Sudhir Kudlure M, Kanupuru Karthik K, Fareed Nusrath, Mahesh Pulagam, Vandana Kuna, Chaitra Nelagondanahalli T
Oral Health Prev Dent. 2016;14(4):355-62. doi: 10.3290/j.ohpd.a35621.
To evaluate CAMBRA (Caries Management by Risk Assessment) as a tool for caries risk prediction among 12- to 13-year-old institutionalised children and to validate it against the new increment of caries lesions.
A longitudinal follow-up study was conducted among 72 institutionalised children. Baseline data were collected in the month of August, 2011. Children were individually interviewed to record the nonclinical information necessary to complete the CAMBRA. Clinical information for the assessment of visible plaque was recorded using the Silness and Löe plaque index and evidence of decalcification and caries was recorded using ICDAS criteria. The children underwent the follow-up examination in August 2013 to determine the new increment of dental caries.
19.44% of the subjects were classified as low risk, 22.22% as moderate risk, and 58.33% as high risk for caries. The highest odds ratio (OR) for disease indicators was 7.31 for restorations in the last 3 years. The highest OR for pathological factors was 7.15 for mutans streptococci, followed by 5.54 for visible heavy plaque. The highest OR for protective factors was 0.56, i.e. a negative association of fluoride toothpaste. Among those subjects assessed as moderate and high risk for caries at baseline, 37.5% and 47.6%, respectively, had new cavities at the follow-up examination. Sensitivity for CAMBRA was found to be 47.62% with a specificity of 80%, and the area under the ROC curve was found to be 0.638.
CAMBRA was valid and highly predictive in determining the caries risk among institutionalised children.
评估基于风险评估的龋病管理（CAMBRA）作为预测12至13岁机构收养儿童龋病风险的工具，并根据龋损的新增加情况对其进行验证。
对72名机构收养儿童进行纵向随访研究。2011年8月收集基线数据。对儿童进行单独访谈，以记录完成CAMBRA所需的非临床信息。使用希尔尼斯和勒 plaque指数记录用于评估可见菌斑的临床信息，并使用国际龋病检测与评估系统（ICDAS）标准记录脱矿和龋病证据。2013年8月对儿童进行随访检查，以确定龋齿的新增加情况。
19.44%的受试者被分类为低风险，22.22%为中度风险，58.33%为高龋病风险。疾病指标的最高比值比（OR）为过去3年修复体的7.31。病理因素的最高OR为变形链球菌的7.15，其次是可见重度菌斑的5.54。保护因素的最高OR为0.56，即与含氟牙膏呈负相关。在基线时被评估为中度和高龋病风险的受试者中，分别有37.5%和47.6%在随访检查时有新龋洞。发现CAMBRA的敏感性为47.62%，特异性为80%，ROC曲线下面积为0.638。
CAMBRA在确定机构收养儿童的龋病风险方面是有效的且具有高度预测性。
