated with fluoride varnish. The differences in caries increments were small, less than 15%, and were not significant. Taking into consideration the great variation between the schools it was concluded that the cariostatic effect of Duraphat application twice yearly in the primary dentition of these children was slight.     

A 2-year clinical evaluation of sealed noncavitated approximal posterior carious lesions in adolescents

The objective was to evaluate the clinical performance of a therapeutic sealant to arrest the progression of noncavitated approximal posterior carious lesions. The study population comprised 50 adolescents in whom bitewing radiographs had been taken for diagnosis of caries. Approximal noncavitated lesions in premolars and molars (4d–7m) were selected. One group (n=17) had a sealant placed after tooth separation on all enamel lesions. A second group (n=7) received sealant and fluoride varnish in a split-mouth design. A control group (n=26) received a standard fluoride varnish treatment without tooth separation. Follow-up radiographs were taken after 2 years and were analyzed together with the baseline radiographs in a blind study setting. About 93% of the sealed initial carious lesions showed no progression. The corresponding value for the fluoride varnish control group was 88%. In the split-mouth study, 92 and 88% of the surfaces with enamel caries showed no progression after sealant or fluoride varnish treatment, respectively. The difference between the two treatment procedures was not statistically significant. The incidence rate for the transition from enamel caries to dentin caries or fillings was 3.5–3.9 surfaces/100 years in the sealant groups and 5.9–6.1 surfaces/100 years in the fluoride varnish groups. The results show the potential of sealants to act as a noninvasive treatment of early approximal enamel lesions.     

Fluoride concentration in plaque in adolescents after topical application of different fluoride varnishes

The aim of the study was to measure the fluoride (F) concentration in plaque after a single topical application of different fluoride varnishes with contrasting levels of F. Thirty adolescents (12–17 years) with fixed orthodontic appliances were randomly assigned to one of three groups: Bifluoride (6% F), Duraphat (2.23% F) and Fluor Protector (0.1% F). The varnishes were applied after professional cleaning in one upper quadrant, leaving the opposite quadrant untreated according to the split-mouth technique. Pooled plaque samples from each quadrant were collected at baseline and 3 days, 7 days and 30 days after the varnish treatment, and fluoride was analysed by microdiffusion. All fluoride varnishes increased the fluoride concentration in plaque compared with baseline, and the mean values varied between 23 and 138 ng F/mg after 3 days, depending on varnish F concentration. Compared with the control quadrant, statistically significant elevations were recorded for Bifluoride after 3 days and 7 days and Duraphat after 3 days, while no significant differences were revealed in the Fluor Protector group. The fluoride concentration in plaque was back to baseline levels for all participants in the Duraphat group after 7 days, while some individuals in the Bifluoride and Fluor Protector groups still registered slightly increased levels after 30 days. The results suggest that fluoride varnish treatments resulted in elevated fluoride levels in plaque adjacent to fixed orthodontic appliances for a period of up to 1 week, although different patterns was disclosed for the various brands. Received: 5 October 1999 / Accepted: 18 November 1999