口腔預(yù)防醫(yī)學(xué)：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)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(wèn)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)展由來(lái)、發(fā)展及臨床效果更多的預(yù)防，更少的創(chuàng)傷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ART的適應(yīng)證材料：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(shù)脂條或T形帶、木楔等基本材料和器械洞形準(zhǔn)備清潔混合與調(diào)拌充填操作步驟符合現(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

2、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)對(duì)ART的評(píng)價(jià)-ART的優(yōu)點(diǎn)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可能影響其推廣的因素充填材料的進(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ART的發(fā)展方向Clin Oral Investig.2012 Apr;16(2):429-41. doi: 10.1007/s00784-011-0513-3. Epub 2011 Jan 28.Survival

3、of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis.The purpose of this study is to perform a systematic investigation plus meta-analysis into survival of atraumatic restorative treatment (ART) sealants and restorations using high-viscosity glass ionomers and to comp

4、are the results with those from the 2005 ART meta-analysis. Until February 2010, four databases were searched. Two hundred four publications were found, and 66 reported on ART restorations or sealant survival. The survival rates of single-surface and multiple-surface ART restorations in primary teet

5、h over the first 2 years were 93% (CI, 91-94%) and 62% (CI, 51-73%), respectively; for single-surface ART restorations in permanent teeth over the first 3 and 5 years it was 85% (CI, 77-91%) and 80% (CI, 76-83%), respectively and for multiple-surface ART restorations in permanent teeth over 1 year i

6、t was 86% (CI, 59-98%). The mean annual dentine lesion incidence rate, in pits and fissures previously sealed using ART, over the first 3 years was 1%. No location effect and no differences between the 2005 and 2010 survival rates of ART restorations and sealants were observed. The short-term surviv

7、al rates of single-surface ART restorations in primary and permanent teeth, and the caries-preventive effect of ART sealants were high.CLINICAL RELEVANCE:ART can safely be used in single-surface cavities in both primary and permanent teeth. ART sealants have a high caries preventive effect.Dent Upda

8、te.2014 Apr;41(3):218-20, 222-4.The state-of-the-art of ART restorations.AbstractART is less anxiety- and pain-provoking than traditionalrestorativetreatments; administration of local anaesthesia is rarely required. Systematic reviews have provided evidence of the high level of effectiveness of high

9、-viscosity glass-ionomer ART restoration in restoring single-surface cavities, both in primary and permanent posterior teeth, but its survival rates in restoring multiple-surface cavities in primary posterior teeth needs to be improved. CLINICAL RELEVANCE:Where indicated, high-viscosity glass-ionomer ART restorations can be used alongside traditional restorations. ART provides a m