Bagramian R A
Community Dent Oral Epidemiol. 1982 Oct;10(5):234-7. doi: 10.1111/j.1600-0528.1982.tb00385.x.
The objectives were to demonstrate that a combination of preventive regimens could significantly reduce dental disease in a school population, to demonstrate the feasibility of a school-based program in relation to sustained benefits. There were 1286 students in 1st and 6th grades enrolled in the study. Subjects were stratified by grade, sex, and race and randomly placed in a treatment or education group. Procedures included ingestion of fluoridated water, oral hygiene education program, dental examinations, prophylaxis, acidulated phosphate fluoride gel (1.23%) applied in trays, pit and fissure sealants (bis-GMA) on occlusal surfaces of all eligible posterior teeth, and provision of all restorative care. Fluoride and sealant procedures were repeated at 6-month intervals. After 3 years the treatment group was randomly divided to provide a group that would not continue with treatment and serve as a comparison. The study population was enrolled in 18 schools and clinical procedures were provided on-site, using mobile dental vans. Five-year results indicate high degree of success with fall-off of benefits to those for whom treatment was terminated. This pilot program gives strong evidence for the possibility of implementing school-based dental programs. The study also indicates that prevention programs must be comprehensive and continuous for maximum benefit to occur.
目标是证明预防性方案的组合能够显著降低学校人群中的牙科疾病，证明基于学校的项目在持续获益方面的可行性。该研究纳入了1286名一年级和六年级的学生。研究对象按年级、性别和种族分层，并随机分为治疗组或教育组。程序包括饮用含氟水、口腔卫生教育项目、牙科检查、预防治疗、用托盘涂抹1.23%的酸化磷酸氟凝胶、对所有符合条件的后牙咬合面进行窝沟封闭（双酚A缩水甘油醚甲基丙烯酸酯），以及提供所有修复治疗。氟化物和窝沟封闭程序每6个月重复一次。3年后，治疗组被随机分组，形成一个不再继续治疗的组作为对照。研究人群来自18所学校，使用流动牙科车在现场提供临床程序。五年的结果表明，该项目取得了高度成功，但对那些终止治疗的人来说，获益有所下降。这个试点项目为实施基于学校的牙科项目的可能性提供了有力证据。该研究还表明，预防项目必须全面且持续，才能实现最大程度的获益。
