学龄儿童第一恒磨牙龋综合干预2年效果评价

Effectiveness of adding cavity filling for first permanent molars to a school-based oral health program:A two-year field trial

目的评估在学龄儿童口腔疾病综合干预项目增加第一恒磨牙龋充填治疗的有效性和可行性。方法采用整群随机抽样,于2016年以班级单位招募了来自湖北省襄阳市大庆路小学的411名7~9岁儿童(对照组208名、试验组203名)作为研究对象。在基线时,所有儿童都接受了口腔健康教育、口腔检查和完全萌出的非龋第一恒磨牙的窝沟封闭。对于患有龋齿的儿童,试验组提供树脂充填治疗,而对照组仅提供治疗建议。随访2年,比较两组儿童第一恒磨牙的患龋情况和龋补充填比。另外,将所有牙齿按是否接受治疗分为两组(治疗组和未治疗组),比较两组的患龋风险。采用t检验和方差分析进行统计分析。通过计算相对危险度(RR)和95%置信区间(CI)比较治疗组和未治疗组的患龋风险。结果共408名儿童(对照组206名,试验组202名)完成了研究。2年后试验组患龋率为11.9%,低于对照组(22.3%),差异有统计学意义(χ^(2)=7.712,P=0.006),试验组龋补充填比(64.2%)高于对照组(22.5%),差异有统计学意义(χ^(2)=32.485,P<0.001)。未治疗组较治疗组的患龋风险更高(龋齿:RR=6.52,95%CI=3.51~12.09;龋面:RR=9.98,95%CI=5.86~17.00)。结论将第一恒磨牙龋的充填治疗加入学校口腔疾病综合干预项目,能更有效控制龋病的发生、发展。因此,将龋齿充填治疗纳入公共口腔健康项目是可行和有效的。

Objectives This study aimed at evaluating the effectiveness and feasibility of adding cavity fillings for the first permanent molars to the Comprehensive Intervention Project of Oral Diseases in school-age children.Methods A total of 411 children aged from 7 to 9(208 in the control group and 203 in the experimental group)from Daqing Road Primary School in Xiangyang City,Hubei Province were recruited by cluster random sampling as the research subjects in class units.At baseline,all children recruited received prevention practice including oral health education,oral examination,and pit and fissure sealants for the non-cavitied fully-erupted first permanent molars.For the cavitied lesions,cavity fillings were provided to the experimental group,while only treatment advice was provided to the control group.At the follow-up for 2 years,the caries prevalence and caries filling ratio of the first permanent molars were compared between the two groups.In addition,all teeth were divided into two groups(the treated group and the non-treated group)according to whether they were treated or not,and the risk of caries in the two groups was compared.Chi-square test and t-test were used to compare the difference in caries rate between the control and experimental groups.The risk of caries was compared between the treated group and non-treated groups by calculating RR and 95%CI.Results A total of 408 children(206 in the control group and 202 in the experimental group)completed this study.At 2 years,the prevalence rate of dental caries in the experimental group was 11.9%,lower than that in the control group(22.3%),with statistically significant difference(χ^(2)=7.712,P=0.006).The filling ratio of the experimental group(64.2%)was higher than that of the control group(22.5%),and the difference was statistically significant(χ^(2)=32.485,P<0.001).The non-treated group had a higher risk of new caries(RR for teeth=6.52,95%CI=3.51-12.09;RR for surfaces=9.98,95%CI=5.86-17.00)compared with the treated group.Conclusions As the cavity fillings could effectively control the occurrence and development of caries,it is feasible and effective to incorporate cavity fillings into public oral health program.