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在参与一项非随机预防试验的偏远地区澳大利亚原住民儿童中,永久性牙齿的龋齿病变减少。

Carious lesions in permanent dentitions are reduced in remote Indigenous Australian children taking part in a non-randomised preventive trial.

机构信息

School of Dentistry, The University of Queensland, Herston, Queensland, Australia.

School of Dentistry & Oral Health, Griffith University, Gold Coast, Queensland, Australia.

出版信息

PLoS One. 2021 Jan 28;16(1):e0244927. doi: 10.1371/journal.pone.0244927. eCollection 2021.

Abstract

We tested the effect of an annual caries preventive intervention, delivered by a fly-in/fly-out oral health professional team, with Indigenous children residing in a remote Australian community. Around 600 Indigenous children aged 5 to 17 years were invited to participate at baseline, of who 408 had caregiver consent. One hundred and ninety-six consented to the epidemiological examination and intervention (Intervention group) and 212 consented to the epidemiological examination only (Comparison group). The intervention, which occurred annually, comprised placement of fissure sealants on suitable teeth, and application of povidone-iodine and fluoride varnish to the whole dentition, following completion of any necessary restorative dental treatment. Standard diet and oral hygiene advice were provided. Caries increment (number of tooth surfaces with new dental caries) in both deciduous and permanent dentitions was measured at the 2-year follow-up. Comparison group children had significantly higher number of new surfaces with advanced caries in the permanent dentition than the Intervention group (IRR = 1.61; 95% CI: 1.02-2.54; p = 0.04); with a preventive fraction of 43%. The effect of intervention remained significant with children in the Comparison group developing significantly more advanced caries lesions in the permanent dentition than the Intervention group children in the adjusted multivariable analysis (IRR = 2.21; 95% CI: 1.03-4.71). Indigenous children exposed to the intervention had less increment in advanced dental caries in the permanent dentition than those not exposed to the intervention.

摘要

我们测试了由飞进飞出的口腔卫生专业团队提供的年度龋齿预防干预措施对居住在澳大利亚偏远社区的土著儿童的效果。大约 600 名 5 至 17 岁的土著儿童受邀参加基线调查,其中 408 名儿童得到了照顾者的同意。196 名同意接受流行病学检查和干预(干预组),212 名仅同意接受流行病学检查(对照组)。该干预措施每年进行一次,包括在合适的牙齿上放置窝沟封闭剂,并在完成任何必要的修复性牙科治疗后,将聚维酮碘和氟化物漆应用于整个牙齿。同时还提供了标准的饮食和口腔卫生建议。在 2 年随访时,测量了两组儿童乳牙和恒牙的龋齿进展情况(新出现龋齿的牙齿表面数量)。与干预组相比,对照组儿童恒牙中出现进展性龋齿的新牙面数量明显更多(IRR = 1.61;95%CI:1.02-2.54;p = 0.04);预防效果为 43%。在调整后的多变量分析中,对照组儿童恒牙中出现进展性龋齿的比例明显高于干预组儿童,这表明干预的效果仍然显著(IRR = 2.21;95%CI:1.03-4.71)。与未接受干预的儿童相比,接受干预的土著儿童恒牙中进展性龋齿的增量较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2df/7842954/3e2907b8032b/pone.0244927.g001.jpg

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