Alaluusua S, Kleemola-Kujala E, Grönroos L, Evälahti M
Institute of Dentistry, University of Helsinki, Finland.
Oral Microbiol Immunol. 1990 Apr;5(2):77-81. doi: 10.1111/j.1399-302x.1990.tb00231.x.
The aim of the study was to evaluate the capability of caries-related salivary tests and a test based on past caries experience (baseline DFS) to select persons at high risk for caries. The subjects (n = 122) were 12-17 years old at the beginning of the study. Caries was registered and salivary samples were taken annually during the 3-study period. The 3-year caries increment was positively correlated to the baseline DFS (r = 0.46, p less than 0.001), salivary level of mutans streptococci (r = 0.30, p less than 0.001) and lactobacilli (r = 0.30, p less than 0.001), and combined level of mutans streptococci and lactobacilli (r = 0.39, p less than 0.001) and negatively correlated to the buffering capacity of saliva (r = -0.22, p less than 0.05). Tests based on either past caries experience or mutans streptococci or lactobacilli levels alone were not efficient in selecting persons at high risk for caries. Among the tests, DFS was the most sensitive and specific. A combination of either microbial test and DFS was more efficient to select persons at risk than various alternatives alone. The sensitivity was 84% and the specificity 62% for the combination of lactobacilli test and DFS and 71% and 79% respectively for the combination of mutans streptococci and DFS. In the former combination the positive prediction value was 43% and in the latter 56%.
本研究的目的是评估与龋齿相关的唾液检测以及基于既往龋齿经历（基线DFS）的检测筛选龋齿高危人群的能力。研究开始时，受试者（n = 122）年龄在12至17岁之间。在3年的研究期间，每年记录龋齿情况并采集唾液样本。3年龋齿增量与基线DFS呈正相关（r = 0.46，p < 0.001）、变异链球菌唾液水平（r = 0.30，p < 0.001）和乳酸杆菌（r = 0.30，p < 0.001）以及变异链球菌和乳酸杆菌的联合水平（r = 0.39，p < 0.001），与唾液缓冲能力呈负相关（r = -0.22，p < 0.05）。仅基于既往龋齿经历或变异链球菌或乳酸杆菌水平的检测在筛选龋齿高危人群方面效率不高。在这些检测中，DFS最敏感且特异。微生物检测与DFS的组合在筛选高危人群方面比单独的各种方法更有效。乳酸杆菌检测与DFS组合的敏感性为84%，特异性为62%；变异链球菌与DFS组合的敏感性和特异性分别为71%和79%。在前一种组合中，阳性预测值为43%，后一种为56%。
