Mijan Maite, de Amorim Rodrigo Guedes, Leal Soraya Coelho, Mulder Jan, Oliveira Luciana, Creugers Nico H J, Frencken Jo E
Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Department of Pediatric Dentistry, School of Health Sciences, University of Brasília, Brasília, Brazil.
Clin Oral Investig. 2014 May;18(4):1061-1069. doi: 10.1007/s00784-013-1077-1. Epub 2013 Aug 13.
This study aimed to test the hypothesis that there is no difference in the survival rates of molars treated according to the conventional restorative treatment (CRT) using amalgam, atraumatic restorative treatment (ART) using high-viscosity glass ionomer, and ultraconservative treatment (UCT) protocol after 3.5 years.
Cavitated primary molars were treated according to CRT, ART, and UCT (small cavities were restored with ART and medium/large cavities were daily cleaned with toothpaste/toothbrush under supervision). Molar extractions resulting from toothache, sepsis, or pulp exposure were failures. The Kaplan-Meier method was used to estimate the survival curves.
The numbers of treated teeth, among the 302 6-7-year-old children, were 341 (CRT), 244 (ART), and 281 (for UCT group: 109 small ART, 166 open cavities, and 6 combinations). Protocol groups were similar at baseline regarding gender and mean decayed missing filled tooth score, but not regarding age and type of surface. The numbers of molars extracted were 22 (CRT), 16 (ART), and 26 (UCT). Fistulae were most often recorded. After 3.5 years, the cumulative survival rate ± standard error for all molars treated was 90.9 ± 2.0 % with CRT, 90.4 ± 2.4 % with ART, and 89.0 [corrected] ± 1.9 % with UCT (p = 0.13). Only a type of surface effect was observed over the 3.5-year period: survival rates for molars were higher for single- than for multiple-surface cavities.
There was no difference in the cumulative survival rates of primary molars treated according to the CRT, ART, and UCT protocols over a 3.5-year period.
Keeping cavities in primary molars biofilm-free might be another treatment option alongside restoring such cavities through conventional and ART protocols.
本研究旨在验证以下假设：采用汞合金的传统修复治疗（CRT）、使用高粘度玻璃离子体的非创伤性修复治疗（ART）和超保守治疗（UCT）方案治疗的磨牙在3.5年后的存活率无差异。
对龋损的乳磨牙采用CRT、ART和UCT进行治疗（小龋洞采用ART修复，中/大龋洞在监督下每天用牙膏/牙刷清洁）。因牙痛、败血症或牙髓暴露导致的磨牙拔除视为治疗失败。采用Kaplan-Meier方法估计生存曲线。
在302名6-7岁儿童中，接受治疗的牙齿数量分别为341颗（CRT）、244颗（ART）和281颗（UCT组：109颗小龋洞采用ART修复，166颗开放龋洞，6颗联合治疗）。各方案组在基线时的性别和平均龋失补牙得分相似，但年龄和牙面类型不同。拔除的磨牙数量分别为22颗（CRT）、16颗（ART）和26颗（UCT）。瘘管最为常见。3.5年后，所有接受治疗磨牙的累积存活率±标准误为：CRT组90.9±2.0%，ART组90.4±2.4%，UCT组89.0[校正后]±1.9%（p = 0.13）。在3.5年期间仅观察到一种牙面类型效应：单牙面龋洞的磨牙存活率高于多牙面龋洞。
在3.5年期间，采用CRT、ART和UCT方案治疗的乳磨牙累积存活率无差异。
除了通过传统和ART方案修复乳牙龋洞外，保持乳牙龋洞内无生物膜可能是另一种治疗选择。
