Szoke Judit
Semmelweis Egyetem, Fogorvostudományi Kar, Budapest.
Fogorv Sz. 2008 Aug;101(4):137-46.
The aim of this review is to give an overview of 50 years experience of fissure sealing and draw conclusions about the applicability and effectiveness of the method. Another purpose is to provide a summary of the relevant scientific evidence that will assist clinicians with their decision-making process. A fissure sealant is a material that is placed in the pits and fissures of teeth in order to prevent the development and/or to arrest of initial caries progression. Sealants, by providing a physical barrier, inhibit microorganisms and food particles from collecting in pits and fissures. Sealants are highly effective in preventing dental caries in pits and fissures of teeth when applied by trained operators. Sealant should be placed on pits and fissures of children's and adolescents' permanent teeth when it is determined that the tooth or the patient is at risk of developing caries. Fissure sealing can be recommended as a caries preventive measure. Whilst there is a good evidence to support the inclusion of fissure sealants as part of a preventive programme from the dental team, a number of related issues need to be considered. In areas of high caries prevalence it has been shown that treatment costs can actually be reduced by sealing susceptible surfaces, usually the occlusal surfaces of first permanent molars. Fissure sealing was introduced and first investigated in the years 1960-1970. During the past decades, evidence-based approaches have developed concerning the effectiveness of this primary and secondary preventive measure. It is generally accepted that the effectiveness of sealants for caries prevention depends on long-term retention. Resin-based sealants are the first choice of material for dental sealants. Glass-ionomer cement may be used as an interim preventive agent. Whilst cost-effectiveness is an important consideration, from an ethical standpoint the protection of oral health should not be viewed purely in economic terms. The oral health care professional should monitor and reapply sealants as needed to maximize effectiveness.
本综述的目的是概述50年的窝沟封闭经验，并就该方法的适用性和有效性得出结论。另一个目的是提供相关科学证据的总结，以协助临床医生进行决策过程。窝沟封闭剂是一种放置在牙齿窝沟内的材料，用于预防初始龋齿的发展和/或阻止其进展。封闭剂通过提供物理屏障，抑制微生物和食物颗粒在窝沟内聚集。由经过培训的操作人员应用时，封闭剂在预防牙齿窝沟龋齿方面非常有效。当确定儿童和青少年的恒牙窝沟有患龋风险时，应在其上放置封闭剂。窝沟封闭可作为一种龋病预防措施被推荐。虽然有充分证据支持将窝沟封闭剂纳入牙科团队的预防计划，但仍有一些相关问题需要考虑。在龋病高发地区，研究表明，通过封闭易感表面（通常是第一恒磨牙的咬合面），实际上可以降低治疗成本。窝沟封闭技术于20世纪60年代至70年代被引入并首次进行研究。在过去几十年中，关于这种一级和二级预防措施的有效性已形成了循证方法。人们普遍认为，封闭剂预防龋齿的有效性取决于其长期保留率。树脂基封闭剂是牙科封闭剂的首选材料。玻璃离子水门汀可作为一种临时预防剂。虽然成本效益是一个重要考虑因素，但从伦理角度来看，口腔健康的保护不应仅仅从经济角度来考量。口腔保健专业人员应根据需要监测并重新应用封闭剂，以最大限度地提高其有效性。
