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Study of different micro-minimally invasive techniques in treatment of elderly root caries |
CHEN Fei1, XUE Peng1, LUO Qiang1, CHU Deqin2, JIA Tingting1, WANG Lin1, CHU Bingfeng1 |
1. Department of Stomatology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; 2. Department of Stomatology, Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force, Hefei 230041, China |
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Abstract Objective To evaluate the clinical effect of atraumatic restorative treatment (ART), Carisolv Ⅲ chemo-mechanical excavation, ultrasonic excavation and conventional excavation with handpieces & burs combined with dental operating microscope on elderly root caries by removal efficiency, pain degree and filling effect. Methods A total of 277 patients (315 teeth) aged 60 and above diagnosed with root caries in the department of stomatology of our hospital from December 2019 to August 2021 were numbered according to the order of visits and randomly divided into 4 groups using the random number table method: 69 patients (79 teeth) in Group A (the ART group), 67 patients (76 teeth) in Group B (the Carisolv Ⅲ group), 72 patients (83 teeth) in Group C (the ultrasonic group C), and 69 patients (77 teeth) in Group D (the conventional group). After removal of the caries by each minimally invasive technique and conventional excavation combined with dental operating microscope, the cavities were filled with Fuji Glass ionomer cement in group A and 3M composite resin in other three groups. The caries-removal time and patient self-assessment of pain by Visual Analogue Score in each group were recorded. All patients received specific oral health instruction. The follow-up was conducted 3 months, 6 months and 12 months and the clinical evaluations of restorations were carried out in accordance with modified USPHS/Ryge clinical evaluation criteria. Results The caries-removal time was Group B[(5.1±1.7) min]> Group A [(4.9±1.6) min]>Group C [(4.5±1.2) min]> D group [(3.9±1.3) min], difference between Group A and Group B, Group A and Group C was found to be statistically insignificant, but there were statistical differences among the other groups (P<0.05). Pain rate (mild and moderate pain) ranked as Group B (17.91%) < Group A (26.09%) < Group C (40.28%) < D group (76.81%), differences between all the minimally invasive technique groups (A, B, C) and conventional group (Group D) were statistically significant (P<0.05), the pain rate was also statistically less in Group B than Group C (P< 0.05). There were no statistical differences in the survival of restorations, marginal adaptation, marginal staining, secondary caries, gingival inflammation and pulp reaction among all groups at the same period, also within group at different period. Conclusions The application of ART, Carisolv Ⅲ chemo-mechanical excavation and ultrasonic excavation combined with dental operating microscope on elderly root caries can achieve satisfactory clinical effect without significant difference except that the caries-removal time are longer than that of conventional excavation with handpieces & burs. Meanwhile, the patients suffer less pain perception during operation. These micro-minimally invasive techniques can give consideration to the clinical effect and comfort of elderly patients with root caries, and are worthy of clinical promotion.
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Received: 20 August 2022
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[1] |
Cardoso M, Coelho A, Lima R, et al. Efficacy and patient’s acceptance of alternative methods for caries removal-a systematic review[J]. J Clin Med, 2020, 9(11): 3407.
|
[2] |
Gao Y B, Hu T, Zhou X D, et al. Dental caries in Chinese elderly people: findings from the 4th National Oral Health Survey[J]. Chin J Dent Res, 2018, 21(3): 213-220.
|
[3] |
郭佳杰, 仇丽鸿. 根面龋的预防与治疗[J]. 中华口腔医学杂志, 2021, 56(1): 27-32.
|
[4] |
杜 倩, 任 彪, 周学东, 等. 根面龋微生态的研究进展[J]. 国际口腔医学杂志, 2019, 46(3): 326-332.
|
[5] |
栾文民. 老年人口腔疾病的治疗特点[J]. 中国实用口腔科杂志, 2010, 3(2): 65-68.
|
[6] |
张佳钰, 刘 佳, 黄莉莉. 不同往复运动镍钛锉根管预备后冲洗效果的比较[J]. 临床口腔医学杂志, 2020, 36(11): 643-646.
|
[7] |
毛 敏, 夏凌云, 施 俊, 等. 高龄老年人根尖周炎的诊治特点及显微手术治疗的临床疗效[J]. 临床口腔医学杂志, 2020, 36(12): 738-740.
|
[8] |
Harrel S K, Wilson T G, Pandya M, et al. Titanium particles generated during ultrasonic scaling of implants[J]. J Periodontol, 2019, 90(3): 241-246.
|
[9] |
汪 磊, 鲍利红, 姚莉莉. 微创去腐技术联合超薄瓷贴面修复前牙深龋缺损的临床研究[J]. 临床口腔医学杂志, 2021, 37(11) :683-687.
|
[10] |
周凤梅. 伢典微创无痛技术治疗龋齿的临床观察[J]. 临床口腔医学杂志, 2015, 31(1): 50-51.
