Zoccola G C, Zaffalon L, Careglio A, Sapino S, Gatto V
Clinica Odontoiatrica, Università degli Studi di Torino.
Minerva Stomatol. 1991 May;40(5):329-37.
In this, the second part of the paper, the main clinical tests available today for carrying out early diagnosis of carioreceptivity are reviewed. On its own, measurement of the DMF-T index can classify an individual as carioactive or evaluate his "experience of caries", but it does non determine with any degree of certainty the probability of future caries. Measurement of stimulated salivary flow is important only when this is greatly reduced, as happens, for example, in xerostomy, but the finding of an almost normal flow is not on its own sufficient to make a diagnosis of carioreceptivity certain. Assessment of salivary pH is not a reliable parameter for the screening of carioreceptivity although it may be an indicator of diseases (e.g. diabetes) or bad habits (e.g. heavy smokers) in the patient in question. So examination with very sophisticated methods is of little importance. The buffer potential of saliva, assessed with a colorimetric test, is the most reliable parameter as it measures an important property of saliva at individual level: the capacity to protect from local acidity. Some studies seem to point to the validity of the combined evaluation of DMF, pH, salivary flow and buffer power of saliva in the prediction of caries at the level of groups of individual, but this has little or no validity in the screening of individual carioreceptive subjects. Specific microbiological cultures for cariogenic microorganisms are the most reliable tests for the diagnosis of carioreceptivity, particularly Dentocult for the search for Streptococcus mutans which is the most important factors in caries. The search for lactobacilli also identifies bad hygienic and dietary habits in the patients.
在本文的第二部分，我们将回顾目前可用于早期诊断龋易感性的主要临床检测方法。仅靠DMF - T指数的测量可以将个体分类为具有致龋活性或评估其“龋齿经历”，但它并不能确定未来患龋的可能性。只有当刺激唾液流量大幅减少时，如在口腔干燥症中出现的情况，测量刺激唾液流量才重要，但仅发现唾液流量几乎正常本身并不足以确定龋易感性的诊断。唾液pH值的评估对于龋易感性筛查不是一个可靠的参数，尽管它可能是所讨论患者疾病（如糖尿病）或不良习惯（如重度吸烟者）的一个指标。因此，使用非常复杂的方法进行检查意义不大。用比色试验评估的唾液缓冲能力是最可靠的参数，因为它在个体水平上测量了唾液的一个重要特性：抵御局部酸度的能力。一些研究似乎表明，在个体群体层面上，联合评估DMF、pH值、唾液流量和唾液缓冲能力对龋齿预测是有效的，但在筛查个体龋易感受试者方面，其有效性很小或没有。针对致龋微生物的特定微生物培养是诊断龋易感性最可靠的检测方法，特别是用于检测变形链球菌的Dentocult，变形链球菌是龋齿最重要的因素。检测乳酸杆菌也能识别患者不良的卫生和饮食习惯。
