School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, QLD 4215, Australia.
School of Dentistry, The University of Queensland, Herston, Queensland, QLD 4072, Australia.
Int J Environ Res Public Health. 2020 Mar 23;17(6):2114. doi: 10.3390/ijerph17062114.
This study evaluates the effect of a topical intervention comprising of fissure sealant, povidone-iodine, and fluoride varnish in preventing caries on occlusal, approximal, and smooth surfaces. This three-year clinical trial was conducted in a remote Indigenous community of Australia. All schoolchildren (age range: 4-17) were invited to participate; those with parental consents to receive three-annual epidemiological examinations and interventions constituted the experimental group, while those with consents for only the epidemiological examination formed a comparison group. The intervention group received an annual application of fissure sealant, povidone-iodine and fluoride varnish for two consecutive years along with the restoration of any cavitated lesions, while the comparison group did not receive any intervention except for the usual care that included emergency treatment and restorations. Incipient and advanced caries were recorded in the permanent dentition while data on confounding variables were collected through questionnaires. Caries increment and progression were the outcome variables. A total of 408 children participated in the baseline examination, 208 finished the study. After adjusting for confounders, the prevented fraction (PF) on occlusal surfaces for advanced caries in the experimental group was 76.1% (mean difference- -0.35, 95% CI: -0.67-0.04), while the PF for progression from incipient to advanced caries was 100%(mean difference- -0.30, 95% CI: -0.52-0.09). The mean number of smooth surfaces that progressed from incipient to advanced caries in the comparison group was more than twice that of the experimental group, the mean difference was -0.25 (95% CI: -0.46--0.03) with a PF of 61%. The intervention was only effective in preventing advanced caries on occlusal surfaces and in halting the progression of caries on occlusal and smooth surfaces but not on approximal caries.
本研究评估了一种局部干预措施的效果，该措施包括裂沟封闭剂、聚维酮碘和氟化物漆，以预防窝沟、邻面和光滑面龋齿。这项为期三年的临床试验在澳大利亚一个偏远的土著社区进行。所有学龄儿童（年龄范围：4-17 岁）都被邀请参加；那些有父母同意接受三年一次的流行病学检查和干预的儿童构成实验组，而那些只有同意接受流行病学检查的儿童则构成对照组。实验组在连续两年内每年接受一次裂沟封闭剂、聚维酮碘和氟化物漆的应用，以及任何已发生龋坏的病变的修复，而对照组除了包括急诊治疗和修复在内的常规护理外，不接受任何干预。在恒牙中记录了初期和进展期龋齿，同时通过问卷收集混杂变量的数据。龋齿增量和进展是结局变量。共有 408 名儿童参加了基线检查，208 名儿童完成了研究。在调整混杂因素后，实验组窝沟面进展性龋齿的预防分数（PF）为 76.1%（平均差异-0.35，95%CI：-0.67-0.04），而从初期到进展性龋齿的进展的 PF 为 100%（平均差异-0.30，95%CI：-0.52-0.09）。对照组从初期到进展性龋齿进展的光滑面平均数量是实验组的两倍多，平均差异为-0.25（95%CI：-0.46--0.03），PF 为 61%。该干预措施仅能有效预防窝沟面的进展性龋齿，并阻止窝沟和光滑面龋齿的进展，但不能预防邻面龋齿。
