CarisolvⅢ化学机械去龋联合玻璃离子水门汀过渡性充填治疗重度低龄儿童龋临床效果研究

Clinical effect of CarisolvⅢchemomechanical caries removal combined with glass ionomer cement for transitional filling repair in the treatment of severe early childhood caries

目的研究CarisolvⅢ化学机械去龋联合玻璃离子水门汀(glass ionomer cement,GIC)过渡性充填修复技术对重度低龄儿童龋(severe early childhood caries,SECC)的临床疗效。方法选取2021年6月至2022年6月于济宁口腔医院儿童口腔科就诊的SECC患儿106例(患牙176颗)。按照随机数字表法将所有患儿分为4组,并依据去龋方法(CarisolvⅢ化学机械去龋、涡轮机去龋)和充填方法(GIC充填、复合树脂充填)分别记为:化学去龋+GIC组(27例,患牙46颗)、化学去龋+树脂组(27例,患牙48颗)、涡轮机去龋+树脂组(26例,患牙40颗)和涡轮机去龋+GIC组(26例,患牙42颗)。采用自制患儿情绪评价量表比较各组情绪差患儿占比。比较各组治疗后3、6、12个月的治疗成功率,以及治疗后12个月的充填体折断或脱落、继发龋发生情况。结果4组情绪差患儿占比比较,差异有统计学意义(χ~2=10.638,P=0.014);且化学去龋+GIC组情绪差患儿占比(29.6%)明显低于涡轮机去龋+树脂组(69.2%),差异有统计学意义(χ~2=8.312,P=0.0039)。治疗后3、6、12个月,4组治疗成功率比较,差异均无统计学意义(均P>0.05)。治疗后12个月,4组充填体折断或脱落、继发龋发生率比较,差异均有统计学意义(均P<0.05);其中,相较于化学去龋+树脂组(0.0%),化学去龋+GIC组的充填体折断或脱落发生率(15.2%)较高;相较于涡轮机去龋+树脂组(25.0%),化学去龋+GIC组继发龋发生率(4.3%)较低,差异均有统计学意义(均P<0.0083)。结论对于SECC患儿,CarisolvⅢ化学机械去龋联合GIC过渡性充填具有良好的临床疗效;且相较于传统涡轮机去龋联合树脂充填,可使患儿的情绪可控性提高并降低继发龋发生风险;但其应用于累及颊舌面的Ⅰ类洞深龋时易发生充填体折断或部分脱落。

Objective To investigate the clinical efficacy of CarisolvⅢchemomechanical caries removal combined with glass ionomer cement(GIC)in transitional filling repair technology for severe early childhood caries(SECC).Methods Totally 106 children with SECC(176 teeth)who visited the Department of Pediatric Stomatology of Jining Stomatological Hospital from June 2021 to June 2022 were selected.According to the random number table method,all children were divided into 4 groups,and according to the caries removal method(CarisolvⅢchemomechanical caries removal,turbine caries removal)and filling method(GIC filling,composite resin filling),they were recorded as follows:chemical caries removal+GIC group(27 cases,46 teeth),chemical caries removal+resin group(27 cases,48 teeth),turbine caries removal+resin group(26 cases,40 teeth),and turbine caries removal+GIC group(26 cases,42 teeth).A self-made emotional evaluation scale for children was used to compare the proportion of children with poor emotions in each group.Compare the success rates of each group at 3,6,and 12 months after treatment,as well as the occurrence of filling fracture or falling off and secondary caries at 12 months after treatment.Results The proportion of children with poor emotions in the four groups was statistically different(χ2=10.638,P=0.014),and the proportion of children with poor emotions in the chemical caries removal+GIC group(29.6%)was significantly lower than that in the turbine caries removal+resin group(69.2%)(χ2=8.312,P=0.0039).After 3,6,and 12 months of treatment,the success rates of the four groups were compared,and the difference was not statistically significant(all P>0.05).After 12 months of treatment,there was a statistically significant difference in the incidence of fracture or falling off of filling materials and secondary caries among the four groups(all P<0.05).Among them,compared to the chemical caries removal+resin group(0.0%),the chemical caries removal+GIC group(15.2%)had a higher incidence of filling fracture or falling off;compared to the turbine caries removal+resin group(25.0%),the chemical caries removal+GIC group(4.3%)had a lower incidence of secondary caries(all P<0.0083).Conclusion For children with SECC,CarisolvⅢchemomechanical caries removal combined with GIC for transitional filling repair has good clinical efficacy.Compared to traditional turbine caries removal combined with resin filling,it can improve the emotional control ability of children and reduce the risk of secondary caries.However,when applied to ClassⅠdeep caries involving the buccal and lingual surfaces,it is prone to the fracture or partial falling off of the filling material.