Department of Odontology, Faculty of Medicine, Umea University, Umea, Sweden,
Clin Oral Investig. 2014 Sep;18(7):1785-92. doi: 10.1007/s00784-013-1160-7. Epub 2013 Dec 11.
The aim of this study is to evaluate the effect of ozone and fluoride varnish on occlusal caries in primary molars in a split-mouth study.
Caries risk was estimated by treating Public Dental Health Service dentists. Children with occlusal caries with Ekstrand index scores ≤3 (VI ≤3) were included. Selection of caries lesions was discontinued for ethical reasons due to non-acceptable clinical results during the follow-up. In the continued evaluation pairs of teeth with non-cavitated caries lesions, Ekstrand score ≤2a (VI ≤2) were selected. Fifty pairs of carious primary molars were included, 18 boys and 15 girls (mean 4.7 years, range 3-8). At baseline, the lesions were assessed by visual inspection (VI) and laser-induced fluorescence (LF), in each pair to treatment with 40 s ozone (HealOzone(TM), 2,100 ppm) or fluoride varnish Duraphat®. The treatments and evaluations were repeated at 3, 6 9 months and evaluations only at 12 months.
Medium-high caries risk was observed in VI ≤3 children and low-medium risk in VI ≤2a children. In the 15 pairs VI ≤3 lesions, 8 treated with ozone and 9 with fluoride progressed to failure. In the 35 pairs VI ≤2a lesions, one lesion failed. Median baseline LF values in the VI ≤3 group were 76 and 69, for ozone and fluoride lesions, respectively, and 21 and 19 in the VI ≤2a group. At 12 months, LF values in the VI ≤2a group were 15 and 18. No improvement or difference in LF values was found over time between the caries lesions treated with ozone or fluoride.
Neither ozone nor fluoride varnish treatments stopped the progression of caries in cavitated lesions. In low and medium caries risk children, non-cavitated lesions following both treatments showed slight or no progression. The use of ozone or fluoride varnish treatments in this regime as caries preventive method, added to the daily use of fluoridated toothpaste, to arrest caries progression in primary molars must therefore be questioned.
本研究旨在通过一项分口研究评估臭氧和氟化物窝沟封闭剂对乳磨牙窝沟龋的影响。
通过公共牙科保健服务牙医评估龋齿风险。纳入 Ekstrand 指数评分≤3（VI≤3）的窝沟龋患儿。由于在随访过程中临床结果不可接受，出于伦理原因停止选择龋损。在继续评估中，选择非窝洞型龋损，Ekstrand 评分≤2a（VI≤2）的对侧同名牙。共纳入 50 对患有窝沟龋的乳磨牙，男 18 例，女 15 例（平均年龄 4.7 岁，范围 3-8 岁）。在基线时，每对牙齿均通过肉眼检查（VI）和激光诱导荧光（LF）进行评估，然后对每对牙齿分别进行 40 秒臭氧（HealOzone（TM），2100ppm）或氟化物窝沟封闭剂 Duraphat®处理。处理和评估分别在 3、6、9 个月重复进行，仅在 12 个月进行评估。
VI≤3 组儿童龋病风险为中高度，VI≤2a 组儿童龋病风险为低中度。在 15 对 VI≤3 病变中，臭氧治疗的 8 对和氟化物治疗的 9 对进展为失败。在 35 对 VI≤2a 病变中，有 1 对病变失败。VI≤3 组的基线 LF 值中位数分别为臭氧病变的 76 和氟化物病变的 69，VI≤2a 组分别为 21 和 19。在 12 个月时，VI≤2a 组的 LF 值分别为 15 和 18。臭氧或氟化物治疗对龋病病变的 LF 值在随访期间没有改善或差异。
臭氧和氟化物窝沟封闭剂治疗均不能阻止窝沟龋的进展。在低、中度龋病风险的儿童中，两种治疗方法的非窝洞型病变均显示轻微或无进展。因此，必须对在这一方案中作为龋齿预防方法使用臭氧或氟化物窝沟封闭剂治疗，以及每天使用含氟牙膏来阻止乳磨牙龋齿进展提出质疑。
