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儿童龋齿管理的微创技术:疗效、应用及未来方向

Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions.

作者信息

Al-Kaff Arwa A, Alshehri Abdulrahman Z, Alasmari Rana A, Alsubaie Najd, Aldaws Albandari, Althaqeel Ameera, Alshehri Rola S, Alawaji Yasmin M

机构信息

Pediatric Dentistry, Ministry of Health, Riyadh First Health Cluster, Riyadh, SAU.

Dentistry, College of Dentistry, King Saud University, Riyadh, SAU.

出版信息

Cureus. 2025 Jul 7;17(7):e87450. doi: 10.7759/cureus.87450. eCollection 2025 Jul.

Abstract

Minimally Invasive Dentistry (MID) represents a transformative approach in pediatric caries management, emphasizing tooth preservation, patient comfort, and preventive care over conventional invasive methods. The aim of this narrative review is to evaluate the efficacy, clinical applications, and future directions of various MID techniques in children, including silver diamine fluoride (SDF), atraumatic restorative treatment (ART), the Hall Technique, resin infiltration, and bioactive restorative materials. These methods have shown considerable success in reducing treatment complexity and improving outcomes, especially for high-risk and special healthcare needs (SHCN) populations. A structured literature search was conducted across PubMed, Scopus, and Google Scholar databases for studies published between 2000 and 2025. Search terms included "minimally invasive dentistry in children," "silver diamine fluoride pediatric caries," "atraumatic restorative treatment," and related techniques. Inclusion criteria encompassed clinical trials, systematic reviews, and expert consensus articles, while animal studies and those lacking rigorous methodology were excluded. Results indicate that MID techniques such as SDF can arrest caries in 80-90% of cases, while ART and the Hall Technique provide minimally invasive, cost-effective alternatives to conventional restorations. Resin infiltration improves esthetics and arrests lesion progression in non-cavitated teeth, while bioactive materials promote remineralization and pulp preservation. Emerging technologies, including laser-assisted caries removal, air abrasion, and AI-driven diagnostics, further enhance MID accessibility and precision. Despite promising outcomes, challenges such as clinician training deficits, parental concerns, and lack of long-term evidence persist. Future efforts should focus on addressing these barriers through research, education, and policy reform to facilitate the integration of MID into routine pediatric dental practice.

摘要

微创牙科(MID)是儿童龋病管理中的一种变革性方法,与传统的侵入性方法相比,它更强调牙齿保存、患者舒适度和预防性护理。本叙述性综述的目的是评估各种MID技术在儿童中的疗效、临床应用和未来发展方向,包括氟化亚锡(SDF)、非创伤性修复治疗(ART)、霍尔技术、树脂浸润和生物活性修复材料。这些方法在降低治疗复杂性和改善治疗效果方面已取得显著成功,尤其是对于高危和有特殊医疗需求(SHCN)的人群。我们在PubMed、Scopus和谷歌学术数据库中进行了结构化文献检索,以查找2000年至2025年发表的研究。检索词包括“儿童微创牙科”、“氟化亚锡儿童龋病”、“非创伤性修复治疗”及相关技术。纳入标准包括临床试验、系统评价和专家共识文章,而动物研究和缺乏严谨方法的研究则被排除。结果表明,SDF等MID技术在80%-90%的病例中可阻止龋病进展,而ART和霍尔技术为传统修复提供了微创、经济高效的替代方案。树脂浸润可改善美观并阻止非龋洞牙齿病变进展,而生物活性材料可促进再矿化和牙髓保存。包括激光辅助龋病去除、空气磨蚀和人工智能驱动诊断在内的新兴技术进一步提高了MID的可及性和精确性。尽管取得了令人鼓舞的成果,但临床医生培训不足、家长担忧以及缺乏长期证据等挑战依然存在。未来的努力应集中于通过研究、教育和政策改革来克服这些障碍,以促进MID融入常规儿童牙科实践。

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本文引用的文献

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