Weerheijm K L, Kidd E A, Groen H J
Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands.
Caries Res. 1997;31(1):30-4. doi: 10.1159/000262370.
It has been suggested that the diagnosis of occlusal dentine carious lesions has become more difficult due to the influence of fluoride on the character of pit and fissure surfaces. The issue pertains to the occurrence of hidden caries exemplified by occlusal surfaces judged as clinically sound but showing a radiolucency on the bite-wing radiograph. The aim of this study was to investigate the influence of water fluoridation on the occurrence of hidden caries in clinically sound occlusal surfaces in young people. The data of 515 persons (15 years of age) collected in 1968/1969 as part of the Dutch longitudinal epidemiological Tiel/Culemborg study were used. The participants in Tiel (F) were exposed to artificially fluoridated drinking water (F-concentration 1.1 ppm F) from birth until the end of the data collection. The participants in Culemborg (NF) were not exposed to extra fluoride (F-concentration 0.1 ppm F). In 1994 the status of occlusal surfaces of the first and second molars, as read from bite-wings made in 1968/1969, were judged by 2 investigators. (Cohen's Kappa intra- and inter-examiner agreement 0.90, 0.83 and 0.85, respectively). The original clinical data of 270 inhabitants of Tiel (F) and 245 of Culemborg (NF) were compared with the radiographic judgements. The children examined in Tiel (F) had a mean of 2.54 clinically sound occlusal surfaces in first and second molars (including surfaces with an enamel demineralization only) of which bite-wing radiographs detected 0.43 surfaces (16.9%) with a radiolucency into dentine. In Culemborg (NF) the children had a mean 0.65 clinically sound judged surfaces of which 0.16 (24.6%) showed a radiolucency on the bite-wing films. The results of the investigation show a proportional reduction of surfaces with hidden caries among clinically sound surfaces in the fluoridated area compared to the control.
有人认为，由于氟化物对窝沟表面特征的影响，咬合面牙本质龋损的诊断变得更加困难。这个问题涉及隐匿性龋的发生，以临床上看似正常但在咬合翼片上显示透射影的咬合面为例。本研究的目的是调查水氟化对年轻人临床上正常咬合面隐匿性龋发生的影响。使用了1968/1969年作为荷兰纵向流行病学蒂尔/库伦堡研究的一部分收集的515人（15岁）的数据。蒂尔（F）的参与者从出生到数据收集结束一直饮用人工氟化饮用水（氟浓度1.1 ppm F）。库伦堡（NF）的参与者未接触额外的氟化物（氟浓度0.1 ppm F）。1994年，由2名调查人员根据1968/1969年拍摄的咬合翼片判断第一和第二磨牙咬合面的状况。（检查者内和检查者间的科恩kappa一致性分别为0.90、0.83和0.85）。将蒂尔（F）地区270名居民和库伦堡（NF）地区245名居民的原始临床数据与影像学判断进行比较。在蒂尔（F）接受检查的儿童第一和第二磨牙平均有2.54个临床上正常的咬合面（包括仅釉质脱矿的表面），其中咬合翼片检测到0.43个表面（16.9%）有牙本质透射影。在库伦堡（NF），儿童平均有0.65个临床上判断为正常的表面，其中0.16个（24.6%）在咬合翼片上显示透射影。调查结果显示，与对照组相比，氟化地区临床上正常表面中隐匿性龋表面的比例有所降低。
