应用釉质成形术对年轻恒牙深窝沟治疗的临床研究

A clinical study of enameloplasty impacting treatment strategies related to deep pit and fissure of young permanent molars

目的临床研究常规检查方法对年轻恒牙深窝沟诊断治疗的可靠性,应用釉质成形术(enameloplasty)后对于最终治疗方案的影响。探讨釉质成形术对发现深窝沟早期龋的意义。方法选择64名(男23女41)6～15岁的青少年共164颗有深窝沟的年轻恒牙。检查的指标为:窝沟内是否有色素沉着(±),是否有墨浸状(±),是否有窝沟探软(±)以及是否窝沟卡探针(±)。临床医生依据四项检查指标做出初步诊断及治疗设计,在对深窝沟进行釉质成形术后直视下诊断有无早期龋并确定最终治疗方案。统计学分析应用釉质成形术的术前治疗设计和术后最终治疗方案的差异。结果常规检查指标中窝沟色素、窝沟探软及卡探针是影响最终的治疗方案的显著性因素(P=0.000),应用釉质成形术与否,治疗设计及最终治疗方案间的差异并无显著性(r=0.897)。应用釉质成形术可以发现早期的窝沟龋。结论常规临床检查对年轻恒牙窝沟早期龋的诊断及治疗设计仍然具有重要意义。应用釉质成形术可以避免窝沟龋漏诊的风险且并不会明显地影响最终的治疗设计。

Objective To check - up the effect of enameloplasty impacting final treatment strategies related to deep pits and fissures of young permanent molars, and explore the feasibility of detecting early caries in deep pits and fissures by enameloplasty. Methods One hundred and sixty - four permanent teeth from 64 children aged from 6 ～ 15 （23 boys and 41 girls） were selected. The conventional diagnoses indexes were： pit and fissure pigment （± ） ; black immersed around pit and fissure （ ± ） ; probe soften （±） ; probe block （±） ; The operators make the treatment decision via those diagnoses indexes. After enameloplasty technique, the operators determined the final treatment method： pit and fissure sealant, preventive resin restoration（PRR） and filling. The difference of treatment strategy before and after enameloplasty technique were analysed, Results The indexes of pit and fissure pigment, probe soften and probe block were the significant factors impacting final treatment strategies （ P = 0. 000） ;The treatment strategy before and after enameloplasty technique showed significant correlativity （ r = 0.897 ）. Early caries beneath deep pits and fissures were detected more rehable via enameloplasty technique. Conclusion The conventional diagnose indexes of deep pits and fissures were still credible and effective. Final treatment method was not significantly impacted by the enameloplasty technique. The enameloplasty technique showed helpful to avoid the ignorance of undetected early caries beneath deep pits and fissures.