Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
Stomatological Hospital, Southern Medical University, No. 366, south of Jiangnan Avenue, Guangzhou, People's Republic of China.
BMC Oral Health. 2019 Jul 16;19(1):156. doi: 10.1186/s12903-019-0846-x.
Analyses of the effects of pit and fissure sealant have been based on small samples and lack large-scale field evaluation data in China. The aim of this study was to understand the effect of pit and fissure sealant in preventing caries in the first permanent molars (FPMs) of children in Guangzhou.
We conducted a population-based cohort study using the database of the pit and fissure sealant program of Guangzhou. The carious status and sealant retention of the FPMs were assessed in 4,822 school children who received pit and fissure sealant 3 years prior to the study. The control group included 4,396 children who had indications for receiving pit and fissure sealant but were not treated and were matched according to sex, age and school.
In the sealant group, the rate of sealant retention in the FPMs was 72.2%. Children in the sealant group had a 37% decreased risk of dental caries compared with the control group (adjusted HR = 0.63 [95% confidence interval (CI), 0.57-0.69], P < 0.001). Compared to no sealant use, the use of pit and fissure sealants reduced the risk of developing dental caries by 44% after 3 years in the FPMs of children from rural areas, reflecting a greater reduction than that among urban children (35%) during the same period (urban: adjusted hazard ratio (HR) = 0.65 [95% CI, 0.58-0.72]; rural: adjusted HR = 0.56 [95% CI, 0.45-0.70], P < 0.001). The mean number of decayed, missing, or filled permanent teeth (DMFT) in the control group was higher than that in the sealant group, and the difference was statistically significant regardless of sex.
Pit and fissure sealant has a significant preventive effect against dental caries in the FPMs, especially for children in rural areas; thus, this sealant represents an effective technique for preventing and controlling dental caries.
分析窝沟封闭剂的效果基于小样本且缺乏中国大规模现场评估数据。本研究旨在了解窝沟封闭剂在预防广州市儿童第一恒磨牙（FPM）龋齿中的效果。
我们使用广州窝沟封闭计划数据库进行了一项基于人群的队列研究。在研究前 3 年接受窝沟封闭的 4822 名学龄儿童中，评估 FPM 的龋齿状况和封闭剂保留情况。对照组包括 4396 名有接受窝沟封闭适应证但未接受治疗的儿童，按照性别、年龄和学校进行匹配。
在封闭剂组中，FPM 封闭剂保留率为 72.2%。与对照组相比，封闭剂组儿童的龋齿风险降低了 37%（调整后的 HR=0.63[95%置信区间（CI），0.57-0.69]，P<0.001）。与未使用窝沟封闭剂相比，使用窝沟封闭剂可将儿童 FPM 3 年后的龋齿发病风险降低 44%，这一降幅在农村地区儿童中大于城市儿童（农村：调整后的危害比（HR）=0.56[95%CI，0.45-0.70]；城市：调整后的 HR=0.65[95%CI，0.58-0.72]，P<0.001）。对照组的平均恒牙龋失补（DMFT）数高于封闭剂组，且无论性别差异均有统计学意义。
窝沟封闭剂对 FPM 龋齿有显著的预防作用，尤其是对农村地区的儿童；因此，这种封闭剂是预防和控制龋齿的有效技术。
