儿童唾液变形链球菌与患龋状况关系的研究

目的：探讨唾液变形链球菌与儿童龋病的关系。方法：通过口腔健康检查,问卷调查等全面了解并分析350名3～7岁在园儿童龋患情况及影响乳牙龋病发生的危险因素。采用直接接种轻唾培养基法检测唾液中变形链球菌浓度,探讨其与患龋情况的关系。结果：350名被检儿童中263名患龋,总患龋率75.14%,龋均4.73,龋面均11.11。单因素分析显示年龄、牛奶或饮用水加糖、吃甜食及糖果糕点次数、父亲刷牙情况及月家庭经济收入与儿童的龋患程度相关（P〈0.05）。多因素回归分析显示年龄、牛奶或饮水加糖、每日进食糖果糕点次数、父亲刷牙情况是乳牙龋的重要影响因素。350例儿童唾液变形链球菌菌落数中位数为1.61×105 CFU/mL,无龋（dmfs=0）、低龋（1≤dmft〈6）、高龋（dmfs≥6）儿童间变形链球菌浓度差异有统计学意义（P〈0.05）。其中184名早期入园的儿童通过为期一年的追踪观察显示唾液变形链球菌浓度与新增dmfs呈正相关关系。结论：儿童唾液变形链球菌浓度与龋患严重程度以及龋活跃性相关。     

同一个体乳牙患龋状况的变化——135名幼儿三年追踪观察分析

１９９４～１９９６年，作者对上海医科大学附属幼儿园１３５名幼儿，进行乳牙患龋状况的３年追踪观察．结果表明：１３５名幼儿的患龋率、ｄｆｔ和ＣＳＩ在性别间均无显著性差异（ｐ＞０．０５）．患龋率、ｄｔｆ在７岁前随年龄的增长而升高，但本文之幼儿在１９９６年时的患龋率、ｄｆｔ与１９９０年上海市同年龄幼儿相比，有所下降．３年的ＣＳＩ仅一个年龄组有高度显著性差异（ｐ＜０．０１），另两个年龄组均无统计学意义（ｐ＞０．０５）．由此可肯定，乳牙患龋率在７岁前随着年龄的增长而升高．而良好的口腔保健工作可以控制龋病的进一步发展     

幼儿唾液中的钙含量及其与患龋状况的关系

目的 :探讨幼儿唾液中的离子钙、总钙含量及两者比值与患龋状况的关系。方法 :将 99名 3～ 5岁乳牙列期儿童依据龋患程度分为无龋组、龋病低危组与高危组。采用原子吸收光谱仪 (火焰法 )和离子选择性电极对三组儿童唾液中的总钙含量 (Ca)和离子钙含量 (Ca2 + )分别测定 ,并计算两者比值 (Ca2 + /Ca) ,统计分析此三种指标与患龋状况的关系。结果 :受检乳牙列期儿童唾液中离子钙含量为 (0 .15 8± 0 .0 4 3)mmol/L ,总钙含量 (1.4 36± 0 .30 0 )mmol/L ,离子钙 /总钙含量值为 0 .112。三项指标在性别间无显著性差异(P >0 .0 5 )。唾液离子钙与总钙含量在无龋组、龋病低危组、龋病高危组之间无统计学差异 (P >0 .0 5 ) ,但无龋组的离子钙 /总钙比值高于龋病低危组与高危组 ,有显著性差异 (P <0 .0 5 )。结论 :乳牙列期儿童唾液中离子钙或总钙含量并不能反映个体的龋患状况 ,但离子钙与总钙的比值或可作为评价儿童患龋状况的一个参考指标。     

