Pearce Euan I F, Dong Yan-Mei, Yue Lin, Gao Xue-Jun, Purdie Gordon L, Wang Jia-De
Wellington School of Medicine, Wellington, New Zealand.
Community Dent Oral Epidemiol. 2002 Feb;30(1):61-9. doi: 10.1034/j.1600-0528.2002.300109.x.
BACKGROUND/AIMS: Attempts to identify subjects who will develop caries lesions in future years have been only moderately successful, suggesting that one or more important risk factors are being overlooked. The aim of this study was to validate the use of plaque calcium, phosphate and fluoride concentrations as significant risk factors in caries.
DMFS and DMFT rates were measured three times over 2 years in a group of rural Chinese schoolchildren initially aged 12 years and not living in a high-fluoride area. At the baseline and year 1 examinations, dental plaque was accumulated for 3 days and, after collection, was analysed for Ca, P and F. Plaque scores, dental health behaviour and parents' occupation data were also recorded.
The mean DMFS increment over 2 years was 1.14 with a range of -2 to +9. Regression analysis taking all factors into account identified only plaque Ca concentration, baseline DMFS score and toothbrushing frequency as significant factors in identifying high-risk individuals. Plaque Ca also showed predictive ability on its own. For example, when high caries was defined as 3+ new DMFS and a Ca cut-off value of 200 nmol/mg dry wt was selected, sensitivity was 0.84 and specificity 0.38. However, with this cut-off value the percentage predicted to have high caries risk was unrealistically high at 66%. As in several other studies, baseline caries score was a useful predictor of future caries.
Low plaque Ca concentration showed a modest ability to predict future caries, and since it is implicated directly in the chain of events leading to caries, its use in caries prediction should be considered further. Plaque P and F showed no predictive ability in this study.
背景/目的：试图识别未来几年会发生龋损的个体，但取得的成功有限，这表明一个或多个重要的风险因素被忽视了。本研究的目的是验证菌斑钙、磷和氟浓度作为龋病重要风险因素的作用。
对一组初始年龄为12岁且不住在高氟地区的中国农村学龄儿童，在2年时间内进行了3次DMFS和DMFT率测量。在基线和第1年检查时，收集3天的牙菌斑，收集后分析其中的钙、磷和氟含量。还记录了菌斑评分、口腔健康行为和父母职业数据。
2年期间DMFS的平均增加值为1.14，范围在-2至+9之间。综合考虑所有因素的回归分析表明，只有菌斑钙浓度、基线DMFS评分和刷牙频率是识别高危个体的重要因素。菌斑钙自身也显示出预测能力。例如，当将高龋定义为新增3个及以上DMFS且选择钙的临界值为200 nmol/mg干重时，敏感性为0.84，特异性为0.38。然而，以此临界值预测有高龋风险的百分比高达66%，不切实际。与其他几项研究一样，基线龋病评分是未来龋病的有用预测指标。
低菌斑钙浓度显示出一定的预测未来龋病的能力，并且由于它直接参与导致龋病的一系列事件，因此应进一步考虑将其用于龋病预测。在本研究中，菌斑磷和氟没有显示出预测能力。
