含氟凝胶辅以口腔护理预防鼻咽癌放射龋的疗效评价

Effects of fluoride gel assisted with oral care on prevention of radiation caries for patients with nasopharyngeal carcinoma

目的:对含氟凝胶辅以口腔护理预防鼻咽癌放射龋的临床疗效进行评价。方法:化疗前随机分为使用含氟凝胶组(A组)与不使用含氟凝胶组(B组)。A组采用个别全口托盘技术,局部应用氟化物凝胶,辅以口腔护理;B组仅进行口腔护理。对患者进行3年的追踪观察,比较两组放疗前后患龋率、龋均、龋面均的差异。结果:放疗前A组与B组间的患龋率、龋均、龋面均无统计学差异(P>0.05),放疗1年和3年后,A组的患龋率、龋均、龋面均明显低于B组,具有明显的统计学差异(P<0.01)。A组放疗前与放疗后1年的三项指标差别无统计学意义(P>0.05),但B组放疗前与放疗后第一、第三年的差别均具统计学意义(P<0.01)。结论:用个别托盘技术,口腔局部使用含氟凝胶,并配合口腔护理,可达到理想的近远期预防放射龋效果。

Objective： To evaluate the clinical therapeutic effectiveness of preventing radiation caries by acidulated phosphate fluoride （APFI） gel for patients with nasopharyngeal carcinoma. Methods： Patients were randomly divided into APFI gel treatment subgroup （A） and control subgroup （B） before irradiation. Group A： Fluoride gel was locally applied with special complete tray, assisted with oral care; Group B： Only oral care applied. The changes of dental caries indexes including caries rates, DMFT and DMFS were compared before and after the treatment via a 3-year tracing observation of oral health. Results： Before radiotherapy between group A and B, there existed no statistical difference in dental caries indexes （P〉0. 05）. Both after one year and three years, dental caries indexes of group B were significantly higher than those of group A （P〈0. 01）. Between pre-radiotherapy and 1 year after radiotherapy, the dental caries indexes of group A had no statistical differences （P〉 0.05） ; while in group B the dental caries indexes existed statistical differences between pre-and postradiotherapy （P〈0. 01）. Conclusions： The local application of fluoride gel with special complete tray assisting with oral care could lead to the desirable therapeutic effect for preventing radiation caries.