Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Denmark.
Clin Oral Investig. 2012 Apr;16(2):521-9. doi: 10.1007/s00784-011-0549-4. Epub 2011 Apr 9.
The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25-38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2-3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (p > 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (p > 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health.
本研究旨在评估使用密封剂来阻止成年人窝沟龋病变的可能性，并评估密封病变的放射学进展、停止和逆转情况。共纳入丹麦哥本哈根牙科学院的 52 名成年患者的 72 个窝沟龋病变，这些患者需要进行修复治疗。如果患者有不止一个窝沟龋病变，则在密封和修复之间进行随机分组；否则，对病变进行密封。总共进行了 60 个树脂密封剂和 12 个复合修复体。随访时间为 25-38 个月（平均 33 个月）。使用非参数统计分析，包括kappa 统计分析数据。2-3 年后，失访率为 15%；两名患者未出现进行复诊，九名之前密封的病变由患者的全科医生进行了修复。所有 12 个修复体和其余 49 个密封剂中的 39 个功能良好，由于失败而需要修复/更换七个（14%）密封剂，由于龋进展而需要修复三个（6%）密封病变（p>0.05）。放射学评估显示五个（10%）密封剂下有龋进展，一个（2%）密封剂下有龋退缩，43 个（88%）密封剂和所有修复体下深度无变化（p>0.05）。大多数被转诊的病变都被密封剂成功阻止，这表明有可能扩大对成年人窝沟龋病变进行密封治疗的标准。然而，还需要更长的观察期来得出最终结论。扩大成年人窝沟龋病变治疗性密封的标准将提高口腔健康水平。
