Gomide Rafael T, Frencken Jo E, Faber Jorge, Kuijpers-Jagtman Anne Marie, Leal Soraya C
Division of Pediatric Dentistry, Dental School, Universidade de Brasília, Brasília, Distrito Federal, Brazil.
Radboud Institute for Health Sciences, Department of Dentistry-Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, Netherlands.
PeerJ. 2020 Feb 7;8:e8439. doi: 10.7717/peerj.8439. eCollection 2020.
An innovative caries treatment protocol for primary teeth, termed Ultra-Conservative Treatment (UCT), restores small cavities through the Atraumatic Restorative Treatment (ART) protocol and cleans medium to large open cavities with toothbrush and fluoride toothpaste. However, UCT-treated primary molars were found to exfoliate earlier than amalgam (CRT) and ART-restored cavities, which may lead to unacceptable loss of space for normal eruption of permanent successors. The null-hypothesis tested was that there is no difference between the three treatment protocols and the intra-arch distances, and index of orthodontic treatment need (IOTN) after 4 years.
Dental casts were taken at baseline (T0) and four (T4) years. The space of the premolars (D + E space), arch perimeter, anterior and total arch depth were measured using a morphometric computer programme. The presence and level of malocclusion were assessed according to the IOTN index. Dependent variables were all intra-arch distances and the IOTN while the independent variable was treatment protocol (CRT, ART and UCT). Data were analysed using linear and logistic regression.
The sample consisted of 867 pairs of casts of 272 initial 6-7-year-olds. No difference was observed between the UCT protocol and the two restorative protocols for the intra-arch variables in both maxilla and mandible over the 4 year period. There was no difference between the UCT and the CRT and ART protocols regarding the occurrence of orthodontic treatment need (malocclusion). In conclusion, the UCT treatment protocol does not differ significantly from the traditional amalgam (CRT) and ART restorative protocols with respect to intra-arch distances and malocclusion. The earlier exfoliation of UCT-treated primary molars does not lead to a worsening of the eruption pattern of permanent successors.
一种针对乳牙的创新型龋病治疗方案，称为超保守治疗（UCT），通过非创伤性修复治疗（ART）方案修复小龋洞，并用牙刷和含氟牙膏清洁中到大的开放龋洞。然而，发现接受UCT治疗的乳牙比汞合金修复（CRT）和ART修复的龋洞更早脱落，这可能导致恒牙正常萌出所需空间的不可接受的丧失。所检验的零假设是，三种治疗方案与4年后的牙弓内距离及正畸治疗需求指数（IOTN）之间没有差异。
在基线（T0）和4年（T4）时取牙模。使用形态计量计算机程序测量前磨牙间隙（D + E间隙）、牙弓周长、前牙弓深度和全牙弓深度。根据IOTN指数评估错牙合的存在情况和程度。因变量为所有牙弓内距离和IOTN，自变量为治疗方案（CRT、ART和UCT）。使用线性和逻辑回归分析数据。
样本包括272名最初6 - 7岁儿童的867对牙模。在4年期间，上颌和下颌的牙弓内变量方面，UCT方案与两种修复方案之间未观察到差异。关于正畸治疗需求（错牙合）的发生，UCT与CRT和ART方案之间没有差异。总之，就牙弓内距离和错牙合而言，UCT治疗方案与传统汞合金（CRT）和ART修复方案没有显著差异。接受UCT治疗的乳牙更早脱落不会导致恒牙后续萌出模式恶化。
