Axelsson P, Lindhe J, Wäseby J
Community Dent Oral Epidemiol. 1976 Nov;4(6):232-9. doi: 10.1111/j.1600-0528.1976.tb00990.x.
The aims of the present study were (1) to analyze the separate effects on plaque, caries, and gingivitis of several measures (oral hygiene instruction, professional tooth cleaning with mechanical instruments, topical application of sodium monofluorophosphate - MFP) which have been incorporated in a prophylactic treatment program, described by AXELSSON & LINDHE1, and (2) to prevent caries and gingivitis by applying the combined treatment but replacing the professional mechanical tooth cleaning with chemical cleaning using a chlorhexidine-containing gel. 164 children, 13-14 years old, divided into four groups, participated in a 2-year trial. All participants were recalled once every 2nd week for preventive treatment provided by dental nurses. During the 1st year Group 3 and 4 received prophylactic treatment identical to that described by AXELSSON & LINDHE1. During the 2nd year the professional tooth cleaning was omitted but oral hygiene instruction was given every 2nd week. During the 1st year Groups 1 and 2 were treated with 0.5% chlorhexidine but during the 2nd year they were subjected to professional tooth cleaning with mechanical instruments. Throughout the trial Groups 1 and 3 rinsed once every 2nd week with a 2% MFP solution. The results showed that by oral hygiene instruction and frequently repeated professional tooth cleanings it was possible to substantially reduce the frequency of gingivitis and prevent caries. When this treatment was used, mouthrinsings with 2% MFP had no additional effect on caries. The substitution of the mechanical cleaning procedure with topical application of a 0.5% chlorhexidine gel failed to (1) remove supragingival plaque accumulations, (2) reduce the frequency of gingivitis, and (3) retard the rate of caries development. The data also revealed that interdental cleaning with mechanical instruments was of decisive importance in the prevention of approximal surface caries.
（1）分析纳入由阿克塞尔松和林德赫[1]所描述的预防性治疗方案中的几种措施（口腔卫生指导、使用机械器械进行专业牙齿清洁、局部应用单氟磷酸钠-MFP）对菌斑、龋齿和牙龈炎的单独影响；（2）通过采用联合治疗，但用含氯己定的凝胶进行化学清洁替代专业机械牙齿清洁，预防龋齿和牙龈炎。164名13 - 14岁的儿童被分为四组，参与了一项为期2年的试验。所有参与者每两周被召回一次，由牙科护士提供预防性治疗。在第1年，第3组和第4组接受与阿克塞尔松和林德赫[1]所描述的相同的预防性治疗。在第2年，省略了专业牙齿清洁，但每两周进行一次口腔卫生指导。在第1年，第1组和第2组用0.5%氯己定治疗，但在第2年，他们接受使用机械器械的专业牙齿清洁。在整个试验过程中，第1组和第3组每两周用2% MFP溶液漱口一次。结果表明，通过口腔卫生指导和频繁重复的专业牙齿清洁，可以大幅降低牙龈炎的发生率并预防龋齿。当采用这种治疗方法时，用2% MFP漱口对龋齿没有额外效果。用0.5%氯己定凝胶局部应用替代机械清洁程序未能：（1）清除龈上菌斑堆积；（2）降低牙龈炎的发生率；（3）延缓龋齿发展速度。数据还显示，使用机械器械进行牙间隙清洁在预防邻面龋齿方面具有决定性意义。
