姚瑶 何柳婷

[摘要]目的：探讨窝沟封闭剂（Fissure sealant， FS）与涂氟漆（Fluoride varnish， FV）预防第一恒磨牙龋的临床效果。方法：选择2015年12月-2017年12月于北京大學深圳医院口腔医学中心进行口腔体检的450例儿童作为研究对象，225例行FS与FV联合预防作为实验组，225例行FS预防作为对照组，封闭术后1年、2年复查并获取两组儿童龋齿发生率和FS脱落率。采用SPSS 22.0软件包对数据进行统计分析。 结果：封闭术后24个月，有420例（93.33%）儿童接受了最终临床检查：实验组209例，对照组211例;未完成实验的最常见原因是离开该地区或儿童接受程度差，与治疗方案无关，丢失数据完全随机丢失;实验组封闭术后2年封闭剂脱落率低于对照组（P<0.05）;实验组封闭术后2年龋齿发生率低于对照组（P<0.05）。分析影响因素：性别、年龄、龋齿位置、额外增加加氟次数、龋齿整体得分、刷牙频率、刷牙时长、调整封闭物次数均与龋齿发生无关（P>0.05）。结论：窝沟封闭剂联合涂氟漆对预防儿童龋病具有更好的远期疗效，可显著降低龋齿率及封闭剂脱落率。

[关键词]窝沟封闭剂;涂氟漆;预防;第一恒磨牙龋

[中图分类号]R788+.1    [文献标志码]A    [文章编号]1008-6455（2021）05-0126-03

Effect of Fissure Sealant and Fluoride Varnish on Prevention of

the First Permanent Molar Caries

YAO Yao1， HE Liu-ting2

（1.Stomatological center， Shenzhen Hospital， Peking University， Shenzhen 518000，Guangdong，China;2. Department of Oral and Maxillofacial Surgery， the Second People's Hospital of Shenzhen，Shenzhen 518000，Guangdong，China）

Abstract：Objective  To investigate the effect of fissure sealant （FS） and fluoride varnish （FV） on prevention of the first permanent molar caries. Methods 450 children who underwent oral physical examination in the Stomatological center， Shenzhen Hospital，Peking University from December 2015 to December 2017 were selected. 225 children in the experimental group received FS and FV， while 225 children in the control group only received FS. The incidence of dental caries and FS drop rate in the two groups were reviewed at 1 and 2 years after closure. SPSS 22.0 software package was used to analyze the data. Results  At 24 months， 420 （93.33%） children underwent final clinical examinations， including 209 cases in the experimental group and 211 cases in the control group; The most common reason for incomplete trials was off-site or poor acceptance by children， regardless of the treatment plan， and lost data was completely lost at random. At 2 years after closure，the sealant shedding rate in the experimental group was significantly lower than that in the control group （P<0.05）， and the incidence of caries in the experimental group was significantly lower than that in the control group （P<0.05）. The results of influencing factors showed that gender， age， position of dental caries， frequency of additional increase of fluoride， overall score of dental caries， frequency of brushing， duration of brushing and frequency of adjusting sealant were not correlated with the occurrence of dental caries （P>0.05）. Conclusion  Both fissure sealant and fluoride varnish have good long-term preventive effect on children's caries， which can significantly reduce caries rate and sealant shedding rate.

Key words： fissure sealant; fluoride varnish; prevention; first permanent molar caries

兒童龋齿易感性各不相同，根据报道第一恒磨牙咬合面龋齿发生率最高，通常在萌出后短时间内出现[1]。控制龋斑、应用氟化物、窝沟封闭和预防性填充均为预防龋病最常用方法，目前，关于预防性牙科技术窝沟封闭剂（Fissure sealant，FS）和氟化物清漆（Fluoride varnish，FV）报道较多，相关研究显示其可靶向第一恒磨牙咬合面而有效预防龋齿发生[2]。既往12项试验中，将FS与无FS对照进行2年随访发现，密封牙龋蚀的可能性显著降低[3];将FV与安慰剂或不治疗进行对比，得出合并FV预防率43%更高[4-5]。既往实验结果均证实FS、FV具有预防龋齿发生效果，哪种技术临床更优仍是未知，且既往随访质量较低，缺乏临床多样化数据支持。……