在早期恒牙中，使用 DMFT、ICDAS II 和 CAST 评估龋齿诊断阈值对第一恒磨牙龋齿患病率的估计——一项横断面研究。
Assessment of caries diagnostic thresholds of DMFT, ICDAS II and CAST in the estimation of caries prevalence rate in first permanent molars in early permanent dentition-a cross-sectional study.
机构信息
Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Al Jouf, Saudi Arabia.
Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Al Jouf, Saudi Arabia.
出版信息
BMC Oral Health. 2022 Apr 20;22(1):133. doi: 10.1186/s12903-022-02134-0.
BACKGROUND
The actual burden of dental caries prevalence varies with the caries assessment tool used. Therefore, the present study evaluated the caries diagnostic potentials of Decayed, Missing and Filled Teeth (DMFT); International Caries Detection and Assessment System (ICDAS) II and Caries Assessment Spectrum and Treatment (CAST) indices in estimating the caries prevalence rate of first permanent molar (FPM) in Saudi male children aged 7-9 years.
METHODS
This descriptive, cross-sectional study included 390 children by multistage stratified cluster sampling method in Al-Jouf Province, Saudi Arabia. The prevalence rates of FPM caries were determined by DMFT, ICDAS II and CAST indices at various diagnostic cut-off points. Intra- and inter-examiner reliability was determined.
RESULTS
The prevalence rates of FPM caries determined by DMFT (decayed), ICDAS II (codes 1-6) and CAST (codes 3-7) were 64.4% (61.6-67.2), 71.5% (69.2-73.2) and 71.0% (68.7-73.3), respectively. The prevalence rates of FPM caries determined by ICDAS II at various diagnostic cut-offs were as follows: 'sound' (code '0'), 28.5% (26.3-30.8); 'enamel caries' (codes 1-3), 57.2% (54.7-59.7) and 'dentinal caries' (codes 4-6), 14.3% (12.6-16.1). Similarly, the prevalence rates estimated by CAST at different diagnostic cut-off points were: 'healthy' (scores 0-2), 28.1% (25.9-30.4); 'premorbid' (score 3, enamel carious), 56.5% (54.0-59.0); 'morbid' (scores 4-5, cavitated carious dentin), 7.9% (6.6-9.3); 'severe morbidity' (scores 6-7, pulp exposure/fistula/abscess), 6.6% (5.4-8.1) and 'mortality' (score 8, lost), 0.8% (0.4-1.4).
CONCLUSION
Enamel caries lesions were found in more than half of the FPMs investigated in the current study. CAST index is preferable because it detects the complete spectrum of caries. ICDAS II at codes 1-6 and CAST at codes 3-7 projected similar caries prevalence rates in FPMs.
背景
龋齿流行率的实际负担因使用的龋齿评估工具而异。因此，本研究评估了 Decayed、Missing 和 Filled Teeth (DMFT)、International Caries Detection and Assessment System (ICDAS) II 和 Caries Assessment Spectrum and Treatment (CAST) 指数在估计沙特阿拉伯 7-9 岁男童第一恒磨牙 (FPM) 龋齿流行率方面的龋齿诊断潜力。
方法
本描述性、横断面研究采用多阶段分层聚类抽样法在沙特阿拉伯焦夫省纳入了 390 名儿童。通过 DMFT、ICDAS II 和 CAST 指数在不同诊断截止点确定 FPM 龋齿的患病率。确定了内部和外部检验员的可靠性。
结果
DMFT（龋齿）、ICDAS II（代码 1-6）和 CAST（代码 3-7）确定的 FPM 龋齿患病率分别为 64.4%（61.6-67.2）、71.5%（69.2-73.2）和 71.0%（68.7-73.3）。在不同诊断截止点使用 ICDAS II 确定的 FPM 龋齿患病率如下：“完好”（代码“0”），28.5%（26.3-30.8）；“釉质龋”（代码 1-3），57.2%（54.7-59.7）和“牙本质龋”（代码 4-6），14.3%（12.6-16.1）。同样，在不同诊断截止点使用 CAST 估计的患病率为：“健康”（评分 0-2），28.1%（25.9-30.4）；“前驱期”（评分 3，釉质龋），56.5%（54.0-59.0）；“患病期”（评分 4-5，有腔洞的牙本质龋），7.9%（6.6-9.3）；“严重患病期”（评分 6-7，牙髓暴露/瘘管/脓肿），6.6%（5.4-8.1）和“死亡期”（评分 8，丧失），0.8%（0.4-1.4）。
结论
在当前研究中，调查的大多数 FPM 中都发现了釉质龋损。CAST 指数更可取，因为它可以检测到完整的龋齿谱。ICDAS II 代码 1-6 和 CAST 代码 3-7 预测 FPM 龋齿的患病率相似。
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