Jurić Hrvoje
Department of Pediatric Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia.
Acta Med Acad. 2013 Nov;42(2):216-22. doi: 10.5644/ama2006-124.89.
Dental caries is a multifactorial disease that affects most populations throughout the world and it is still the primary cause of oral pain and tooth loss. The occlusal surfaces of posterior teeth are the most vulnerable sites for dental caries due to their anatomy. Therefore, the aim of the following article is to summarize current knowledge on occlusal caries development and the possibilities of its prevention. Although the overall caries rate today has fallen for populations in industrialized countries, the rate of occlusal surface caries has not decreased. This may be explained with fact that topically applied fluorides and their mode of action prevent caries better on smooth than on occlusal surfaces. As we know, tooth decay of first permanent molars causes a great deal of different short and long term difficulties for patients. Therefore, there is a continuous need for implementation of programs for caries prevention in permanent teeth. Nowadays, we like to treat our patients by minimally invasive methods. A very important step in our effective preventive treatment is sealing pits and fissures as a cornerstone of occlusal caries management. Reliable assessment of caries activity is also very important for defining treatment needs and plans. A very important decision, which should be made during occlusal caries management, is the selection of restorative material according to the treatment plan.
Current possibilities in occlusal caries prevention and management are very effective. Therefore, dentists today do not have any excuse for avoiding the philosophy of Minimally Invasive Dentistry, especially when we talk about caries management of occlusal surfaces in permanent molars.
龋齿是一种影响全球大多数人群的多因素疾病，仍是口腔疼痛和牙齿缺失的主要原因。后牙的咬合面因其解剖结构是龋齿最易发生的部位。因此，本文的目的是总结当前关于咬合面龋齿发展及其预防可能性的知识。尽管如今工业化国家人群的总体龋齿率有所下降，但咬合面龋齿率并未降低。这可能是因为局部应用氟化物及其作用方式在光滑表面比在咬合面能更好地预防龋齿。如我们所知，第一恒磨牙的龋齿会给患者带来诸多不同的短期和长期问题。因此，持续需要实施恒牙龋齿预防项目。如今，我们倾向于用微创方法治疗患者。在我们有效的预防性治疗中，一个非常重要的步骤是封闭窝沟，这是咬合面龋齿管理的基石。可靠评估龋齿活动度对于确定治疗需求和计划也非常重要。在咬合面龋齿管理过程中应做出的一个非常重要的决定是根据治疗计划选择修复材料。
目前咬合面龋齿预防和管理的方法非常有效。因此，如今的牙医没有任何借口回避微创牙科理念，尤其是当我们谈论恒牙磨牙咬合面的龋齿管理时。
