Cortes Andrea, Ekstrand Kim Rud, Martignon Stefania
UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia.
Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Int J Paediatr Dent. 2018 Nov 15. doi: 10.1111/ipd.12448.
To describe the 2-year clinical and combined with radiographic caries progression pattern in three cohorts of 2-(a), 4-(b), and 6-yr-old children (c).
Baseline sample comprised 600 children (each-cohort: n = 200). Children's dental surfaces were clinically assessed at schools without air-drying (epi) in terms of: Clinical (C) caries lesions (d/D) with ICDASepi-merged system (C-ICDASepi-d/D:Sound/Initial-epi/Moderate/Extensive); fillings (f/F), and missing teeth (m/M). Clinical ICDAS (C) and Radiographic ICDAS (R) indexes were combined (C + R). Caries experience (dmf + DMF) was expressed as: C-dmfs + DMFS (Moderate/Extensive-d/D); C-ICDASepi-dmfs + DMFS (including Initial-epi-d/D); C + R-dmfs + DMFS; and C + R-ICDASepi-dmfs + DMFS. Follow-up caries progression corresponded to more severe caries score.
Two-year follow-up sample was n = 352 (58.7%-baseline sample): a: n = 81; b: n = 131; c: n = 140. Around 100% of children presented C + R-ICDASepi-dmf + DMF ≥ 1, with following C + R-ICDASepi-dmfs + DMFS means: a: 7.3 ± 14.1; b: 12.2 ± 19.5; c: 13.3 ± 16.9. Progression was about 60% in all cohorts, mainly corresponding, in cohort b and c, to occlusal and distal surfaces of lower first/second-molar-primary teeth, and in cohort a to buccal surfaces of upper primary-incisor teeth. The addition of radiographs increased caries mean and prevalence in 10% as compared to only visual examination.
Children showed a high C + R caries experience progression rate, mainly related to occlusal and proximal surfaces in lower-molar teeth and buccal in upper-incisor teeth.
描述2岁(a组)、4岁(b组)和6岁(c组)三组儿童2年的临床及结合影像学检查的龋病进展模式。
基线样本包括600名儿童(每组n = 200)。在学校不对牙齿表面进行吹干处理的情况下,对儿童的牙面进行临床评估,评估内容包括:采用ICDAS-Epi合并系统评估临床(C)龋损情况(d/D),即C-ICDAS-Epi-d/D:完好/初始龋- Epi/中度/重度;补牙情况(f/F)和缺牙情况(m/M)。将临床ICDAS(C)和影像学ICDAS(R)指数相结合(C + R)。龋病经验(dmf + DMF)的表示方式有:C-dmfs + DMFS(中度/重度-d/D);C-ICDAS-Epi-dmfs + DMFS(包括初始龋-Epi-d/D);C + R-dmfs + DMFS;以及C + R-ICDAS-Epi-dmfs + DMFS。随访时龋病进展表现为龋病严重程度增加。
2年随访样本量为n = 352(占基线样本的58.7%):a组:n = 81;b组:n = 131;c组:n = 140。约100%的儿童C + R-ICDAS-Epi-dmf + DMF≥1,C + R-ICDAS-Epi-dmfs + DMFS的均值如下:a组:7.3±14.1;b组:12.2±19.5;c组:13.3±16.9。所有队列的进展率约为60%,在b组和c组中,主要发生在第一/二乳磨牙的咬合面和远中面,在a组中主要发生在上颌乳切牙的颊面。与仅进行视觉检查相比,增加影像学检查使龋病均值和患病率提高了10%。
儿童的C + R龋病进展率较高,主要与下颌磨牙的咬合面和邻面以及上颌切牙的颊面有关。