学龄前儿童患龋率与生长发育的关系探讨

目的探讨学龄前儿童生长发育水平与乳牙患龋率的关系。方法对西安市不同区域6所幼儿园中班、大班2 307名4～6岁儿童进行龋病流行病学及身高、体重的调查,计算Kaup指数以评价儿童生长发育水平,比较不同生长发育水平儿童的患龋率、龋失补牙数及龋失补牙面数。结果过度肥胖的儿童患龋率最高,为68.4%;生长发育水平优良的儿童患龋率最低,为43.8%;瘦及过度肥胖的儿童患龋率明显高于生长发育优良的儿童,差异有统计学意义（χ^2=14.690,P=0.000）。各生长发育水平儿童的龋失补牙数（F=2.137,P=0.054）、龋失补牙面数（F=1.305,P=0.259）的差异无统计学意义。不同生长发育水平儿童龋面充填构成比的差异有统计学意义（χ^2=14.690,P=0.000）。结论儿童乳牙龋与生长发育的关系密切,儿童瘦或过度肥胖都是一种非健康的表征,应尽快提高家长乃至全社会对儿童龋病危害的认识。     

儿童唾液富酪蛋白与患龋状况的分析研究

目的：应用高效液相色谱法（high performance liquid chromatography,HPLC）测量儿童全唾液富酪蛋白浓度,分析全唾液富酪蛋白浓度与患龋状况之间的关系。方法：采集20名4～6岁龋病高危组（Caries-Susceptible,CS组,dft≥5且CSI≥10）及23名无龋组（Caries-Free,CF组,dft=0,CSI=0）儿童的非刺激性及刺激性全唾液,应用高效液相色谱法及氨基酸组成分析法对全唾液中的富酪蛋白进行测定,分析富酪蛋白浓度与患龋状况的关系。结果：CS组的非刺激性全唾液浓度低于CF组（P〈0.05）,而两组的刺激性全唾液富酪蛋白浓度无显著性差异。唾液富酪蛋白浓度与dft、dfs及CSI值无相关关系。结论：龋病高危组的非刺激性全唾液富酪蛋白浓度低于无龋组,提示富酪蛋白具有一定的抗龋作用;全唾液中的富酪蛋白浓度与dft、dfs、CSI之间无相关关系。     

放射性龋患者唾液中变形链球菌的产酸性及耐酸性

目的 探讨放射龋患者与健康无龋者唾液中变形链球菌致龋性的差异.方法 从放射性龋患者(实验组)及健康无龋者(对照组)唾液中分离培养的变形链球菌各20株,将其接种至不同pH值(以0.5为间隔,pH.4.0～7.0)的PYG液体培养基中,37℃、厌氧(80% N2、10% H2、10% CO2)条件下培养48 h.pHS-25型精密酸度计测定培养物上清的终末pH值,比较产酸能力(△pH值);将菌沉淀用PBS液重悬,紫外分光光度计测定600 nm处吸光度A值,比较细菌的生长情况.结果 初始pH>5.5时,实验组组和对照组的△pH值及生长情况无统计学差异(P>0.05);pH=5.0时,实验组和△pH值及生长情况明显高于于对照组(P<0.05);pH<5时,所有的变形链球菌分离株均不能生长.结论 放射性龋者唾液中变形链球球菌临床分离菌株具有较强的产酸性和耐酸性.     

口腔乳杆菌菌落密集度与乳牙龋患状况及进展的相关性分析

目的:观察口腔唾液中乳杆菌菌落密集度与乳牙龋患状况及进展的相关性,评价Dentocult LB龋活跃性检测方法的有效性.方法:以223名2～4岁深圳市属幼儿园小班儿童为研究对象,进行口腔检查并采用Dentocult LB法检测口腔唾液中乳杆菌菌落密集度,2年后复查,分别计算2年前后患龋率、龋失补牙数(dmft)、龋失补...     

母亲唾液变形链球菌水平与幼儿变形链球菌检出关系的研究

目的：研究母亲唾液中变形链球菌水平与幼儿变形链球菌检出的关系。方法：选取北京市海淀区124对1～2岁幼儿和母亲,检测母亲刺激性唾液中变形链球菌水平及幼儿菌斑中变形链球菌检出情况,问卷获取幼儿看护信息。结果：在50对主要看护母亲和幼儿中,幼儿变形链球菌检出阳性组和阴性组的母亲唾液中变形链球菌水平分布的差异有统计学意义;母亲唾液变形链球菌水平较高组的幼儿变形链球菌检出率明显高于较低组的幼儿变形链球菌检出率,差异有统计学意义。而在74对非主要看护母亲和幼儿中,以上组间差异均无统计学意义。结论：主要看护母亲是幼儿变形链球菌的主要传播源,而非主要看护母亲可能不是幼儿变形链球菌的主要传播源。     

