Preventive Department, Key Laboratory for Oral Biomedical Engineering, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, China.
Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Br Dent J. 2019 Apr;226(8):590-594. doi: 10.1038/s41415-019-0195-9.
Aim The hypothesis was tested that dentine carious lesion progression is higher in sealed micro-cavitated pits and fissures than in sealed pits and fissures having no or enamel carious lesions at baseline over a period of four years.Results Epidemiological survey identified no enamel carious lesions (code 0), enamel carious lesions (code 1), and micro-cavitated dentine carious lesions (code 2), in pits/fissures of occlusal surfaces of first permanent molars at baseline. Using block randomisation, 405 children (mean age of eight years) were allocated to high-viscosity glass-ionomer, atraumatic restorative treatment method (HVGIC/ART), thermo-cured HVGIC/ART, glass-carbomer, and resin composite groups, receiving 1,344 sealants. Evaluation was performed after six months and annually. Carious lesion progression for baseline code 0 (n = 784) and code 1 (n = 481) was determined by scoring code 2, and that for baseline code 2 (n = 79) by scoring code 3 or 4 (frank cavitation). Tests were performed using a proportional hazard model with frailty correction.Discussion and conclusion There was neither an effect for sealant group nor between baseline codes 0 and 1. A total of 19 baseline code 0, and 20 code 1 developed a cavitated dentine carious lesion; while 5% of the sealed over micro-cavitated dentine carious lesions developed frank cavitation. The progression of carious lesions in the group baseline code (0 + 1) was not statistically significantly different from the group of baseline code 2 (p = 0.29). Progression of micro-cavities sealed over with HVGIC according to the ART method, a glass-carbomer or a resin composite over a period of four years is low. Dentine lesions with a small orifice (Ø <0.5 mm) in pits/fissures of occlusal surfaces in permanent molars have a high chance of surviving four years if they are sealed over.
测试在四年的时间内，与基线时无或仅有釉质龋损的封闭窝沟相比，封闭微裂区的窝沟龋损进展是否更高。
采用整群随机抽样方法，对基线时第一恒磨牙咬合面窝沟内无釉质龋损（编码 0）、釉质龋损（编码 1）和微裂区牙本质龋损（编码 2）的 405 名儿童（平均年龄 8 岁）进行了研究。这些儿童被随机分配到高粘度玻璃离子体、非创伤性修复治疗方法（HVGIC/ART）、热固化 HVGIC/ART、玻璃碳和树脂复合材料组，共接受了 1344 个窝沟封闭剂。在 6 个月和每年进行评估。通过计分编码 2 来确定基线编码 0（n=784）和编码 1（n=481）的龋损进展情况，通过计分编码 3 或 4（明显空洞）来确定基线编码 2（n=79）的龋损进展情况。采用带有脆弱性校正的比例风险模型进行检验。
无论密封剂组之间还是基线编码 0 和 1 之间均无影响。总共有 19 个基线编码 0 和 20 个编码 1 发展为有腔洞的牙本质龋损，而 5%的封闭微裂区牙本质龋损出现明显空洞。基线编码（0+1）组的龋损进展与基线编码 2 组无统计学差异（p=0.29）。在四年的时间内，根据 ART 方法用 HVGIC、玻璃碳或树脂复合材料封闭微裂区，其进展缓慢。在磨牙咬合面窝沟内有小孔（<0.5mm）的牙本质病变，如果进行封闭，其在四年内存活的几率很高。
