Faculty of Dentistry, University of Hong Kong, 3/F, Prince Philip Dental Hospital, Hong Kong SAR.
J Dent Res. 2012 Aug;91(8):753-8. doi: 10.1177/0022034512452278. Epub 2012 Jun 26.
To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine fluoride (SDF) solution, annual application; and (4) placebo control. Follow-up examinations were conducted every 6 months by a masked examiner. After 24 months, 485 children (97%) were examined. Proportions of pit/fissure sites with dentin caries in the sealant, NaF, SDF, and control groups were 1.6%, 2.4%, 2.2%, and 4.6%, respectively. A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls (p < 0.05). We concluded that placement of resin sealant, semi-annual application of NaF varnish, and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars (ClinicalTrials.gov number CT01446107).
为了研究局部用氟化物预防窝沟龋的效果，我们进行了一项平行组随机对照试验。共有 501 名儿童（1539 颗磨牙，3078 个部位），平均年龄 9.1 岁，他们至少有一颗具有深窝沟或具有早期龋迹象的窝沟的完整恒第一磨牙。将他们随机分配到以下四组：（1）树脂密封剂，单次放置；（2）5%氟化钠漆，半年应用一次；（3）38% 氟化银（SDF）溶液，每年应用一次；（4）安慰剂对照。由一名盲法检查者每 6 个月进行随访检查。24 个月后，对 485 名儿童（97%）进行了检查。密封剂、NaF、SDF 和对照组中窝沟部位的牙本质龋比例分别为 1.6%、2.4%、2.2%和 4.6%。考虑到数据聚类和混杂因素影响的多水平逻辑回归分析表明，在任何三组治疗组中，窝沟发生龋齿进展为牙本质的风险均显著低于对照组（p < 0.05）。我们得出结论，放置树脂密封剂、半年应用 NaF 漆和每年应用 SDF 溶液均能有效预防恒牙窝沟龋（ClinicalTrials.gov 编号 CT01446107）。
