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无活性龋损的长期随访:4-5 年的结果。

Long-term follow-up of inactive occlusal caries lesions: 4-5-year results.

机构信息

School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.

Department of Stomatology, School of Dentistry - UFSM, Floriano Peixoto 1184, Santa Maria, RS, 97015-372, Brazil.

出版信息

Clin Oral Investig. 2019 Feb;23(2):847-853. doi: 10.1007/s00784-018-2498-7. Epub 2018 Jun 8.

Abstract

OBJECTIVE

To assess the clinical behavior of inactive caries lesion on the occlusal sites of permanent molars over 4-5 years and to estimate the risk for progression of caries-inactive sites compared with sound ones.

METHODS

Clinical examinations were conducted at baseline (n = 258) and after 4-5 years and included the recording of dental plaque and dental caries at the occlusal surfaces and the eruption stage of each permanent molar.

RESULTS

One hudred ninety-three schoolchildren were followed (response rate of 74.8%), totalizing 1152 teeth. Of the children, 30.6% (n = 59) presented at least one molar containing an active lesion, filling, or that had been extracted; according to the activity criterion, inactive lesions presented around a twofold increased risk for caries progression than sound surfaces (OR = 2.34 95%CI = 1.51-3.62). Thirteen percent (n = 25) of the children presented at least one molar progressing to dentine cavity, filling, or extraction; according to the severity criterion, inactive caries lesions presented a significantly higher risk for progression when compared with sound surfaces (OR = 2.69, 95% CI = 1.50-4.83).

CONCLUSION

The vast majority of lesions (85-90%) identified as inactive enamel caries at baseline did not progress over 4-5 years. Despite this fact, it was possible to detect an increased risk for caries progression in caries-inactive occlusal sites compared with the sound ones.

CLINICAL RELEVANCE

Considering the low progression rates, inactive caries lesions do not need a specific caries-controlling treatment and should be monitored longitudinally in the same manner as sound surfaces.

摘要

目的

评估磨牙咬合面静止龋损在 4-5 年内的临床行为,并评估与健康表面相比,龋损静止部位发生进展的风险。

方法

基线时(n=258)和 4-5 年后进行临床检查,包括记录磨牙咬合面和萌出阶段的牙菌斑和龋齿。

结果

193 名儿童得到随访(应答率为 74.8%),共 1152 颗牙。其中 30.6%(n=59)的儿童至少有一颗磨牙有活跃病变、补牙或已被拔除;根据活动性标准,静止性病变发生龋病进展的风险比健康表面高两倍(OR=2.34,95%CI=1.51-3.62)。13%(n=25)的儿童至少有一颗磨牙进展为牙本质龋、补牙或拔除;根据严重程度标准,与健康表面相比,静止性龋损发生进展的风险显著更高(OR=2.69,95%CI=1.50-4.83)。

结论

在基线时被诊断为静止性釉质龋的绝大多数病变(85-90%)在 4-5 年内没有进展。尽管如此,与健康表面相比,龋损静止的咬合面仍存在龋病进展的风险增加。

临床意义

考虑到低进展率,静止性龋损不需要专门的龋病控制治疗,应与健康表面一样进行纵向监测。

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