单访与双访银改性非创伤性修复技术（SMART）治疗乳磨牙的成功率评估——一项随机对照试验

Evaluation of the success of single-visit versus two-visit silver modified atraumatic restorative technique (SMART) in primary molars- a randomized controlled trial.

作者信息

Sharawat Nidhi, Bansal Kalpana, Mathur Vijay Prakash, Tewari Nitesh, Morankar Rahul, Mishra Richa

机构信息

Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India.

出版信息

J Dent. 2025 May;156:105661. doi: 10.1016/j.jdent.2025.105661. Epub 2025 Mar 3.

DOI:10.1016/j.jdent.2025.105661

PMID:40043883

Abstract

OBJECTIVES

To compare the success of glass ionomer cement (GIC) restorations in carious primary molars using single-visit and two-visit silver modified atraumatic restorative technique (SMART).

METHODS

This was a parallel-group, two-arm randomized controlled trial conducted in a tertiary-care hospital. 150 children aged 4-9 years with asymptomatic carious lesions were recruited and randomized to one of the two interventions: single-visit and two-visit SMART. For each participant, a single tooth was selected to receive one of the interventions. Caries excavation was performed until firm dentin using hand instruments. In single-visit SMART, silver diamine fluoride (SDF) application, and GIC restoration were performed on the same visit while in the two-visit SMART, the GIC restoration was performed one week after the SDF application. Children were followed up at 6 and 12 months for the evaluation of restorations. The primary outcome was the success of the restoration at 12 months. Secondary outcomes were the proportions of failures (minor and major) in two groups. Fischer-exact test, logistic regression, and Kaplan-Meier curve were used for statistical analyses.

RESULTS

A total of 150 SMART restorations (single-visit=75, two-visit=75) were performed. At 12-months, 51 (68 %) restorations in the single-visit group and 62 (82.7 %) restorations in the two-visit group were evaluated as success (p = 0.051). Minor failures were observed in 21 teeth (28 %) in single-visit and 13 teeth (17.3 %) in two-visit SMART. Major failures were noted only in single-visit SMART in 3 teeth (4.0 %) (p = 0.052).

CONCLUSION

There was no statistically significant difference in the success rates of GIC restorations in single-visit and two-visit SMART groups.

CLINICAL SIGNIFICANCE

Both single-visit and two-visit SMART restorations showed comparable success rates, thus clinicians can choose either protocol based on the patient's needs and cooperation.

摘要

目的

比较使用单次就诊和两次就诊的银改性非创伤性修复技术（SMART）对龋损乳牙进行玻璃离子水门汀（GIC）修复的成功率。

方法

这是一项在三级医院进行的平行组双臂随机对照试验。招募了150名4 - 9岁有无症状龋损的儿童，并随机分为两种干预措施之一：单次就诊和两次就诊的SMART。对于每位参与者，选择一颗牙齿接受其中一种干预措施。使用手动器械进行龋洞预备，直至露出坚硬牙本质。在单次就诊的SMART中，在同一次就诊时应用氟化亚锡（SDF）并进行GIC修复，而在两次就诊的SMART中，在应用SDF一周后进行GIC修复。在6个月和12个月时对儿童进行随访，以评估修复情况。主要结局是12个月时修复的成功率。次要结局是两组中失败（轻微和严重）的比例。采用Fisher精确检验、逻辑回归和Kaplan-Meier曲线进行统计分析。

结果

共进行了150次SMART修复（单次就诊 = 75次，两次就诊 = 75次）。在12个月时，单次就诊组中有51例（68%）修复被评估为成功，两次就诊组中有62例（82.7%）修复被评估为成功（p = 0.051）。在单次就诊的SMART中有21颗牙齿（28%）观察到轻微失败，在两次就诊的SMART中有13颗牙齿（17.3%）观察到轻微失败。仅在单次就诊的SMART中有3颗牙齿（4.0%）观察到严重失败（p = 0.052）。