杭州市区12岁儿童患龋状况5年观察及影响因素分析

目的调查(五年间)杭州市区12岁组儿童患龋状况并分析其影响因素。方法问卷调查结合纵向观察2002年至2006年杭州城区35所小学中13306名12岁儿童的患龋状况,采用logistic回归分析患龋状况与影响因素之间的关系。结果2002年至2006年五年间杭州市城区12岁儿童患龋率和龋均呈逐年下降趋势;每天刷牙2次以上与龋齿发生呈负相关;睡前吃零食与龋齿发生呈正相关(P<0.05)。结论深入学校开展口腔健康检查和龋病防治宣教使杭州市城区12岁儿童患龋状况呈逐年下降趋势。     

幼儿猛性龋病原菌的分离鉴定

目的:确定幼儿猛性龋的优势病原菌,为其防治提供依据。方法:采用细菌分离培养、形态学、生理生化学和 DNAG+C mol%测定方法,对30名2~5岁猛性龋患儿牙菌斑菌丛进行分离鉴定,采样部位为上颌患龋乳切牙龋损部位及邻近健康釉质表面,对照组的非猛性龋和无龋儿童则采集上颌乳前牙唇面颈1/3处的菌斑。结果:猛性龋儿童龋损部位变链菌和远缘链球菌的检出率及两个采样部位菌斑标本中变链菌和远缘链球菌的检出水平均显著高于非猛性龋和无龋儿童(P<0105)。结论:变链菌和远缘链球菌为幼儿猛性龋的优势病原菌。关键词 幼儿猛性龋变链菌远缘链球菌。     

龋活跃性检测与龋病现状及发展的相关性研究——Dentocult SM、Dentocult LB试验应用评价

目的探讨Dentocult SM、Dentocult LB龋活跃性试验在反映龋病现状及预测龋病发展方面的有效性、可靠性及可行性。方法以91名3岁的幼儿为研究对象，均行口腔检查，并计算龋、补牙数（decay ＆ filling teeth，dft）和龋严重度指数（caries severity index，CSI）；龋活跃性检测采用Dentocult SM、Dentocult LB龋活跃性试验（记录等级分值）。2年后复查dft和CSI。结果Dentocult SM各等级之dft及CSI在同期及2年后差异均有统计学意义；且各等级与dft及CSI在同期及2年后均呈高度正相关。Dentocult LB各等级之dft及CSI在同期及2年后差异亦有统计学意义；且各等级与dft及CSI在同期及2年后亦呈正相关。结论Dentocult SM能真实反映龋病的现状，较准确地预测现有龋病的进展和新龋的发生。Dentocult LB在反映龋病现状方面准确度不及Dentocult SM；但在预测现有龋病的进展方面可信度较高，有一定的临床应用价值。     

Caries prevalence and severity in the primary dentition and Streptococcus mutans levels in the saliva of preschoolchildren in South Africa

The caries prevalence (dmft) and severity (css) in 3-, 4-, and 5-yr-old children in South Africa were examined. Four levels of S. mutans in the saliva of 228 of these children was estimated by the spatula method. In all three age groups a statistically higher dmft and css was found with a S. mutans level of greater than 10(6) CFU/ml in saliva than at lower concentrations. At age 5 ANOVA showed significant differences between dmft and css at all S. mutans levels. A high concentration of S. mutans in the saliva may be an indicator of the high risk child at an early age.     

