Hujoel P P, Mäkinen K K, Bennett C B, Isokangas P J, Isotupa K P, Pape H R, Lamont R J, DeRouen T A, Davis S
Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle 98195, USA.
Caries Res. 1995;29(6):461-6. doi: 10.1159/000262115.
Dental caries explorers may become contaminated during routine caries examinations with pathogenic organisms and thereby potentially transmit infections from one tooth to another within a patient. The purpose of this study was to test the hypothesis that the contamination status of explorers influenced the caries risk of second molars. Two explorer contamination statuses were defined: (1) contamination status 1--explorers which had probed a carious molar just prior to examining the second molar, and (2) contamination status 2--sterile explorers versus explorers which had probed several teeth. Caries examinations were performed by 4 dentists on a cohort of 4th grade students in Belize City. The examination dates and sample sizes (n) were: September-October 1989 (n = 1,277), January 1991 (n = 1,111), and January 1992 (n = 961), and January-February 1993 (n = 861). Within this cohort, there were 221 subjects who (1) had at least one pit and fissure carious onset on a caries-free second molar, (2) had no evidence of dental treatments, and (3) were examined by the same examiner during the entire study. After adjusting for confounding variables, the examination of a second molar with a dental caries explorer in either contamination status 1 or 2 had no substantial effect on the caries risk (rate ratio 0.95, 95% confidence interval: 0.77-1.18, and rate ratio 1.18, 95% confidence interval: 0.89-1.56, respectively). If a true rate ratio of 1.7 or greater was associated with the contamination status 1 and 2, these analyses had more than 99 and 80% probability of detecting it, respectively.
Examining a sound second molar with a contaminated dental explorer either does not affect the caries risk, or results in such a small increase in caries risk that it can only be reliably identified in studies where the exposure of sound teeth to contaminated dental explorers is randomized.
在常规龋齿检查期间，龋齿探针可能会被致病生物体污染，从而有可能在患者体内将感染从一颗牙齿传播到另一颗牙齿。本研究的目的是检验以下假设：探针的污染状况会影响第二磨牙的龋齿风险。定义了两种探针污染状况：（1）污染状况1——在检查第二磨牙之前刚刚探查过一颗龋齿磨牙的探针，以及（2）污染状况2——无菌探针与探查过几颗牙齿的探针。4名牙医对伯利兹城一群四年级学生进行了龋齿检查。检查日期和样本量（n）分别为：1989年9月至10月（n = 1277）、1991年1月（n = 1111）、1992年1月（n = 961）以及1993年1月至2月（n = 861）。在这个队列中，有221名受试者：（1）在一颗无龋的第二磨牙上至少有一处窝沟龋发病，（2）没有牙科治疗的证据，并且（3）在整个研究期间由同一名检查者进行检查。在对混杂变量进行调整后，使用处于污染状况1或2的龋齿探针检查第二磨牙对龋齿风险没有实质性影响（率比分别为0.95，9 5%置信区间：0.77 - 1.18；以及率比1.18，95%置信区间：0.89 - 1.56）。如果污染状况1和2与真实率比1.7或更高相关，这些分析分别有超过99%和80%的概率检测到它。
用受污染的龋齿探针检查健康的第二磨牙要么不会影响龋齿风险，要么只会使龋齿风险有极小的增加，以至于只有在将健康牙齿暴露于受污染的龋齿探针的情况进行随机化的研究中才能可靠地识别出来。
