【作者】 张文； 卢展民；

【Author】 ZHANG Wen~*,Colman MCGRATH,LO CM Edward.(*Guanghua School of Stomatology, Sun Yat-sen University,Guangzhou,China)

【机构】 中山大学光华口腔医学院； 香港大学牙医学院；

【摘要】 目的:社区长者牙根龋正成为一个公众关心的健康问题。本临床对照试验为期24个月,用以研究氟化氨银和口腔健康教育对社区长者根龋的预防和静止作用。方法:本实验从香港1 1个社区中选取了266名长者。这些长者有至少5颗牙齿根面暴露并且没有严重的全身疾病。他们被随机分配到不同的组中接受干预。组1(对照组)——接受口腔健康指导并每年在暴露的牙根面涂布安慰剂一次;组2——接受口腔健康指导并每年在暴露的牙根面涂布氟化氨银一次;组3——接受口腔健康指导,每年在暴露的牙根面涂布氟化氨银一次并每半年参加一次口腔健康教育。结果:85%(227/266)的长者完成了24个月的随访。24个月新增活性根龋面在组1,组2和组3中分别为1.33,1.00和0.70(ANOVA,P<0.001)。组3比组1新增活性根龋少(P<0.05)。佩戴局部活动义齿和牙龈退缩严重者产生了更多的活性根龋(ANCOVA,P<0.05)。24个月活性根龋面转变为静止根龋面在组1,组2和组3中分别为0.04,0.28和0.33(ANOVA,P<0.001)。组3和组2比组1新增静止龋多(ANCOVA,P<0.05)。基线活性根龋严重者产生了更多的静止根龋(ANCOVA,P<0.01)。结论:每年使用氟化氨银一次并每半年参加一次口腔健康教育较口腔健康指导更有效预防新根龋,每年使用氟化氨银一次较口腔健康指导更有效静止活性根龋。更多还原

【Abstract】 OBJECTIVE:Root caries among elderly communities is of growing public health concern.This 24-months controlled clinical trial was to compare the effectiveness of silver diamine fluoride and oral health education in preventing and arresting root caries among community-dwelling elders.METHODS:In the clinical trial 266 elders were recruited from 11 community centers in Hong Kong.Elders having at least 5 teeth with exposed root surfaces and no serious medical problems were randomly allocated to participate in one of the following oral health promotion strategy groups:Group 1(the control group) - received oral hygiene instruction(OHI) and a placebo application to their exposed root surfaces annually;Group 2 - received OHI and annual applications of silver diamine fluoride(SDF) solution to exposed root surfaces;Group 3- received OHI and annual applications of SDF to exposed root surfaces and participated in an oral health education program every 6 months.RESULTS:At 24 months,85%(227/266) of the subjects remained in the trial. The mean numbers of root surfaces with new active caries at 24 months in Groups 1,2 and 3 were 1.33,1.00 and 0.70 respectively(ANOVA,P<0.001).Group 3 had fewer root surfaces with new active caries than Groups 1(P<0.05).Moreover,elders possessing partial dentures in close contact to dento-gingival sites,those having higher baseline root caries levels and greater baseline gingival recession developed more new root caries (ANCOVA,P<0.05).The mean numbers of active root caries surfaces which became arrested in the subjects in Groups 1,2 and 3 after 24 months were 0.04,0.28,and 0.33 respectively(ANOVA,P<0.001).Group 3 and Group 2 had a greater number of active root caries surfaces which became arrested than Group 1(Scheffe multiple comparison test, P<0.05).Furthermore,elders with higher baseline root caries experience had more active root caries which became arrested(ANCOVA,P<0.01).CONCLUSION:Annual application of SDF with biannual oral health education was more effective in preventing new root caries compared to OHI alone.Annual application of SDF every 6 months was found to be more effective in arresting root caries than OHI alone.更多还原