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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(P<0.05),二者之间无明显差异(P>0.05);3种去龋方法的去龋操作时间无明显差异(P>0.05);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(P<0.05),二者之间无明显差异(P>0.05);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(P<0.05),二者之间无明显差异(P>0.05);三种方法治疗后患牙充填物折断/脱落发生率无明显差异(P>0.05)。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。
OBJECTIVE: To compare the effects of traditional mechanical cutting, atraumatic restorative treatment (ART) and Carisolv chemistry in the treatment of primary deciduous dental caries. Methods: Totally 96 pediatric patients with 5-8 years old who were treated in our department from January 2011 to June 2012 were randomly divided into three groups: traditional mechanical caries-decayed group, ART group And Carisolv caries-decayed group were treated with corresponding tooth filling. The differences between different caries removal techniques were compared in terms of caries-removing effect, caries removal time, incidence of intraoperative pain and long-term curative effect. Results: The results of caries removal in the conventional mechanical caries decalcification group and Carisolv group were significantly better than those in the ART group (P <0.05). There was no significant difference between the two groups (P> 0.05) (P> 0.05). The incidence of intraoperative pain in Carisolv group and ART group was significantly lower than that in conventional mechanical caries removal group (P <0.05), there was no significant difference between the two groups (P> 0.05) (P0.05); the incidence of secondary caries in the conventional mechanical caries-decayed group and Carisolv group was significantly lower than that in the ART group (P0.05) There was no significant difference in the rate of breakage / shedding of dental fillings after treatment (P> 0.05). Conclusion Carisolv decarboxylation can effectively reduce intraoperative pain and postoperative recurrence rate, which is worthy of promotion in the treatment of clinical deciduous teeth. Caries removal and long-term efficacy of ART may limit its wide application.