Dennison J B, Straffon L H, Smith R C
Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor 48109, USA.
J Am Dent Assoc. 2000 May;131(5):597-605. doi: 10.14219/jada.archive.2000.0233.
The authors analyzed an insurance claim database to evaluate the use and effectiveness of placing sealants on first and second permanent molars of children in private dental practices.
A retrospective study was conducted using an insured population with sealant coverage at 70 percent of the usual fee in a preferred provider organization than that limited reapplication to once every three years. Children were selected who were eligible for sealant benefits from July 1, 1990, to June 30, 1991. Two groups were selected for analysis, based on age, as determined by permanent molar eruption dates. Children who received sealants were compared with those who did not to determine post-sealant restorative outcomes after five years.
During the full year of coverage, sealants were used in only 16.3 percent of first permanent molars and 11.6 percent of second permanent molars. The five-year incidence of an occlusal restoration having been placed was 13.7 percent and 20.8 percent, respectively, on nonsealed first and second molars and 6.5 percent and 10.4 percent, respectively, on sealed first and second molars. From years three to five, sealant placement provided only nominal additional preventive effect.
In the population selected, both the incidence of occlusal caries and the use of sealants were lower than expected for both age groups. However, within these groups, molar occlusal surfaces were only half as likely to have been restored in sealed teeth than in nonsealed teeth after five years.
Based on the five-year data from a population with a low incidence of caries, the authors found that 15 sealed first permanent molars or 10 sealed second permanent molars prevented placement of one occlusal restoration. Therefore, sealants are more effective when placed in patients with risk factors for occlusal caries.
作者分析了一个保险理赔数据库，以评估在私人牙科诊所为儿童的第一恒磨牙和第二恒磨牙放置窝沟封闭剂的使用情况及效果。
进行了一项回顾性研究，研究对象为在一家优选医疗机构中享受窝沟封闭剂保险覆盖的人群，保险费用为通常费用的70%，且每三年仅允许重新涂抹一次。选取了1990年7月1日至1991年6月30日期间符合窝沟封闭剂保险福利条件的儿童。根据恒牙萌出日期确定的年龄，选取两组儿童进行分析。将接受窝沟封闭剂治疗的儿童与未接受治疗的儿童进行比较，以确定五年后的窝沟封闭剂修复后效果。
在全年保险覆盖期间，仅16.3%的第一恒磨牙和11.6%的第二恒磨牙使用了窝沟封闭剂。未封闭的第一恒磨牙和第二恒磨牙进行咬合面修复的五年发生率分别为13.7%和20.8%，而封闭的第一恒磨牙和第二恒磨牙分别为6.5%和10.4%。从第三年到第五年，放置窝沟封闭剂仅提供了名义上的额外预防效果。
在所选人群中，两个年龄组的咬合面龋齿发生率和窝沟封闭剂的使用均低于预期。然而，在这些组中，五年后，封闭牙齿的磨牙咬合面修复的可能性仅为未封闭牙齿的一半。
基于龋病低发人群的五年数据，作者发现15颗封闭的第一恒磨牙或10颗封闭的第二恒磨牙可预防一次咬合面修复。因此，窝沟封闭剂应用于有咬合面龋齿危险因素的患者时效果更佳。
