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与儿童恒磨牙新生龋损相关的风险因素:一项为期 5 年的历史性队列随访研究。

Risk factors associated with new caries lesions in permanent first molars in children: a 5-year historical cohort follow-up study.

机构信息

Department of Stomatology, Facultad de Medicina y Odontología, Universitat de València, C/Gascó Oliag 1, 46010, Valencia, Spain.

出版信息

Clin Oral Investig. 2018 Apr;22(3):1579-1586. doi: 10.1007/s00784-017-2253-5. Epub 2017 Oct 23.

Abstract

OBJECTIVE

The objective of this study is to analyze the factors associated with the occurrence of caries in the permanent teeth (PT) and in the permanent first molar (PFM) 5 years after their eruption.

MATERIAL AND METHODS

Children born in 2005 and enrolled in a community dental program were included. The inclusion criteria were: age 10 years in 2015; the availability of clinical dental history (CDH) data from before eruption of the PT and a follow-up period of 5 years after eruption of the PT. A total of 206 children were enrolled. Risk factors evaluated were: caries experience in the mother, educational level of the mother, frequent drug use, systemic diseases, eating habits, brushing frequency, presence of molar incisor hypomineralization (MIH) in PT, and caries in deciduous teeth (DT). Associations between explanatory factors and the DMF-T (decayed, missing, filled teeth in PT) and DMFT-M (DMF in PFM) indexes, independently considering cavitated or cavitated and non-cavitated caries as outcomes, were evaluated by poisson regression with robust variance analysis.

RESULTS

In the multivariate analysis, a cariogenic diet, especially soft drinks, was associated to high DMF-T and DMFT-M scores when both cavitated and non-cavitated caries were considered. A brushing frequency < 1 a day was significantly associated to high DMF-T scores. The presence of df-t (decayed and filled temporary teeth) score > 0 and MIH conditioned high DMF-T or DMFT-M values, considering cavitated or cavitated and non-cavitated caries.

CONCLUSIONS

The intake of sweets and soft drinks, brushing frequency, caries in DT, and MIH in PT were the best predictors of caries in PT.

CLINICAL RELEVANCE

Control of risk factors in early childhood is important for preventing caries in PT.

摘要

目的

本研究旨在分析恒牙(PT)和第一恒磨牙(PFM)萌出后 5 年发生龋齿的相关因素。

材料和方法

纳入 2005 年出生并参加社区牙科项目的儿童。纳入标准为:2015 年 10 岁;PT 萌出前的临床牙科史(CDH)数据可用,且随访时间为 PT 萌出后 5 年。共纳入 206 名儿童。评估的危险因素有:母亲的龋齿经历、母亲的教育水平、频繁使用药物、系统疾病、饮食习惯、刷牙频率、PT 中存在低矿化磨牙(MIH)以及乳牙(DT)龋齿。采用泊松回归分析具有稳健方差分析的方法,评估解释因素与 DMF-T(PT 中龋齿、缺失、填充的牙齿)和 DMFT-M(PFM 中的 DMF)指数之间的关系,分别考虑有腔或无腔龋齿的结局。

结果

在多变量分析中,致龋饮食,尤其是软饮料,与考虑有腔和无腔龋齿时较高的 DMF-T 和 DMFT-M 评分相关。每天刷牙频率<1 次与较高的 DMF-T 评分显著相关。df-t(龋齿和填充的临时牙齿)评分>0 以及 MIH 与考虑有腔或有腔和无腔龋齿时较高的 DMF-T 或 DMFT-M 值相关。

结论

甜食和软饮料的摄入、刷牙频率、DT 龋齿和 PT 中的 MIH 是预测 PT 龋齿的最佳指标。

临床意义

控制儿童早期的危险因素对于预防 PT 龋齿很重要。

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