Batawi Hisham El, Fakhruddin Kausar Sadia
Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, United Arab Emirates.
Eur J Dent. 2017 Apr-Jun;11(2):168-173. doi: 10.4103/ejd.ejd_120_17.
The present study aimed to assess and monitor patterns of dental caries among primary and permanent molars using Caries Assessment Spectrum and Treatment (CAST) index and to evaluate integration of CAST tool into patient health information (PHI) system of a Teaching Dental Hospital.
Dental records of = 348 children, aged 7-9-years, attending University Dental Hospital Sharjah, for routine checkup and treatment as part of School Dental Program were assessed and translated into CAST codes. Dental caries prevalence for the second primary and first permanent molars were recorded. Spearman's correlation coefficient was used to assess the correlation of the status between primary and permanent molar.
CAST codes 0-2 were observed only in about 3% of primary and almost 5% in permanent dentition. The prevalence of children with diseased first permanent molar (codes 4-7) was almost 67%, while it was over 70% in second primary molars. A strong correlations were observed in the status between second primary and first permanent molars in the lower jaw on both right and left sides, was 0.694 and 0.643 ( = 0.001), respectively. In the upper jaw, both right and left second primary molars revealed moderate correlation = 0.435 ( ≤ 0.05) between disease stages with their neighboring permanent first molars. The unweighted kappa value for the intraexaminer reliability was 0.97 for second primary and 0.95 for first permanent molars.
Our study recommends the integration of CAST tool in the PHI system where a simple numerical value can express clinical progress, overcome interruptions of treatment, and ensures continuity of patient care in teaching hospitals.
本研究旨在使用龋病评估光谱与治疗（CAST）指数评估和监测乳牙及恒牙磨牙的龋病模式，并评估CAST工具纳入教学牙科医院患者健康信息（PHI）系统的情况。
对348名7至9岁在沙迦大学牙科医院参加学校牙科项目进行常规检查和治疗的儿童的牙科记录进行评估，并转换为CAST代码。记录第二乳磨牙和第一恒磨牙的龋病患病率。使用Spearman相关系数评估乳牙和恒牙磨牙状况之间的相关性。
CAST代码0至2仅在约3%的乳牙中观察到，在恒牙列中约为5%。患有第一恒磨牙病变（代码4至7）的儿童患病率近67%，而在第二乳磨牙中超过70%。在下颌左右两侧，第二乳磨牙和第一恒磨牙的状况之间观察到强相关性，分别为0.694和0.643（P = 0.001）。在上颌，左右第二乳磨牙与其相邻的第一恒磨牙在疾病阶段之间显示出中等相关性（P = 0.435，P≤0.05）。检查者内部可靠性的未加权kappa值，第二乳磨牙为0.97，第一恒磨牙为0.95。
我们的研究建议将CAST工具纳入PHI系统，在该系统中一个简单的数值可以表达临床进展，克服治疗中断，并确保教学医院患者护理的连续性。
