0.5%含氟涂料对龋高危儿童的防龋效果研究

Effect of 0.5% fluoride varnish on caries prevention for children with high caries risk

目的 评价0.5%含氟涂料对龋高危儿童乳牙龋病的预防效果。方法 本研究为随机、对照、检查者单盲、为期24个月的临床试验研究。选取北京市石景山区6所幼儿园中3岁龋高危儿童465名为研究对象。采用分层随机的方法将入选儿童按照两组人数比例1:2分为2组,对照组儿童(n=155)只接受北京市氟化泡沫预防龋齿项目的干预措施,即每年2次1.23%氟化泡沫局部应用和口腔健康教育;试验组儿童(n=310)除了接受北京市氟化泡沫预防龋齿项目的干预措施外,每年增加4次0.5%含氟涂料局部应用。项目开始后12个月和24个月时,两组儿童均接受口腔健康检查,观察两组的新生龋的发病情况,并计算试验组的预防分数以评价0.5%含氟涂料的预防效果。结果 项目开始后12个月内,试验组儿童的龋病发病率(33.0%)、新生龋均(0.67)及新生龋面均(1.43),都显著低于对照组儿童(分别为46.4%、1.23及2.36, P <0.05)。与对照组相比,试验组儿童的新生齲均和新生龋面均分别减少45.5%和39.4%。结论 在3岁龋高危儿童中,每年4次应用0.5%含氟涂料可有效预防乳牙龋病的发生,但长期的防龋效果有待项目实施24个月时的结果进一步验证。

Objective To evaluate the caries prevention effect of 0.5% fluoride varnish for children with high caries risk. Methods This was a 24-month randomized and controlled examiner-blind clinical study. A total of 465 3-year-old children with high caries risk in the 6 kindergartens in Shijingshan District, Beijing were included in this study. The stratified random method was used to allocate the selected children into two groups. Children in the control group(n=155) were advised to participate in the oral health promotion program for preschool children, which included biannual applications of fluoride foam and oral health education. For the children in the test group(n=310), in addition to the same interventions for children in the control group, 0.5% fluoride varnish were applied four times per year. Oral examinations were carried out at 12-month and 24-month to examine the caries incidence. The preventive fraction of the test group was calculated to evaluate the prevention effect of 0.5% fluoride varnish. Results At 12 months evaluation, the incidence of dental caries(33.0%),the mean increments in dmft(0.67) and dmfs(1.43) in the test group were significantly lower than those in the control group(46.4%,1.23 and 2.36, respectively, P<0.05). Compared to the control group, the mean increments of dmft and dmfs were reduced by 45.5% and 39.4%, respectively. Conclusions The application of a 0.5% fluoride varnish four times a year can effectively prevent the new caries for children aged 3 years old with high caries risk. However, the long-term effect will be evaluated by the 24 months results.