不同去龋技术在乳牙龋病治疗中的应用疗效分析

目的:比较传统机械切割法、非创伤性充填法(atraumatic restorative treatment,ART)和Carisolv化学法在临床乳牙龋病治疗中的应用效果差异。方法:选取2011年1月-2012年6月来我科就诊的5-8岁儿牙患者96名,患牙180颗,随机分为3个不同的治疗组:传统机械去龋组、ART组和Carisolv化学去龋组进行相应牙体充填治疗,通过去龋效果、去龋时间、术中疼痛发生率和术后长期疗效等方面比较不同去龋技术之间的差异。结果:常规机械去龋组和Carisolv组的去龋效果明显优于ART组(P0.05),二者之间无明显差异(P0.05);3种去龋方法的去龋操作时间无明显差异(P0.05);Carisolv组和ART组去龋治疗中患儿术中疼痛发生例数明显低于常规机械去龋组(P0.05),二者之间无明显差异(P0.05);治疗1年后的复诊发现,常规机械去龋组和Carisolv组中患牙继发龋发生率明显低于ART组(P0.05),二者之间无明显差异(P0.05);三种方法治疗后患牙充填物折断/脱落发生率无明显差异(P0.05)。结论:Carisolv化学去龋法能有效减轻术中疼痛和术后复发率,值得在临床乳牙治疗中推广应用;ART的去龋效果和远期疗效可能限制其广泛应用。

Analysis of Different Techniques Applied in the Dental Caries Treatment of Deciduous Teeth

Objective:To compare the effect of conventional mechanical caries removal treatment, atraumatic restorative treatment (ART) and Carisolv chemical caries removal treatment applied in the dental caries treatment of primary teeth.Methods:96 pediatric patients diagnosed of mild/moderate dental caries in deciduous teeth from January 2011 to June 2012 were randomly divided into conventional mechanical removal treatment group, atraumatic restorative treatment (ART) group and Carisolv chemical caries removal treatment group with 60 dentals each. Then operative reaction, operation time and long-term efficacy were recorded and analyzed.Results:The efficacy of dental removal in conventional mechanical caries removal group and Carisolv chemical caries removal treatment group were significantly better than ART group (P<0.05). There was no significant difference in the operation time spent among all treatment groups (P>0.05). The number of intraoperative pain occurs in ART group and Carisolv chemical caries removal treatment group were lower than that on the conventional mechanical caries removal group (P<0.05). In one-year post-treatment, secondary caries incidence in conventional mechanical caries removal group and Carisolv chemical caries removal treatment group were significantly lower than that in ART group(P<0.05). However, there was no significant difference in the incidence of break/loss dental filling among all treatment groups (P>0.05).Conclusion:Carisolv chemical caries removal treatment can effectively relieve intraoperative pain and recurrence rate after operation, which is worthy of promotion and application in clinical treatment of deciduous teeth. Caries removal effects and long-term efficacy of ART may limit its widespread application.