Reiker J, van der Velden U, Barendregt D S, Loos B G
Afdeling Parodontologie van het Academisch Centrum Tandheelkunde Amsterdam (ACTA).
Ned Tijdschr Tandheelkd. 2000 Oct;107(10):402-5.
The aim of this cross-sectional study was to investigate the prevalence and several risk indicators of root cariës in 45 periodontal maintenance patients, who had been actively treated for adult periodontitis 11-22 years ago. These patients were part of a routine 3-6 monthly maintenance schedule. Active and inactive root caries and root fillings were recorded, as well as coronal caries experience. Plaque and bleeding scores, number of exposed root surfaces, rate of saliva secretion, saliva buffer capacity, S. mutans counts and Lactobacilli were also scored. From the total of 45 subjects, 37 patients (82%) showed root lesions (root caries and/or fillings), while only 8 patients were free of any root lesions. On average, there were 4.3 lesions per patient (range 0-19) in the present study. Of all damaged root surfaces, 9% were active lesions, mostly located on mandibular teeth at lingual and vestibular sites; 40% were inactive lesions often detected at vestibular sites. The remaining damaged root surfaces (51%) were restored; they were equally divided over both jaws. A higher number of root lesions was observed in those patients with > 106 S. mutans/ml saliva. Although the actual number of lesions per patient was low in relation to the large number of sites with gingival recession, the results from this cross-sectional study in periodontal maintenance patients indicate that: root cariës can be regarded as a complication in periodontal maintenance patients, that the individual number of root lesions correlate with individual dental plaque score, that a high number of root lesions is associated with counts of salivary S. mutans, and that no relation between root cariës and coronal caries experience, salivary secretion rate or salivary buffering capacity seems present. Therefore, repeated oral hygiëne instructions and adjunctive preventive measures including diet counseling and fluoride rinses, as well as fluoride and chlorhexidine varnishes, should be advocated in high-risk patients.
这项横断面研究的目的是调查45名牙周维护患者根龋的患病率及若干风险指标,这些患者在11至22年前曾积极接受成人牙周炎治疗。这些患者是常规3至6个月维护计划的一部分。记录了活动和静止根龋及根充填情况,以及冠龋经历。还对菌斑和出血评分、暴露根面数量、唾液分泌率、唾液缓冲能力、变形链球菌计数和乳酸杆菌进行了评分。在总共45名受试者中,37名患者(82%)有根病变(根龋和/或充填),而只有8名患者没有任何根病变。在本研究中,每位患者平均有4.3个病变(范围为0至19个)。在所有受损根面中,9%为活动病变,主要位于下颌牙的舌侧和前庭部位;40%为静止病变,常在前庭部位发现。其余受损根面(51%)已修复;上下颌分布均等。唾液中变形链球菌>106/ml的患者根病变数量较多。尽管相对于大量牙龈退缩部位,每位患者的实际病变数量较少,但这项针对牙周维护患者的横断面研究结果表明:根龋可被视为牙周维护患者的一种并发症,个体根病变数量与个体牙菌斑评分相关,根病变数量多与唾液变形链球菌计数相关,且根龋与冠龋经历、唾液分泌率或唾液缓冲能力之间似乎没有关联。因此,对于高危患者,应提倡反复进行口腔卫生指导以及包括饮食咨询和氟化物漱口在内的辅助预防措施,以及使用氟化物和洗必泰清漆。