非創(chuàng)傷性修復(fù)治療

1、非創(chuàng)傷性修復(fù)治療（Atraumatic restorative treatment, ART)支清惠支清惠由來、發(fā)展及臨床效果 發(fā)展中地區(qū)缺乏傳統(tǒng)齲病充填治療設(shè)備 汞合金的壽命問題 黏結(jié)性修復(fù)材料的發(fā)展 充填體和封閉物可使其下齲損停止進(jìn)展 齲壞組織無(wú)需完全去除 釋氟性材料玻璃離子的發(fā)展 更多的預(yù)防，更少的創(chuàng)傷更多的預(yù)防，更少的創(chuàng)傷ART的適應(yīng)證 恒牙和乳牙的中小齲洞，能允許最小的挖器進(jìn)入；無(wú)牙髓暴露，無(wú)可疑牙髓炎基本材料和器械 材料：玻璃離子粉、液牙本質(zhì)處理劑基本材料和器械 器械：口鏡、鑷子、探針、調(diào)拌紙、挖匙、牙用手斧（鋤形器）、雕刻刀、樹脂條或T形帶、木楔等操作步驟 洞形準(zhǔn)備 清潔 混合與

2、調(diào)拌 充填對(duì)ART的評(píng)價(jià)-ART的優(yōu)點(diǎn) 符合現(xiàn)代預(yù)防觀點(diǎn)：最少的損傷，最佳的預(yù)防 手用器械 操作簡(jiǎn)單易學(xué) 控制交叉感染方便 病人容易接受 玻璃離子含氟 容易修補(bǔ)可能影響其推廣的因素 充填微漏 玻璃離子的強(qiáng)度 長(zhǎng)期保留率尚待觀察 對(duì)ART技術(shù)的誤解 誤認(rèn)為玻璃離子是臨時(shí)充填材料 病例丟失率高ART的發(fā)展方向 充填材料的進(jìn)步：更強(qiáng)的黏結(jié)性、更強(qiáng)的耐磨性、較小的微漏、更強(qiáng)的再礦化能力 作為完整預(yù)防的一部分，與其他措施相結(jié)合 適用于所有經(jīng)濟(jì)發(fā)展水平的人群，符合現(xiàn)代預(yù)防和口腔修復(fù)的概念，發(fā)展前景良好Med Princ Pract. 2009;18(1):26-30. Epub 2008 Dec 4.Ac

3、ceptance and discomfort from atraumatic restorative Acceptance and discomfort from atraumatic restorative treatment in secondary school students in Egypt.treatment in secondary school students in Egypt.Farag A, Frencken JE.SourceSourceDepartment of Operative Dentistry, Faculty of Oral and Dental Med

4、icine, Minia University, Minia City, Egypt.OBJECTIVES: To assess the level of acceptance and discomfort experienced by secondary school students when undergoing an atraumatic restorative treatment (ART) restoration.SUBJECTS AND METHODS: Ninety secondary school students, aged 14 and 15 years, were in

5、cluded in the study. The ART restorations were prepared in 90 cavities and restored using an encapsulated high-viscosity glass ionomer. The depth of the cavities was judged from radiographs and clinically into outer, middle and inner third of dentine. Using a graded periodontal probe, cavity size wa

6、s measured, into approximately half the width of the mesiodistal and buccolingual/palatal distance of the occlusal surface. The students were asked about the level of sensation experienced during cavity preparation immediately after completion of restoration. chi(2)-Test was used to test the effect

7、of cavity depth and size on sensitivity from the teeth.RESULTS: Of the 90 students, 6 (6.6%) and 26 (29.2%) experienced pain and discomfort, respectively, during cavity preparation, more often in large than in small cavities (p = 0.003) and in cavities extending into the inner third than in the midd

8、le and outer third of dentine (p 0.0001). Only 1 student reported postoperative sensitivity.CONCLUSIONS: The ART approach to treat dental cavities was well accepted by this group of secondary school students. Only a few reported pain during cavity instrumentation, and this was more prevalent in large cavities and in cavities with the floor close to the pulp.Hobdell M, Petersen PE, Clarkson J, Johnson N. G