窝沟封闭剂防治龋病的循证病案讨论.pdfVIP

·146 · Ch inese J EvidenceB ased M edicine, 2006 , Vol6 (2) 窝沟封闭剂防治龋病的循证病案讨论 阙克华 　郭 　斌 四川大学华西口腔医学院老年口腔医学教研室 (成都 6 1004 1) 　　【摘要 】为评价窝沟封闭剂防治牙齿窝沟点隙龋病的临床效果 ,作者检索了从 1991～2005 年的 OV ID EBM ( ) R eview s 包括 ACP Jou rnal Club、Cochrane 图书馆 和 M EDL IN E 的随机对照试验 、M eta分析和系统评价 。结果发现 , 窝沟封闭剂防龋有效 ,并且两种不同窝沟封闭剂的疗效略有区别 ,树脂型窝沟封闭剂具有明显防龋效果 ,且流动型 复合树脂保存率较理想 ,而玻璃离子窝沟封闭剂防龋效果还有待确认 。临床中应用酸蚀技术有助于减少产生微渗 漏和提高保存率 ;机械空气喷磨结合酸蚀技术有可能会获得最好的边缘封闭;而其它的技术如 Er: YA G la ser激光 、 牙钻预备和粘接技术等临床效果还不能肯定 ,还需要更进一步临床研究 。据以上证据 ,我们对患者制定了治疗方 案 , 尚未获得随访资料 。 　　【关键词 】窝沟封闭剂 ; 龋病预防;循证实践 Ev iden ceba sed Practice of P it an d F issure Sea lan ts　 QU E Ke hu a , GUO B in W es t Ch ina Col leg e of S tom a tology , S ichuan Un ivers ity , Cheng du 610041, Ch ina 　　【A b stract 】W e searched random ized con trolled trials, m etaanalysis and system atic review s from OV ID EBM R e view s wh ich included ACP Journal Club, The Coch rane L ibra ry, and M EDL IN E ( 199 1 to 2005) to evaluate clin ical effec tiveness of p it and fissure sealants for carie s. The re su lts showed that p it and fissu re sealants were recomm ended to p revent carie s of the occlu sal surface. The effectiveness varied between the two typ e s of sealants. In general, flowab le re sin com po site had a more satisfactory reten tion than gla ss ionom er compo site. A cid etch wa s help fu l for le ss m icroleakage and more satisfactory reten tion. M echan ical airab ra sion w ith acid etch m ay have the be st border seal. However, we were not sure of the effectiveness of Er: Y