Gil-Montoya J A, Mateos-Palacios R, Bravo M, González-Moles M A, Pulgar R
School of Dentistry, Special Care in Dentistry-Gerodontology Department, Granada University, Granada, Spain.
Facultad de Odontología, Paseo de Cartuja, 18071, Granada, Spain.
Clin Oral Investig. 2014 May;18(4):1089-1095. doi: 10.1007/s00784-013-1087-z. Epub 2013 Aug 22.
New preventive and treatment strategies are required to address the high prevalence of caries among the elderly. The main objective of this study was to analyze the effectiveness of Carisolv® gel to improve the clinical behavior of restorations obtained by atraumatic restorative treatment (ART) in root caries of elderly patients. A secondary objective was to determine the factors associated with the failure of ART restorations after a 2-year follow up.
A randomized controlled trial with 2-year follow-up was designed for this purpose. Candidate caries lesions were randomly assigned to an ART group for root caries treatment with the conventional ART technique, filling with glass ionomer, or an ART + Carisolv® gel for the same ART plus the application of a caries solvent (Carisolv®). Evaluations were conducted at 6, 12, and 24 months.
A total of 81 restorations were performed, 37 in the ART group and 44 in the ART + Carisolv® gel group, with 22 and 26 restorations, respectively, surviving at the end of the 24-month follow-up. Survival rates at 24 months did not significantly differ between ART (63 %) and ART + Carisolv® gel (62 %) restorations. The best model for predicting the failure of the restorations included the number of tooth-brushings/day, the presence or not of prosthesis, the anterior or posterior location of the tooth, and the baseline plaque level.
The application of Carisolv does not modify the survival rate of ART restorations in elderly patients.
The use of Carisolv gel does not improve the outcomes of atraumatic restorative treatment.
需要新的预防和治疗策略来应对老年人龋齿的高患病率。本研究的主要目的是分析Carisolv®凝胶改善老年患者根龋无创修复治疗(ART)后修复体临床性能的有效性。次要目的是确定2年随访后与ART修复体失败相关的因素。
为此设计了一项为期2年随访的随机对照试验。将候选龋损随机分配至ART组,采用传统ART技术治疗根龋,用玻璃离子充填,或ART + Carisolv®凝胶组,采用相同的ART加上应用一种龋齿溶剂(Carisolv®)。在6、12和24个月时进行评估。
共进行了81次修复,ART组37次,ART + Carisolv®凝胶组44次,在24个月随访结束时分别有22次和26次修复体留存。ART修复体(63%)和ART + Carisolv®凝胶修复体(62%)在24个月时的留存率无显著差异。预测修复体失败的最佳模型包括每天刷牙次数、是否有假牙、牙齿的前后位置以及基线菌斑水平。
Carisolv的应用并未改变老年患者ART修复体的留存率。
Carisolv凝胶的使用并未改善无创修复治疗效果。