釉质成形窝沟封闭术结合释氟流动树脂在窝沟釉质龋中的疗效评价

Evaluation of the efficacy of enameloplasty sealant techniquecombined with fluoresced releasing flowable resin in the treatmentof pit and fissure enamel caries

目的分析釉质成形窝沟封闭术(EST)结合释氟流动树脂在窝沟釉质龋中的临床疗效。方法选取就诊于乌鲁木齐市口腔医院的6~12岁患儿125例,以诊断为早期窝沟釉质龋的247颗年轻恒磨牙作为研究对象,分为4组:A组(常规清洁窝沟+常规封闭剂)32例、62颗,B组(常规清洁窝沟+释氟流动树脂)29例、62颗,C组(EST+常规封闭剂)33例、62颗,D组(EST+释氟流动树脂)31例、61颗。随访6、18个月后,比较各组封闭剂保留率与无龋率。结果随访6个月A、B、C、D组的封闭剂保留率分别为75.00%、76.67%、93.33%和95.00%,随访18个月分别为45.76%、41.38%、71.93%和94.92%,差异均有统计学意义(P<0.05);进一步多重比较显示,随访6、18个月A组与C组、B组与D组的封闭剂保留率均有明显差异(P<0.0083),且随访18个月C组与D组的封闭剂保留率有明显差异(P<0.0083)。随访18个月,A、B、C、D组的无龋率分别为66.10%、63.79%、94.74%和98.31%;进一步多重比较显示,A组与C组、B组与D组的无龋率均有明显差异(P<0.0083)。结论在窝沟釉质龋的治疗中,采用EST的封闭剂保留率和远期防龋效果都明显优于常规窝沟封闭术,结合释氟流动树脂可进一步提高封闭剂保留率。

Objective To evaluate the clinical efficacy of enameloplasty sealant technique(EST)combined with fluoride releasing flowable resin in pit and fissure enamel caries.Methods A total of 247 young permanent molars diagnosed as early pit and fissure enamel caries from 125 children aged 6-12 years in Urumqi Stomatological Hospital were selected as the study subjects.They were divided into four groups:group A(conventional cleaning of pit and fissure+conventional sealant)32 cases,62 teeth;group B(conventional cleaning of pit and fissure+fluorine releasing flowable resin)29 cases,62 teeth;group C(EST+conventional sealant)33 cases,62 teeth;group D(EST+fluorine releasing flowable resin)31 cases,61 teeth.After 6 and 18 months of follow-up,the retention rate of sealants and rate of caries-free were compared among the various groups.Results After 6 months of follow-up,the retention rates of sealant in groups A,B,C and D were 75.00%,76.67%,93.33%and 95.00%respectively,and which after 18 months of follow-up were 45.76%,41.38%,71.93%and 94.92%respectively,and the differences were statistically significant(P<0.05).The results of further multiple comparisons showed that there were statistically significant differences in the retention rate of sealant between group A and group C,group B and group D after 6 and 18 months of follow-up(P<0.0083),moreover there was statistically significant difference in the retention rate of sealant between group C and group D after 18 months of follow-up(P<0.0083).After 18 months of follow-up,the rates of caries-free in groups A,B,C and D were 66.10%,63.79%,94.74%and 98.31%,respectively.The results of further multiple comparisons showed that the rates of caries-free between group A and group C,group B and group D were statistically significantly different(P<0.0083).Conclusion The retention rate of sealant and long-term caries prevention effect of adopting the EST in the treatment of pit and fissure enamel caries are superior to the conventional sealant technique.EST combining with fluorine releasing flowable resin could further increase the retention rate of sealant.