幼儿龋（ECC）的临床结局：变形链球菌唾液水平的影响

Clinical outcomes for Early Childhood Caries (ECC): the influence of salivary mutans streptococci levels.

作者信息

Chase I, Berkowitz R J, Mundorff-Shrestha S A, Proskin H M, Weinstein P, Billings R

机构信息

Department of Pediatric Dentistry, School of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Eur J Paediatr Dent. 2004 Sep;5(3):143-6.

PMID:15471521

Abstract

AIM

To assess the relationship between clinical outcomes for children treated for Early Childhood Caries (ECC) and salivary mutans streptococci (MS) levels.

STUDY DESIGN AND METHODS

The study cohort consisted of 79 children (42 males, 37 females) treated for ECC, aged from 2.3 to 7.3 years at time of entry. Whole non-stimulated saliva samples were obtained from each subject prior to dental surgery and at 6 mths post dental surgery, by saturating a cotton swab in the saliva pooled in the floor of the mouth. Samples were placed into PBS on ice and processed within 2 hours. Samples were sonicated, serially diluted and plated onto MSB and SBA agar plates, then incubated 48 hours anaerobically; SBA plates were incubated an additional 24 hours aerobically. The MS level in each sample was expressed as a percentage of the total cultivable flora. The cohort was evaluated for new caries lesions at 6 months post dental surgery. Relapse was defined as the presence of new smooth surface caries lesions.

STATISTICS

Comparisons between Relapse (R) and Non-Relapse (NR) groups with respect to mutans streptococci levels were performed using Wilcoxon tests. Within group comparisons were performed using Wilcoxon signed-rank tests.

RESULTS

57 children (72%) returned for the 6 months examination and 21 of these subjects (37%) relapsed. No statistically significant difference in median salivary MS levels existed between the R (0.20%) and NR (0.033%) groups at baseline (p=0.647) or at 6 months post dental surgery (R=0.03%; NR=0.01%; p=0.273). A statistically significant difference between baseline and 6 months post dental surgery was noted in the median salivary MS level within the R group (p=0.0007) and within the NR group (P<0.0001).

CONCLUSIONS

The relapse rate (37%) was high and rapid for children treated for ECC. Dental surgery resulted in a statistically significant reduction in salivary MS reservoirs for children treated for ECC. However, this did not translate into acceptable clinical outcomes.

摘要

目的

评估患有幼儿龋（ECC）的儿童的临床治疗结果与唾液变形链球菌（MS）水平之间的关系。

研究设计与方法

研究队列由79名接受ECC治疗的儿童组成（42名男性，37名女性），入组时年龄在2.3至7.3岁之间。在牙科手术前及术后6个月，通过将棉签浸入口腔底部汇集的唾液中，从每个受试者获取全唾液非刺激性样本。样本置于冰上的磷酸盐缓冲盐溶液（PBS）中，并在2小时内进行处理。样本经超声处理、系列稀释后接种于变形链球菌琼脂培养基（MSB）和血琼脂培养基（SBA）平板上，然后在厌氧条件下培养48小时；SBA平板再在需氧条件下额外培养24小时。每个样本中的MS水平以可培养菌群总数的百分比表示。在牙科手术后6个月对该队列进行新龋损评估。复发定义为出现新的光滑面龋损。

统计学方法

使用Wilcoxon检验对复发（R）组和未复发（NR）组的变形链球菌水平进行比较。组内比较采用Wilcoxon符号秩检验。

结果

57名儿童（72%）返回进行6个月检查，其中21名受试者（37%）复发。在基线时（p = 0.647）或牙科手术后6个月时（R = 0.03%；NR = 0.01%；p = 0.273），R组（0.20%）和NR组（0.033%）的唾液MS水平中位数无统计学显著差异。在R组内（p = 0.0007）和NR组内（P < 0.0001），观察到牙科手术前基线与术后6个月唾液MS水平中位数存在统计学显著差异。