|
[11] |
陈 智, 卢展民, Schwendicke F, 等. 龋损管理: 龋坏组织去除的专家共识[J]. 中华口腔医学杂志, 2016, 51(12): 712-716.
|
[12] |
Shi L, Wang X, Zhao Q, et al. Evaluation of packable and conventional hybrid resin composites in Class I restorations: three-year results of a randomized, double-blind and controlled clinical trial[J]. Oper Dent, 2010, 35(1): 11-19.
|
[13] |
Frencken J E. Atraumatic restorative treatment and minimal intervention dentistry[J]. Br Dent J, 2017, 223(3): 183-189.
|
[14] |
Frencken J E, Pilot T, Songpaisan Y, et al. Atraumatic restorative treatment(ART): rationale, technique, and development[J]. J Public Health Dent, 1996, 56(3 Spec): 135-140,161-163.
|
[15] |
Leal S, Bonifacio C, Raggio D, et al. Atraumatic restorative treatment: restorative component[J]. Monogr Oral Sci, 2018, 27: 92-102.
|
[16] |
Göstemeyer G, Mata C, McKenna G, et al. Atraumatic vs conventional restorative treatment for root caries lesions in older patients: Meta-and trial sequential analysis[J]. Gerodontology, 2019, 36(3): 285-293.
|
[17] |
Jiang M, Fan Y, Li K Y, et al. Factors affecting success rate of atraumatic restorative treatment(ART) restorations in children: a systematic review and meta-analysis[J]. J Dent, 2021, 104: 103526.
|
[18] |
邵佳琪, 汪淑华. 非创伤性修复与乳牙龋病治疗的研究现状[J]. 口腔医学, 2018, 38(8): 765-768.
|
[19] |
Arita K, Yamamoto A, Shinonaga Y, et al. Hydroxyapatite particle characteristics influence the enhancement of the mechanical and chemical properties of conventional restorative glass ionomer cement[J]. Dent Mater J, 2011, 30(5): 672-683.
|
[20] |
Yoshida Y, Meerbeek B, Nakayama Y, et al. Evidence of chemical bonding at biomaterial-hard tissue interfaces[J]. J Dent Res, 2000, 79(2): 709-714.
|
[21] |
Burke F J. Dental materials: what goes where? Class V restorations[J]. Dent Update, 2015, 42(9): 829-830, 833-836, 839.
|
[22] |
张 军, 彭 彬. 不同类型玻璃离子水门汀氟离子体外释放的比较[J]. 牙体牙髓牙周病学杂志, 2008, 18(1): 28-30.
|
[23] |
储冰峰, 刘洪臣. Carisolv(伢典)化学机械祛腐技术[J]. 中华老年口腔医学杂志, 2005, 3(3): 180-181.
|
[24] |
张 勇, 储冰峰, 刘洪臣. Carisolv(伢典)微创化学机械去龋法治疗老年人龋齿的临床研究[J]. 中华老年口腔医学杂志, 2005, 3(2): 81-83.
|
[25] |
Ali A H, Koller G, Foschi F, et al. Self-Limiting versus conventional caries removal: a randomized clinical trial[J]. J Dent Res, 2018, 97(11): 1207-1213.
|
[26] |
王 云, 叶 鹏, 王凤艳, 等. 化学机械法与传统牙钻法去腐效果对比的Meta分析[J]. 北京口腔医学, 2020, 28(2): 94-99.
|
[27] |
魏雅楠, 陈 筠, 李志艳. Er:YAG激光对恒牙牙本质黏接性能的影响[J]. 口腔疾病防治, 2020, 28(10): 673-676.
|
[28] |
赵涓彤, 焦倩倩, 谢凤莲, 吴佩玲. 3种方法去除老年根面龋龋坏的效果观察[J]. 中华实用诊断与治疗杂志, 2014, 28(2): 142-143.
|
[29] |
Breschi L, Maravic T, Cunha S R, et al. Dentin bonding systems: from dentin collagen structure to bond preservation and clinical applications[J]. Dent Mater, 2018, 34(1): 78-96.
|
[30] |
Liu Y, Tjäderhane L, Breschi L, et al. Limitations in bonding to dentin and experimental strategies to prevent bond degradation[J]. J Dent Res,2011,90(8):953-968.
|
[31] |
Cianetti S, Abraha I, Pagano S, et al. Sonic and ultrasonic oscillating devices for the management of pain and dental fear in children or adolescents that require caries removal: a systematic review[J]. BMJ Open, 2018, 8(4): e020840.
|
[32] |
吴 茜, 訚 侃, 宋光泰. 超声微创去龋对牙本质影响的体外实验研究[J]. 口腔医学研究, 2014, 30(9): 865-867.
|
[33] |
Ntovas P, Doukoudakis S, Tzoutzas J, et al. Evidence provided for the use of oscillating instruments in restorative dentistry: a systematic review[J]. Eur J Dent, 2017, 11(2): 268-273.
|
|
|
|