口腔预防医学：预防性树脂充填

1、预防性树脂充填Preventive resin restoration支清惠Ph.D. MDS DDS 预防性树脂充填定义仅去除窝沟处的病变牙釉质或牙本质，根据龋损大小，采用酸蚀技术和树脂材料充填早期窝沟龋，并在牙牙合面涂一层封闭剂，是一种窝沟封闭与窝沟龋充填相结合的预防性措施。适应证窝沟有龋损能卡住探针深的点隙窝沟有患龋倾向沟裂有早期龋迹象，釉质混浊或呈白垩色无邻面龋损分类A:需用最小号圆钻去除脱矿牙釉质，用不含填料的封闭剂充填B:用小号或中号圆钻去除龋损组织，洞深基本在牙釉质内，通常用稀释的树脂材料充填C:中号或较大圆钻去除龋坏组织，洞深已达牙本质，需垫底，涂布牙本质或牙釉质粘结剂后用后牙

2、复合树脂材料充填操作步骤以手机去除窝沟龋损，圆钻大小由龋损决定，不作预防性扩展操作步骤彻底清洁牙面，干燥，隔湿操作步骤在C型暴露的牙本质上涂布氢氧化钙操作步骤酸蚀咬合面及窝洞操作步骤Type C: 牙釉质粘结后以后牙复合树脂充填；Type B: 稀释的树脂或含填料的封闭剂充填；Type A: 咬合面及窝洞涂布封闭剂操作步骤 检查充填Opinions about PRRSimonsen RJ. Preventive resin restorations and sealants in light of current evidence. Dent Clin North Am. 2005;49(4

3、):815-23.Pit and fissure sealant should be treatment option provided to all children, particularly at the age immediately after eruption of the posterior teeth and especially, but not exclusively, the permanent teeth. Opinions about PRRPreventive resin restoration is minimally invasive procedure tha

4、t should be the treatment of choice for small carious lesions in the posterior teeth. The Class I amalgam should not be placed as a first-time restorative material to treat incipient or small carious lesions under any circumstances. Opinions about PRRThe amount of tooth structure removal necessary f

5、or Class I Black preparation, which requires sufficient depth of amalgam and extension for prevention, is an unacceptable treatment when minimally-invasive options are available.Opinions about PRRJ Investig Clin Dent. 2012 Feb 8Dall M, Colak H, Mustafa Hamidi M.The current treatment philosophy is to

6、 prevent and detect dental disease at the earliest stage in order to avoid invasive treatment. With the current understanding of the nature of dental disease and its process, the treatment philosophy is now changing to a more conservative approach and the concept of minimal intervention is gaining p

7、opularity in modern dentistry throughout the world. Opinions about PRRIt is now established that demineralized but non-cavitated enamel and dentine can be healed and traditional surgical approach of drilling and filling may no longer be necessary as this only treats the symptoms of the disease and n

8、ot the cause. However, when surgical intervention is indicated, the least invasive techniques such as preventive resin restoration and minimal cavity preparation are utilized. Evidence-based Update of Pediatric Dental Restorative Procedures: Preventive Strategies.J Clin Pediatr Dent. 2015 ;39(3):193

9、-7. There has been significant advances in the understanding of preventive restorative procedures regarding the advantages and disadvantages for restorative procedures; the evidence for conservative techniques for deep carious lesions; the effectiveness of pit and fissure sealants; and the evidence for use of resin infiltration techniques.CONCLUSIONS:Substantial evide