临床预防技术（中山大学）非创伤性修复治疗.pptxVIP

非创伤性修复治疗（Atraumatic restorative treatment, ART);发展中地区缺乏传统龋病充填治疗设备 汞合金的寿命问题 黏结性修复材料的发展 充填体和封闭物可使其下龋损停止进展 龋坏组织无需完全去除 释氟性材料玻璃离子的发展;更多的预防，更少的创伤;恒牙和乳牙的中小龋洞，能允许最小的挖器进入；无牙髓暴露，无可疑牙髓炎;材料：玻璃离子粉、液牙本质处理剂;器械：口镜、镊子、探针、调拌纸、挖匙、牙用手斧（锄形器）、雕刻刀、树脂条或T形带、木楔等;洞形准备 清洁 混合与调拌 充填;符合现代预防观点：最少的损伤，最佳的预防 手用器械 操作简单易学 控制交叉感染方便 病人容易接受 玻璃离子含氟 容易修补;充填微漏 玻璃离子的强度 长期保留率尚待观察 对ART技术的误解 误认为玻璃离子是临时充填材料 病例丢失率高 ;充填材料的进步：更强的黏结性、更强的耐磨性、较小的微漏、更强的再矿化能力 作为完整预防的一部分，与其他措施相结合 适用于所有经济发展水平的人群，符合现代预防和口腔修复的概念，发展前景良好 ;Clin Oral Investig.?2012 Apr;16(2):429-41. doi: 10.1007/s00784-011-0513-3. Epub 2011 Jan 28. Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. ;The purpose of this study is to perform a systematic investigation plus meta-analysis into survival of atraumatic restorative treatment (ART) sealants and restorations using high-viscosity glass ionomers and to compare the results with those from the 2005 ART meta-analysis. Until February 2010, four databases were searched. Two hundred four publications were found, and 66 reported on ART restorations or sealant survival. ;The survival rates of single-surface and multiple-surface ART restorations in primary teeth over the first 2 years were 93% (CI, 91-94%) and 62% (CI, 51-73%), respectively; for single-surface ART restorations in permanent teeth over the first 3 and 5 years it was 85% (CI, 77-91%) and 80% (CI, 76-83%), respectively and for multiple-surface ART restorations in permanent teeth over 1 year it was 86% (CI, 59-98%). The mean annual dentine lesion incidence rate, in pits and fissures previously sealed using ART, over the first 3 years was 1%. ;No location effect and no differences between the 2005 and 2010 survival rates of ART restorations and sealants were observed. The short-term survival rates of single-surface ART restorations in primary and permanent teeth, and the caries-preventive effect of ART sealants were high. ;CLINICAL RELEVANCE: ART can safely be used in single-surface cavities in both primary a