应用微创理念构建老年龋病防治方案(二)  

Minimal intervention dentistry:A vision of caries management for older patients.Ⅱ

作　　者：储冰峰[1] 张鹰[1] 刘洪臣[1] 

机构地区：[1]中国人民解放军总医院老年口腔科,北京100853

出　　处：《华西口腔医学杂志》2010年第1期9-12,共4页West China Journal of Stomatology

摘　　要：微创牙科治疗(MID)是一种全新的齿科医学理念,着眼于疾病的早发现、早诊断、早治疗,强调病症早期的微创(甚至分子水平)治疗以及发生不可逆性损伤时以患者为本的治疗方案。依据MID理念构建的老年龋病防治方案是着眼于改善口腔微环境、降低患龋风险,终止甚至逆转龋病进程,必须进行手术治疗时尽量减轻患者疼痛的综合性防治体系。应用MID理念构建的老年龋病防治方案包括对蚀损、磨损、脱矿、猛性冠根龋、残根、继发龋(冠和其他修复体周围)、龈下龋,唾液腺机能障碍、高菌斑水平、牙龈肿胀出血,治疗时隔湿困难等老年人常见的口内情况,以及伴有行为障碍等全身疾病的老年龋病患者进行系统、完善的治疗。本文主要阐述了MID在老年龋病修复方面的应用,包括在去龋、窝洞预备,生物性修复材料的选择,蚀损和磨损的治疗,隔湿困难患者的治疗以及活髓保存技术中的应用。Minimal intervention dentistry（MID） is a new approach to caries management in older patients,which emphasize on early discussion,early diagnosis and early treatment.It focuses on stopping the disease process and patient-friendly surgical intervention only when required.Geriatric MID can improve oral ecological balance,lower caries risk,reverse dental caries process and reduce the pain when surgical intervention required.It can help clinicians in coping with erosion,abrasion,demineralization,rampant dental caries,retained roots,recurrent caries,subgingival caries,＂wet＂oral environment,salivary dysfunction,high plaque levels,swollen or bleeding gum and poor compliance in older patients.This article mainly describes the application of MID in surgical intervention of dental caries,including the strategies for caries removal,cavity preparation,choice of biology material,management of erosion and abrasion,＂wet＂subgingival environment and vital pulp therapy.

关 键 词：牙科微创治疗 龋病预防与控制 窝洞预备 玻璃离子黏固剂 

分 类 号：R781.1[医药卫生—口腔医学]