乳牙化学机械去龋的临床应用研究

Clinical evaluation of chemo-mechanical caries removal in primary teeth

目的评价化学机械去龋技术在临床治疗中对患儿就诊行为的影响及临床应用价值。方法按临床就诊顺序及家长意愿选择6至10岁患有乳磨牙龋坏的100名儿童随机分为实验组(50颗)和对照组(50颗)进行操作。实验组采用化学机械去龋技术去龋;对照组采用传统机械去龋法去腐备洞。去龋后均进行常规树脂充填。采用独立样本t检验方法评价治疗过程中的操作时间、采用患儿视觉模拟法(visual analogue scale,VAS)和Wong-Baker脸来记录患儿的疼痛程度、焦虑程度、接受程度以及12个月后复诊脱落、继发龋、牙髓炎及尖周炎情况。结果与对照组相比,实验组在治疗过程中虽耗时较长,但对患儿造成的疼痛程度及焦虑程度较低,患儿的接受程度较高,与对照组相比均有显著性差异(P<0.05);12个月后复诊,实验组失访率6%,对照组失访率12%,并且实验组患牙充填物脱落、继发龋、牙髓炎及根尖周炎情况与对照组相比无明显差异。结论化学机械去龋技术是治疗儿童龋病的一种有效方法。该方法虽然操作时间长,但操作步骤简单,无噪音,产生的疼痛及焦虑较轻,对于儿童龋病患者,接受度高,有明显的临床应用价值。

Objective To evaluate the clinical effect of Carisolv Ⅲ on the treatment of caries in primary teeth. Methods 100 patients aged from 6 to 10 were randomly divided into two groups： 50 cases using chemo-mechanical caries removal and 50 cases using traditional bur caries removal. The treatment time and the state of visual analogue scale（ VAS） and Wong-Baker,the degree of anxiety and acceptance and filling effect were compared between the two groups. Results Comparing with traditional bur caries removal group,the chemo-mechanical caries removal group cost more treatment time.The scores of VAS and Wong-Baker and the degree of anxiety in experimental group were lower than those of control group,and the differences were statistically significant（ P〈0.05）.There were no significant differences with filling effect between the two groups after 12-month follow-up. Conclusion The Carisolv chemo-mechanical caries removal is an optional method in children dental caries,which is a safe and simple operation.It can also effectively relieve pain and anxiety,which is easy to be accepted by children.