Feldens Carlos Alberto, Braga Vanessa Simas, Kramer Paulo Floriani, Vítolo Márcia Regina, Rodrigues Priscila Humbert, de Barros Coelho Elisa Maria Rosa, Chaffee Benjamin W
Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil.
Department of Pediatric Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
Caries Res. 2023;57(2):167-176. doi: 10.1159/000529620. Epub 2023 Feb 13.
The aims of this study were to estimate the risk of caries in the permanent teeth at 12 years of age and to describe the diagnostic accuracy of caries patterns in the primary dentition at age 4 years to predict caries at age 12 years. A prospective cohort study followed children from birth to age 12 years in the city of São Leopoldo, Brazil. Sociodemographic variables were collected at birth, and dental caries was measured at 4 and 12 years of age (n = 204). At 4 years, children were classified according to the presence of caries (cavitated and non-cavitated lesions), number of lesions, affected segment (anterior or posterior), and affected surface (occlusal, smooth, or proximal). Prediction of permanent dentition caries occurrence (DMFT ≥1) (primary outcome) involved Poisson regression with robust variance and standard diagnostic accuracy measures. The prevalences of caries at age 4 years (including non-cavitated lesions) and 12 years were 61.8% and 42.2%, respectively. All caries patterns in the primary dentition were associated with caries in the permanent dentition. In multivariable analysis, the strongest associations were carious lesions on the primary posterior teeth (RR 2.2; 95% CI 1.5-3.2) and occlusal surfaces (RR 2.1; 95% CI 1.4-3.0). Among patterns evaluated, the presence of any tooth with caries (cavitated or non-cavitated) had the highest sensitivity (73%), but any tooth with cavitated decay had the highest accuracy (67%). In conclusion, any dental caries experience in early childhood is strongly predictive of dental caries experience in early adolescence. Primary dentition carious lesions on the posterior teeth or occlusal surfaces and the presence of cavitated lesions were stronger predictors.
本研究的目的是评估12岁时恒牙患龋风险，并描述4岁时乳牙列龋病模式对12岁时龋齿的诊断准确性。一项前瞻性队列研究追踪了巴西圣莱奥波尔多市从出生到12岁的儿童。出生时收集社会人口统计学变量，并在4岁和12岁时测量龋齿情况（n = 204）。4岁时，根据龋齿情况（龋洞和非龋洞病变）、病变数量、受影响区段（前部或后部）和受影响表面（咬合面、平滑面或邻面）对儿童进行分类。恒牙列龋齿发生情况（DMFT≥1）（主要结局）的预测采用稳健方差的泊松回归和标准诊断准确性指标。4岁（包括非龋洞病变）和12岁时的龋齿患病率分别为61.8%和42.2%。乳牙列中的所有龋病模式均与恒牙列龋齿有关。在多变量分析中，最强的关联是乳牙后牙的龋损（RR 2.2；95%CI 1.5 - 3.2）和咬合面（RR 2.1；95%CI 1.4 - 3.0）。在所评估的模式中，任何有龋齿（龋洞或非龋洞）的牙齿敏感性最高（73%），但任何有龋洞的牙齿准确性最高（67%）。总之，幼儿期的任何龋齿经历都能强烈预测青春期早期的龋齿经历。后牙或咬合面的乳牙列龋损以及龋洞病变的存在是更强的预测因素。
