Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brazil.
Department of Specific Training, School of Dentistry, Universidade Federal Fluminense UFF, Nova Friburgo, RJ, Brazil.
Clin Oral Investig. 2018 Apr;22(3):1355-1362. doi: 10.1007/s00784-017-2227-7. Epub 2017 Oct 8.
The main purpose of this split month, randomized, controlled clinical trial was evaluate the efficacy of caries infiltration in controlling the progression of non-cavitated proximal lesions in primary molars. Anxiety and time required for the caries infiltration was also evaluated.
Fifty healthy children, 5 to 9 years, presenting two primary molars with proximal caries lesions (1/2 of the enamel or outer 1/3 of dentin), were included. Lesions were randomly allocated to the test group (fluoridated toothpaste + flossing + infiltration) or to the control group (fluoridated toothpaste + flossing). Caries risk was based on the Cariogram model. The main outcome after 1-year radiographic follow up was assessed by an independent blinded examiner A facial image scale (FIS) was applied to assess dental anxiety and time required to perform the infiltration was recorded.
Of the sample, 92.9% corresponded to high or medium caries risk. In 42 patients (1-year follow up), caries progression was observed in 11.9% (5/42) of the test lesions compared with 33.3% (14/42) of the control lesions (p < 0.05). Five control and three test lesions progressed to the middle 1/3 of dentin and were restored. No side effects were observed. Anxiety was both low before and after the treatment, and mean time required for the infiltration was 11.29 min (± 1.16 min).
Caries infiltration of proximal caries lesions in primary molars is significantly more efficacious than standard therapy alone (fluoride toothpaste + flossing).
Caries infiltration is an applicable and well-accepted method be used in children, representing a promising micro-invasive approach.
本为期一个月的随机对照临床试验的主要目的是评估窝沟封闭剂在控制儿童第一恒磨牙邻面早期龋进展中的疗效。同时评估窝沟封闭剂治疗的焦虑情况和所需时间。
共纳入 50 名 5-9 岁的健康儿童，这些儿童有两颗邻面龋（牙釉质 1/2 或牙本质外 1/3）的第一恒磨牙。将病变随机分配到实验组（含氟牙膏+牙线+窝沟封闭剂）或对照组（含氟牙膏+牙线）。根据 Cariogram 模型评估患龋风险。主要结局是在 1 年放射随访后由独立盲法评估员进行评估。采用面部图像量表（FIS）评估儿童的口腔焦虑程度，并记录窝沟封闭剂治疗所需的时间。
样本中，92.9%的儿童属于高或中度患龋风险。在 42 名患者（1 年随访）中，实验组的 11.9%（5/42）的病变出现龋进展，而对照组的 33.3%（14/42）的病变出现龋进展（p<0.05）。5 个对照病变和 3 个实验病变进展到牙本质的中 1/3，需要进行修复。未观察到不良反应。治疗前后焦虑均较低，窝沟封闭剂治疗所需的平均时间为 11.29 分钟（±1.16 分钟）。
窝沟封闭剂治疗第一恒磨牙邻面早期龋的疗效明显优于单纯标准治疗（含氟牙膏+牙线）。
窝沟封闭剂是一种适用于儿童且易于接受的方法，代表了一种很有前途的微创方法。
