CLINICAL EFFECTIVENESS OF FISSURE SEALING METHOD WITH USING THE PHOTOACTIVATED DISINFECTION
Abstract. Fissure caries in permanent teeth remains an important issue in modern dentistry, occupies a leading place among carious lesions at other sites. At present, for the prevention of tooth decay on the chewing surfaces of teeth using a wide variety of tools and techniques aimed at removing carious genetic factors: the low resistance of enamel, excess carbohydrates, poor oral hygiene.
At the moment, the most common and effective method of preventing caries of chewing surfaces is fissure sealing.
It was proved that the leading role in the occurrence of caries play oral microorganisms, primarily different types of streptococci and lactobacilli, which produce organic acids, which leads to a progressive demineralization of hard tissue of the teeth. Nowadays the use of the method of antimicrobial therapy - photoactivated disinfection has been introduced. This method is based on the selective destruction of pathogenic microorganisms, sensitized by special preparations and activated by laser radiation relatively small capacity.
The purpose of research – to evaluate the clinical effectiveness of the method of fissure sealing through the use of low-intensity laser radiation for the photoactivated disinfection.
Materials and methods. To carry out preventive measures were selected 100 children of 6-7 years. Depending on the method of antiseptic treatment of hard tissue of teeth, patients were divided into two groups. Group №1 (main) treatment was carried out with the use of dental photoactivated disinfection, group №2 (control) will hold its traditional antiseptic 0?05% chlorhexidine. Other steps of sealing fissure in all groups were similar.
Patients in each group were divided into two groups, depending on the type of preventive measures - invasive or non-invasive fissure sealing. The main group consisted of 50 children they had sealed 143 first permanent molars. In the second group were also 50 children, which sealing was performed in 146 teeth.
In the first group invasive sealing was carried out of 16 children (44 teeth), non-invasive sealing - 34 children (99 teeth), in the second group were 15 children (41 tooth) and 35 children (105 teeth), respectively. The clinical definition of quality seal, we performed at 3, 6 and 12 months, using the index of G. Ryge, modified assessment for sealers. To quantify the preservation of sealant retention, we used the index as the average durability of the coating.
Results. 3 months after sealing the main and control group matched the criteria for evaluating all Alfa. 6 months after such teeth has been assigned rating Bravo (in the main group the subgroup non-invasive sealing - 2% in the control group in the subgroup invasive sealing - 4, 9% and the control group in the subgroup non-invasive sealing – 4,8%). In the main group in the assessment of the conservation assessment Alfa sealant were 98 - 100% of the teeth. In the control group in the subgroup invasive sealing of a violation of sealant preservation in 9,8% of cases (score Bravo) in the subgroup of non-invasive assessment of sealing Bravo had 8,6% of the assessment Charlie - 1,9%. After 12 months only a small percentage of teeth had violations of the surface sealant assessment Alfa corresponded 93,3 - 96% teeth. In assessing the seal with Ryge - criterion also found deterioration of the sealant in the control group. So the study of the conservation of the sealant in the second group in the subgroup of invasive sealing Alfa assessment corresponded only 78,1% of the teeth, evaluation Bravo - 7,3%, and the evaluation of Charlie received 12,2% of the teeth, the figures in the subgroup of non-invasive sealing totaled 72,4 %, 7,6% and 15,2% respectively. Manifestations of caries in the fissures of teeth in the main group was not found in the control group in the subgroup of invasive sealing caries teeth were 2,4% in the subgroup of non-invasive seal – 4,8% (estimate Bravo).
After 3 months after the complex of preventive measures in children in main and control groups (first and second sub-groups) index value retention amounted to 2,0, characterized as a good retention.
After 6 months in children from the main group has been established a good retention as a subgroup with invasive and noninvasive with sealing (2,0 and 1,99 ± 0,01, respectively). Children in the control group retention index in the first subgroup was 1,96 ± 0,02 and the second sub-group - 1,91 ± 0,03, which is also characterized as a good retention.
The essential difference appears to us 12 months after sealing. In the main group to maintain good retention: performance index in the first subgroup amounted to 1,99 ± 0,01, in the second sub-group - 1,98 ± 0,01. In the control group in the subgroup of invasive sealing retention index was 1,79 ± 0,08 (difference is statistically significant, p <0,05). In the subgroup of non-invasive sealing the index decreased by 1,3 times compared with the values in the study group and made up 1,53 ± 0,1 (p <0,01), which is characterized as satisfactory/
Conclusions. Thus, according to research of quantitative and qualitative effectiveness of fissure sealing of the first permanent molars found a significant clinical advantage of the proposed method of caries prevention using photoactivated disinfection compared with traditional methods of sealing.
2. Бутвиловский А.В. Изучение антимикробной активности при 30-секундной экспозиции опытных образцов препаратов для контроля кариесогенной микрофлоры / А.В. Бутвиловский, И.С. Кармалькова, В.Э.Бутвиловский // Медицинский журнал. – 2013. – №2. – С. 157–158.
3. Микробиологический мониторинг состояния биоплёнки зуба при применении хлоргексидина и ксилита в комплексном лечении кариеса у детей раннего возраста / [Кириллова Е.Н. и др.] // Стоматология детского возраста и профилактика. – 2009. – №2. – С. 86–94.
4. Курочкина А.Ю. Классификация фотосенсибилизаторов антимикробной фотодинамической терапии заболеваний периодонта / А.Ю. Курочкина, В.Ю. Плавский, Н.А. Юдина // Медицинский журнал. – 2010. – №2. – С. 131–133.
5. Леонтьев В.К. Профилактика стоматологических заболеваний / В.К. Леонтьев, Г.М. Пахомов. – М., 2006. – 416 с.
6. Полякова С.В. Эффективность применения герметиков в профилактике кариеса зубов / Полякова С.В., Велигория И.Е. // Современная стоматология. – 2004. – №3. – С. 26–27.
7. К вопросу о выборе зубных паст / [Хамадеева A.M. и др.] // Новое в стоматологии. – 2008. – № 3. – С. 35–37.
8. Bailie R.S. Association of natural fluoride in community water supplies with dental health of children in remote indigenous communities – implications for policy / R.S. Bailie, M. Stevens, J.M. Armfield // J. Public Health. – 2009. – № 33(3). – Р. 205–211.
9. Hancock E. B. The role of periodontal maintenance in dental practice / E. B. Hancock, D. H. Newell // The Journal of the Indiana Dental Association. –2002. – №81. – Р. 25–30.
10. Singh K.A. Effects of water fluoride exposure at crown completion and maturation on caries of permanent first molars / K.A. Singh, A.J. Spencer, D.S. Brennan // Caries Res. – 2007. – Vol. 41, № 1. – P. 34–42.