Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Department of Cariology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Am J Orthod Dentofacial Orthop. 2020 Jul;158(1):92-101.e3. doi: 10.1016/j.ajodo.2019.07.017. Epub 2020 May 21.
Dental caries is an undesirable side effect of orthodontic treatment with fixed appliances. Caries lesions can result in long-term esthetic disturbance, costly interventions, and even interrupted treatment. Therefore, it is crucial to assess accurately both a patient's caries risk before treatment and their suitability for orthodontic treatment. This study aimed to evaluate the validity of 5 caries risk assessment methods for predicting caries outcome during orthodontic treatment: Cariogram, Caries Management by Risk Assessment (CAMBRA), R2, decayed filled teeth (DFT), and decayed initial filled surfaces (DiFS).
A prospective longitudinal clinical study of 270 adolescents who were referred to the Specialist Clinic for Orthodontics, Mölndal Hospital, Sweden for treatment with fixed orthodontic appliances. The following data were collected before treatment: plaque index, radiographs to determine caries prevalence (DFT, DiFS), photographs to determine white-spot lesions, saliva samples (Streptococcus mutans and Lactobacilli), and responses to a questionnaire (regarding diet and oral hygiene). The variables were compiled to assess caries risk according to Cariogram, CAMBRA, and R2. Radiographs were also taken posttreatment to assess caries incidence. The caries outcomes after treatment were analyzed and compared with the caries risk, assessed by the caries risk assessment methods at baseline.
DiFS proved to be the most reliable method for predicting caries during orthodontic treatment, presenting the highest area under the receiver operating characteristic curve for both manifest caries (0.77) and initial caries (0.71).
The DiFS prevalence index was demonstrated to be useful in identifying patients who are at risk for developing manifest and initial caries during orthodontic treatment.
正畸固定矫治器治疗的一个不良副作用是龋齿。龋齿病变可导致长期的美观障碍、昂贵的干预措施，甚至中断治疗。因此，准确评估治疗前患者的龋齿风险及其是否适合正畸治疗至关重要。本研究旨在评估 5 种龋齿风险评估方法预测正畸治疗中龋齿结果的有效性：龋齿风险评估（Cariogram）、风险评估的龋齿管理（CAMBRA）、R2、龋坏充填牙数（DFT）和初期龋充填面数（DiFS）。
这是一项在瑞典莫尔纳达尔医院正畸专科诊所接受固定正畸治疗的 270 名青少年的前瞻性纵向临床研究。在治疗前收集了以下数据：菌斑指数、确定龋齿流行程度的射线照片（DFT、DiFS）、确定白斑病变的照片、唾液样本（变形链球菌和乳杆菌）以及问卷调查的回答（关于饮食和口腔卫生）。根据 Cariogram、CAMBRA 和 R2 评估龋齿风险，将这些变量进行编译。治疗后还拍摄了射线照片以评估龋齿的发生情况。分析治疗后的龋齿结果，并与基线时龋齿风险评估方法评估的龋齿风险进行比较。
DiFS 被证明是预测正畸治疗中龋齿的最可靠方法，其表现出最高的显性龋和初期龋的受试者工作特征曲线下面积（分别为 0.77 和 0.71）。
DiFS 流行率指数在识别正畸治疗中发生显性龋和初期龋风险较高的患者方面具有一定的实用价值。
