Ефективність проведення профілактичних заходів в перших постійних молярах у дітей м. Полтави

Abstract

Динамічне спостереження, протягом 2-х років, в групі дітей, яким провели герметизацію фісур в перших постійних молярах з урахуванням глибини ямок їх жувальних поверхонь показало високу ефективність таких профілактичних заходів. Тому цей метод профілактики необхідно в першу чергу проводити в перших постійних молярах, які мають глибокі ямки, так як саме вони, втративши захисне покриття, найбільш часто уражаються карієсом порівняно з ямками, меншими за глибиною; Динамическое наблюдение в течение 2-х лет, в группе детей, которым провели герметизацию фиссур в первых постоянных молярах с учетом глубины ямок их жевательных поверхностей показало высокую эффективность таких профилактических мероприятий. Поэтому этот метод профилактики необходимо в первую очередь проводить в первых постоянных молярах, которые имеют глубокие ямки, так как они, утратив защитное покрытие, наиболее часто поражаются кариесом по сравнению с ямками, меньшими по глубине; The most common among permanent teeth affected by caries are the first permanent molars, due to the complexity of the structure of the occlusal surface. The pathological process in the pits and fissures of molars in 40% of cases occurs in the range of 12 to 18 months after the eruption, so early prevention of dental caries in these teeth is becoming increasingly important. Aim. To study the effectiveness of the sealing of fissures and pits of the first permanent molars in children taking into account the depth of the pits and odontoglific of their chewing surfaces. Object and methods. The study involved 946 first permanent molars in 240 children without background pathology at the age of 6-7 years. Pattern type chewing surfaces of the first permanent molars was determined according to the odontoglific schemes variants teeth of the upper and lower jaws, and proposed by Gasyuk A.P. and Skripnikov P.N. (2001). The depth of the pits of the chewing surfaces of molars measured way offered by us. The upper molars selected for further study had type II chewing surfaces, lower molars — Type Y5, +5. Each type molars were divided into three groups, depending on the depth of the pits of their chewing surfaces (group 1 — with shallow pits, group 2 — middle pits, group 3 — with deep pits).To carry out preventive measures of the number of observations molars third group were selected 203 teeth of 100 children who underwent prophylactic closure of fissures and pits sealant light curing «Jen Fissu-Fill» («Jen Dental» the United States). 110 molars third group have 71 children served as the control, they performed only trained dental hygienists and supervised brushing with a focus on the chewing surface of the molars. The effectiveness of preventive measures was assessed according to clinical studies, which were performed at 6, 12 and 24 months. Results and discussion. After 24 months in the experimental group molar sealant completely preserved in 172 teeth, which accounted for 84,48%. On examination of the teeth that saved the coating did not reveal a single case of caries of pits and fissures. A study of 31 teeth, which lost sealant, has determined that the caries were hit only 7 teeth left without sealant for the first half. The characteristic was that cavities in the teeth above was localized only in the dental pits, which in 6 cases (85,71%) were deep and in 1 case (14,29%) — shallow that there was a significant difference (p<0,001). In the control group of molars after 24 months was found 42 carious teeth, which amounted to 38,18%. Now, 2 years after the start of the study in the study group molar percentage of affected teeth was significantly lower than in the control group (p<0,001), which made up 3,45% and 38,18%. Reduction fissure caries of teeth in the experimental group compared to controls after 24 months was 83,33%. Conclusions. The use of the method of fissures sealing in permanent molars based on the depth of the pits of the chewing surfaces showed its high efficiency. Therefore, this method must be first carried out in the first permanent molars, which have deep pits, as they lost the protective coating, the most commonly affected caries compared with pits shallower depth.