Frencken J E, Makoni F, Sithole W D, Hackenitz E
Dental Department, Ministry of Health and Child Welfare, Harare, Zimbabwe.
Caries Res. 1998;32(2):119-26. doi: 10.1159/000016441.
An oral health care programme in secondary schools using the atraumatic restorative treatment (ART) approach for dental caries was started in 1993. Glass ionomer (restorative type II, 1) was used as the restorative and sealant material. Sealants were placed using the 'press-finger' technique. Results after 3 years revealed a survival percentage for one-surface ART restorations of 85.3 (95% CL: 89.7-80.9%), which ranged from 96.1 to 69.3% per operator. Failures were related to 'unacceptable marginal defects' (8.1%), 'falling out' (6.1%) and 'excessive wear' (2.5%). Of the 33 failed one-surface ART restorations, 17 were material-related, 7 had caries and no information was available for 9 restorations. Sealants were placed only on surfaces diagnosed as early enamel lesions and on some small dentinal lesions. After 3 years, 50.1% (95% CL: 55.1-45.1%) of the fully and partially retained sealants survived with a range of 68.5-25.9% per operator. Regardless of the low rate of retention, the sealed surfaces had a 4 times lower chance of developing caries than unsealed surfaces with early enamel lesions over the 3-year period. The retention of sealants and the survival of one-surface ART restorations were influenced by an operator effect. The mean treatment time for one-surface ART restorations without chairside assistance was 22.1 min (range per operator of 19.8-23.6 min), whilst the mean time for placing sealants was 9.3 min (range per operator of 8.2-10.8 min). It is concluded that the ART approach and the use of glass-ionomer sealants have made preventive and restorative dental care available for this student population and further that ART seems to be appropriate for population groups currently not receiving preventive and restorative dental care.
1993年，在中学启动了一项口腔保健计划，采用非创伤性修复治疗（ART）方法治疗龋齿。玻璃离子体（II型修复材料，1类）用作修复和封闭材料。使用“按压手指”技术放置封闭剂。3年后的结果显示，单面ART修复体的存留率为85.3%（95%可信区间：89.7 - 80.9%），每位操作人员的存留率在96.1%至69.3%之间。失败原因包括“边缘缺陷不可接受”（8.1%）、“脱落”（6.1%）和“过度磨损”（2.5%）。在33个失败的单面ART修复体中，17个与材料有关，7个有龋齿，9个修复体情况不明。仅在诊断为早期釉质病变的表面以及一些小的牙本质病变表面放置封闭剂。3年后，完全和部分存留的封闭剂的存留率为50.1%（95%可信区间：55.1 - 45.1%），每位操作人员的存留率在68.5%至25.9%之间。尽管存留率较低，但在3年期间，有封闭剂的表面发生龋齿的几率比有早期釉质病变的未封闭表面低4倍。封闭剂的存留情况和单面ART修复体的存留率受操作人员的影响。无椅旁协助时，单面ART修复体的平均治疗时间为22.1分钟（每位操作人员的范围为19.8 - 23.6分钟），而放置封闭剂的平均时间为9.3分钟（每位操作人员的范围为8.2 - 10.8分钟）。结论是，ART方法和玻璃离子体封闭剂的使用为该学生群体提供了预防性和修复性牙科护理，而且进一步表明，ART似乎适用于目前未接受预防性和修复性牙科护理的人群。
