J Am Dent Assoc. 2019 Oct;150(10):873-882. doi: 10.1016/j.adaj.2019.05.025. Epub 2019 Aug 28.
Adenosine triphosphate bioluminescence (ATP-B) readings have been proposed as markers of caries risk. ATP readings may indicate bacteria or oral streptococci activity in microbial plaque. The authors of this study aimed to evaluate whether readings using a commercial ATP meter (CariScreen Testing Meter, Oral BioTech) are significantly different for patients with low, moderate, and high caries risk in the Caries Management by Risk Assessment Practice-Based Research Network study.
Twenty practice-based research network dentists enrolled 460 patients; 271 returned for 2 or more semiannual follow-up visits over 2 years. Dentists were trained and calibrated to perform ATP-B testing and caries risk assessment (CRA) using established protocols. ATP-B readings were compared via CRA category (low, moderate, high). Generalized estimating equations were used to compare the risk of experiencing incident clinical outcomes (newly recorded decayed, missing, or restored tooth surfaces and CRA disease indicators) according to ATP-B reading at prior patient visits (≥ 1,500 versus < 1,500 relative light units).
Median ATP-B readings did not differ statistically significantly by clinician-assessed caries risk level (low, 2,323; moderate, 2,940; high, 3,217; P = .65). Adjusted for patient demographics and trial intervention assignment, higher readings were not associated with newly developed decayed, missing, or restored tooth surface (relative risk, 1.57; 95% confidence interval, 0.55 to 4.45) or disease indicators (relative risk, 1.08; 95% confidence interval, 0.85 to 1.37) at the following visit, whereas clinician-assessed caries risk level was strongly associated.
ATP-B readings poorly predicted caries risk and future clinical outcomes. CRA incorporating multiple risk, protective, and disease indicators has superior predictive performance.
The findings of this study do not provide evidence supporting the use of ATP-B to predict caries risk.
三磷酸腺苷生物发光（ATP-B）读数已被提议作为龋齿风险的标志物。ATP 读数可能表明微生物菌斑中细菌或口腔链球菌的活性。本研究的作者旨在评估在龋齿管理风险评估实践研究网络研究中，使用商业 ATP 计（CariScreen 测试计，Oral BioTech）对低、中、高龋齿风险患者的读数是否存在显著差异。
20 位基于实践的研究网络牙医招募了 460 名患者；271 名患者在 2 年内返回了 2 次或更多次半年随访。牙医经过培训并根据既定方案进行 ATP-B 测试和龋齿风险评估（CRA）。通过 CRA 类别（低、中、高）比较 ATP-B 读数。使用广义估计方程比较根据先前患者就诊时的 ATP-B 读数（≥1500 与<1500 相对光单位）发生新记录的龋齿、缺失或修复牙面以及 CRA 疾病指标的临床结局的风险。
按临床医生评估的龋齿风险水平，ATP-B 读数中位数无统计学显著差异（低风险，2323；中风险，2940；高风险，3217；P=0.65）。调整患者人口统计学和试验干预分配后，较高的读数与新出现的龋齿、缺失或修复牙面（相对风险，1.57；95%置信区间，0.55 至 4.45）或疾病指标（相对风险，1.08；95%置信区间，0.85 至 1.37）无关，而临床医生评估的龋齿风险水平具有很强的相关性。
ATP-B 读数不能很好地预测龋齿风险和未来的临床结局。包含多个风险、保护和疾病指标的 CRA 具有更好的预测性能。
本研究的结果并未提供支持使用 ATP-B 预测龋齿风险的证据。
