【作者】 冯娟；

【导师】 胡德渝；

【作者基本信息】 四川大学 ， 口腔临床医学， 2002， 硕士

【摘要】 随着我国人口结构老年化，老年人口腔疾病的治疗是一个急待解决的问题，由于条件限制，边远地区和农村老年人的口腔疾病基本没有得到治疗。非创伤性充填技术(ART，Atraumatic Restoration Treatment)使用手工器械去除龋坏，再用玻璃离子材料修复牙体，由于玻璃离子既有粘结性又能释放氟离子，起到防龋的作用，ART操作流程简单易行，还可以就地(田间、学校、自己家)治疗，是牙科临床充填修复技术的一次革命。目的：探索在我国中小城镇及农村采用ART技术(非创伤性充填技术)治疗老年人楔状缺损和牙根面龋可行性。方法：对昆明某社区及楚雄某处，501名60-75岁老人进行楔状缺损和牙根面龋患病情况调查，并筛选符合要求的受试者154人，患牙431颗，参加实验。实验组：使用ART技术充填治疗，对照1组：简单旋转器械+Ketac-molar充填；对照2组：简单旋转器械+国产玻璃离子充填(仅对楔状缺损组实施)。结果： 1．昆明市区和楚雄地区楔状缺损的患病率分别为67.79％与66.50％。牙根面龋患病率分别为22.15％与28.00％。大部分患者未得到治疗，最高治疗率仅20％，楚雄地区根面龋的治疗几乎为零。 2．ART方法治疗可接受度调查，98％患者满意，愿意以后接受同样方法治疗。 — ———g——W“ 3．楔状缺损治疗 1与 2年成功率：试验组为 84．00％，sl．82％；对照组 1为 85．86％，79．17％；对照组2为72．15％；64．94％。根面龋治疗成功率：试验组 为80．77％，73．gi％；对照组为82．98％，76．77％。 4．楔状缺损组中试验组与对照组2一年后结果有显著性差异，余者皆无差异。 结论：该实验结果提示只要使用改进的、粘接性更好的玻璃离子材料充填，ART 方法能够代替传统方法治疗楔状缺损与牙根面龋。该方法对落后、无电、交通 不便的地区和山区人群更适用。更多还原

【Abstract】 With a trend of aging in the Chinese population,great need of treatment of oral diseases was exited in the old people,especially in rural areas,remote regions and counties,where the dental resources are very limited and the majority of dental diseases cannot be treated at all. ART (Atraumatic Restorative Treatment) restoration which uses manual apparatus to eliminate dental soft caries,and then restores teeth with high-strength glass-ionomer cement. Because glass-ionomer cement has the properties of adhesiveness and releases fluoride ion,it provides preventive treatment of dental caries. In addition the operation of ART restoration is relatively easy and convenient and can be carried out in the field circumstances (in farms,at schools,at home,and etc.). Therefore,it is a revolution in the development of restorative treatment techniques in dentistry.Objectives:This study is to 1. Investigate the prevalence of abrasion and root caries in the old people.2.Evaluate the ART restoration of abrasion and root caries in the old people of middle and small towns as well as counties.Methods:A total of 501 old people aged 60-75 years old were surveyed for abrasion and root caries,qualified 154 persons were selected (at least 2 teeth were selected for each person),and 431 caries were included in the study. Experimental Group: ART restoration,according to the procedures recommendedin the ART Manual;Control Group 1:simple drilling +Keter-molar Glass-ionomer filling;Control Group 2:simply drilling + domestic-made Glass-ionomer filling (used in theabrasion group)Results:1. Prevalence of abrasion & root caries in town and Chuxiong district are:67.79%,66.50% and 22.15%,28.00% respectively. Most of the surveyed people were nottreated,the treatment rate is only 20%,and almost none of root caries was treatedin Chuxiong district. 2.Investigation on acceptability of ART. 98% of the treated patients are satisfied andare willing to accept the same treatment again in the future. 3.Survival rates of abrasion. Experimental Group:84.00%,Control Group 1:85.86%,Control Group 2:72.15% of 1-year and,while 81.82%;79.17%;and 64.94% indifferent groups of 2-year.1 and 2-year success rates of root caries:Experimental Group:80.77%,73.91%;Control Group:82.98%,76.77%. 4. There is statistically significant difference after 1 year between ExperimentalGroup and Control Group 2 in the treatment of Abrasion,and no differencebetween the rest groups.Conclusion:The study results show that the ART restoration can replace traditional treatment as long as improved,high-strength material is adopted,and it is especially suitable for the people in the remote areas of developing countries.更多还原