Ou-Yang Li-Wei, Chang Pei-Ching, Tsai Aileen I, Jaing Tang-Her, Lin Shiao-Yu
Department of Pediatric Dentistry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan (Republic of China).
Pediatr Dent. 2010 May-Jun;32(3):218-22.
The aim of this study was to evaluate the caries activity in children undergoing maintenance stage chemotherapy courses.
Forty-six children with acute lymphoblastic leukemia (ALL) were examined, the age ranged from 3 to 12 years with a mean age of 7(1/2) years. They were under maintenance stage chemotherapy at the Department of Pediatric Hematology of Chang-Gung Memorial Hospital, Taoyuan, Taiwan. A control group of healthy children was recruited by age and sex-matching criteria. The children received only a clinical dental examination without radiographs. Decayed (D), Missing (M), and Filled (F) Tooth surfaces (S) scores were recorded following the WHO criteria. After oral examination, stimulated saliva samples were collected from the subjects to exam the salivary Streptococcus mutans counts, salivary lactobacilli counts and salivary buffer capacity.
The Wilcoxon signed-rank test shows that the salivary Streptococcus mutans counts in ALL children were significantly lower than healthy subjects (P<.001) and lactobacilli counts were similar on both groups (P=.47). However, the ALL group tended to have lower salivary buffer capacity than the control group (P=.002). The mean DEFTS/DMFTS scores of the ALL group were higher than the control group, but the differences did not reach statistical significance.
Specific oral prevention regimens for ALL children undergoing chemotherapy should be planned for patients with unusually low salivary buffer capacity.
本研究旨在评估处于化疗维持阶段的儿童的龋齿活动情况。
对46例急性淋巴细胞白血病（ALL）患儿进行检查，年龄范围为3至12岁，平均年龄为7（1/2）岁。他们在台湾桃园长庚纪念医院儿科血液科接受化疗维持治疗。根据年龄和性别匹配标准招募了一组健康儿童作为对照组。这些儿童仅接受了临床口腔检查，未进行X光检查。按照世界卫生组织标准记录龋失补牙面（DMFS）评分。口腔检查后，从受试者中收集刺激唾液样本，以检测唾液变形链球菌计数、唾液乳杆菌计数和唾液缓冲能力。
Wilcoxon符号秩检验显示，ALL患儿的唾液变形链球菌计数显著低于健康受试者（P<0.001），两组的乳杆菌计数相似（P=0.47）。然而，ALL组的唾液缓冲能力往往低于对照组（P=0.002）。ALL组的平均龋失补牙面（DMFS）/龋面均（defs）评分高于对照组，但差异未达到统计学意义。
对于唾液缓冲能力异常低的接受化疗的ALL患儿，应制定特定的口腔预防方案。
