Hänsel Petersson G, Twetman S, Bratthall D
Department of Cariology, Faculty of Odontology, University of Malmö, Sweden.
Caries Res. 2002 Sep-Oct;36(5):327-40. doi: 10.1159/000065963.
The 'Cariogram' is an interactive PC program for caries risk evaluation. It takes into account the interactions between caries-related factors and expresses a graphic assessment of the risk. The aim of this study was to assess the caries risk in schoolchildren using the Cariogram and to evaluate the program by comparing the caries risk assessments with the actual change in DMF. A 2-year prospective study on 446 schoolchildren, 10-11 years old, was conducted. At baseline, data on general health, diet, oral hygiene and use of fluoride were obtained. Saliva analyses included mutans streptococci and lactobacilli counts, buffer capacity and secretion rate. DMFT and DMFS were calculated from records and bitewing radiographs. Scores were entered and caries risk was assessed. Re-examination for caries was done after 2 years. The children were divided into 5 groups according to the assessed caries risk at baseline. Where the Cariogram predicted a 0-20% (high risk), 21-40%, 41-60%, 61-80% and 81-100% (low risk) chance of avoiding new lesions, 8, 35, 42, 73 and 83%, respectively, had no new lesions 2 years later. Logistic regression analyses were carried out. When the Cariogram was included, only two factors, the Cariogram (p < 0.001) and the DMFS at baseline, i.e. past caries experience (p = 0.001), turned out to be significantly associated with caries increment. The Cariogram was the most powerful explanatory variable. When the Cariogram was excluded, lactobacillus count, mutans streptococci, diet intake frequency and DMFS at baseline were significantly associated with caries increment. The Cariogram predicted caries increment more accurately than any included single-factor model. How this finding can be translated into daily practice in the best and most practical way is a matter for future research.
“龋病风险预测软件（Cariogram）”是一款用于龋病风险评估的交互式计算机程序。它考虑了龋病相关因素之间的相互作用，并以图形方式表达风险评估结果。本研究的目的是使用Cariogram评估学龄儿童的龋病风险，并通过将龋病风险评估结果与DMF的实际变化进行比较来评估该程序。对446名10至11岁的学龄儿童进行了一项为期2年的前瞻性研究。在基线时，收集了有关一般健康状况、饮食、口腔卫生和氟化物使用情况的数据。唾液分析包括变形链球菌和乳酸杆菌计数、缓冲能力和分泌率。根据记录和咬合翼片X线片计算DMFT和DMFS。输入分数并评估龋病风险。2年后进行龋病复查。根据基线时评估的龋病风险将儿童分为5组。当Cariogram预测避免新病变的几率为0 - 20%（高风险）、21 - 40%、41 - 60%、61 - 80%和81 - 100%（低风险）时，2年后分别有8%、35%、42%、73%和83%的儿童没有新病变。进行了逻辑回归分析。纳入Cariogram时，只有两个因素，即Cariogram（p < 0.001）和基线时的DMFS，即既往龋病经历（p = 0.001），与龋病增量显著相关。Cariogram是最有力的解释变量。排除Cariogram后，乳酸杆菌计数、变形链球菌、饮食摄入频率和基线时的DMFS与龋病增量显著相关。Cariogram比任何纳入的单因素模型更准确地预测龋病增量。如何以最佳和最实用的方式将这一发现转化为日常实践是未来研究的课题。
