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含氟化钠和二水磷酸二钙的双腔管牙膏增强防龋功效:巴西儿童的一项为期2年的龋齿临床研究。

The enhanced anticaries efficacy of a sodium fluoride and dicalcium phosphate dihydrate dentifrice in a dual-chambered tube. A 2-year caries clinical study on children in Brazil.

作者信息

Silva M F, Melo E V, Stewart B, De Vizio W, Sintes J L, Petrone M E, Volpe A R, Zhang Y, McCool J J, Proskin H M

机构信息

Department of Dentistry, Federal University of Alagoas, Maceio, Brazil.

出版信息

Am J Dent. 2001 May;14 Spec No:19A-23A.

Abstract

PURPOSE

To clinically evaluate and compare a dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate (Test Dentifrice delivering 0.243% sodium fluoride), to a dentifrice containing 0.243% sodium fluoride in a silica base (Positive Control Dentifrice).

MATERIALS AND METHODS

This study was conducted in harmony with the published 1988 American Dental Association guidelines for studies geared toward the comparison of fluoride dentifrices. This 2-yr caries clinical study employed a double-blind, parallel-group design, and involved 6-10 yr-old children from the metropolitan area of Maceio, Alagoas, Brazil. Qualifying subjects were stratified according to age and sex, and were randomly assigned to the two treatment groups, with multiple subjects in the same household all assigned to the dentifrice randomly allocated to the first among them. Caries examinations were conducted in accordance with U.S. Food and Drug Administration guidelines for the clinical evaluation of drugs to prevent dental caries. One calibrated examiner performed all the measurements. After treatment assignment, study participants were instructed to brush their teeth at home with their assigned dentifrice at least twice daily. Brushing instructions were reinforced by indoctrination in proper oral hygiene techniques by dental professionals, supplemented by pamphlets supplied by the sponsor and yearly mailings to participants, emphasizing good oral hygiene and the need to enforce compliance with the study. Post-baseline examinations were performed after 1 yr of product use, and again after 2 yrs of product use.

RESULTS

Two thousand four hundred thirty-two (2,432) subjects completed this 2-yr study. For these subjects, the mean caries scores (DMFS, decayed, missing and filled tooth surfaces) at baseline were 3.84 for the Test Dentifrice group, and 4.06 for the Positive Control Dentifrice group. For caries increments after 1 yr, the respective means were 2.02 for the Test Dentifrice group and 2.12 for the Positive Control Dentifrice group. Finally, after 2 yrs, the mean caries increments were 4.30 for the Test Dentifrice group, and 4.83 for the Positive Control Dentifrice group. No statistically significant difference was indicated between the treatment groups at baseline or between the 1-yr caries increment scores. However, there was a statistically significant difference in the 2-yr caries increment scores between the treatment groups. Relative to the Positive Control Dentifrice group, the Test Dentifrice group presented a 10.97% reduction in caries increment scores at 2 yrs. In accordance with the procedures and standards provided by the published guidelines of the American Dental Association for the comparison of the anticaries efficacy of fluoride dentifrices, the results of this study support the conclusion that the dentifrice system in a dual-chambered tube, wherein one chamber contained sodium fluoride in a silica base and the other chamber contained dicalcium phosphate dihydrate, delivering 0.243% sodium fluoride, provided a superior level of anticaries efficacy than did the dentifrice containing 0.243% sodium fluoride in a silica base.

摘要

目的

临床评估并比较一种双腔管牙膏体系与一种以二氧化硅为基质、含0.243% 氟化钠的牙膏(阳性对照牙膏),其中双腔管牙膏体系的一个腔室含有二氧化硅基氟化钠,另一个腔室含有二水磷酸二钙(测试牙膏,提供0.243% 的氟化钠)。

材料与方法

本研究按照1988年美国牙科协会发布的关于含氟牙膏比较研究的指南进行。这项为期2年的龋齿临床研究采用双盲、平行组设计,涉及来自巴西阿拉戈斯州马塞约市大都市区6至10岁的儿童。符合条件的受试者按年龄和性别分层,随机分配到两个治疗组,同一家庭中的多个受试者均随机分配到分配给其中第一个人的牙膏组。龋齿检查按照美国食品药品监督管理局预防龋齿药物临床评估指南进行。由一名经过校准的检查者进行所有测量。在分配治疗方案后,研究参与者被指示在家中每天至少用分配的牙膏刷牙两次。牙科专业人员通过适当口腔卫生技术的灌输强化刷牙指导,并辅以赞助商提供的宣传册以及每年向参与者邮寄的信件,强调良好的口腔卫生以及遵守研究的必要性。在产品使用1年后进行基线后检查,在产品使用2年后再次进行检查。

结果

2432名受试者完成了这项为期2年的研究。对于这些受试者,测试牙膏组基线时的平均龋齿评分(DMFS,龋、失、补牙面数)为3.84,阳性对照牙膏组为4.06。1年后龋齿增加量,测试牙膏组的相应平均值为2.02,阳性对照牙膏组为2.12。最后,2年后,测试牙膏组的平均龋齿增加量为4.30,阳性对照牙膏组为4.83。在基线时治疗组之间或1年龋齿增加量评分之间未显示出统计学上的显著差异。然而,治疗组之间在2年龋齿增加量评分上存在统计学上的显著差异。相对于阳性对照牙膏组,测试牙膏组在2年时龋齿增加量评分降低了10.97%。根据美国牙科协会发布的含氟牙膏防龋功效比较指南所提供的程序和标准,本研究结果支持以下结论:双腔管牙膏体系,其中一个腔室含有二氧化硅基氟化钠,另一个腔室含有二水磷酸二钙,提供0.243% 的氟化钠,其防龋功效优于以二氧化硅为基质、含0.243% 氟化钠的牙膏。

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