Correlation between child caries incidence and S. mutans/ lactobacilli in saliva after correction for confounding factors

The correlation between caries incidence and Streptococcus mutans/lactobacilli in saliva was studied in two different age groups, followed from ages 5 to 7 and from 12 to 14. The coefficients of correlation were computed before and after correction for the confounding effect of oral hygiene and the alternative bacteria. The best value for S. mutans was found for the total material in the younger age group (r = 0.24). For lactobacilli the best value was found for the total materials and in the subgroup with less favorable oral hygiene and S. mutans count in the older age group (r = 0.18). The connection between caries incidence and these bacteria was shown to be weak at the individual level, particularly after correction for confounding. The caries differences at group level between subgroups with less favorable and favorable counts of the bacteria were also checked after correction for confounders. The "reduction" figures for S. mutans varied between 23 and 63% and for lactobacilli between 8 and 37% in the two sets of material.     

封闭型维吾尔族和汉族不同龋敏感儿童口腔变形链球菌临床分离株LDH活性与龋病相关性研究

目的：研究新疆封闭型维吾尔族和汉族不同龋敏感儿童变形链球菌乳酸脱氢酶（LDH）活性与龋病发生的相关性。方法：对喀什市3~5岁封闭型维吾尔族儿童179名、汉族儿童289名进行口腔变形链球菌分离培养,选取119株高龋菌株[龋失补牙数（dmft）≥5],120株无龋菌株[龋失补牙数（dmft）=0],通过还原性辅酶Ⅰ氧化法测定乳酸脱氢酶活性。结果：维族儿童变链菌LDH活性均值较汉族儿童高（P=0.025）,维族儿童高龋组LDH活性均值高于汉族儿童（P=0.018）,维族儿童无龋组LDH活性均值与汉族儿童无龋组比较无显著差异（P=0.239）。两族儿童高龋组LDH活性均值均高于无龋组,差异有统计学意义（P=0.000）。总体样本中,不同LDH活性菌株分布在高龋组和无龋组差异有统计学意义（P=0.000）。维、汉族不同LDH活性菌株分布在高龋组和无龋组的差异有统计学意义（高龋组P=0.04;无龋组P=0.013）,维、汉族不同LDH活性菌株在高龋组和无龋组的分布与其活性有相关性（维吾尔族P=0.000;汉族P=0.000）。结论：不同LDH活性菌株在两组儿童分布与其LDH活性有关,变形链球菌LDH活性与乳牙龋的发生有一定的相关性。     

乳牙菌斑钙含量与患龋状况关系的研究

目的:分析乳牙集合菌斑中钙含量与儿童患龋状况的关系,为龋病预防研究提供基础资料。方法:应用原子吸收分光光度仪测定53例不同患龋状况的儿童集合菌斑中钙含量值。统计分析集合菌斑中钙含量值与龋病易感性的关系。结果:集合菌斑钙含量为(0.931±0.384)mg/g,菌斑钙含量无龋组、有龋组间差异有高度显著性P<0.01;无龋组、低危组、高危组间差异有显著性P<0.05,菌斑钙含量无龋组高于低危组,低危组高于高危组;有龋组集合菌斑中钙含量与龋补牙数(dft),龋补牙面数(dfs),龋蚀指数(CSI)具有负相关性。结论:集合菌斑中总钙含量与龋患程度具有一定的相关性,可为预测龋病易感性提供参考。     

Bacteriologic and Nonbacteriologic Criteria for Identifying Individuals at High Risk of Developing Dental Caries: A Review

A review of the literature on bacteriologic and nonbacteriologic criteria for identifying individuals at high risk to dental caries is presented. The studies have been evaluated on the basis of 1) their ability to predict future caries activity of individuals and 2) their practical use. Single measurements of past caries experience in the primary and permanent dentitions, filled tooth surfaces, and S. mutans in dental plaque and saliva were found to have limited value in identifying individuals that later would develop carious lesions, as judged from the low values of sensitivity and specificity. Lactobacilli counts in saliva indicated some evidence of high reliability as a basis for selecting patients susceptible to dental decay. The results of these studies, however, were not comparable because of variations in methods, critical value of the screening criteria, and age and size of the samples. A combination of two or more predictors showed promising results, as the predictive value was increased. More research is needed on appropriate screening methods to provide higher reliability and validity of the predictors.     

Prevalence of Dental Caries and Dental Fluorosis in Areas with Optimal and Above-optimal Water Fluoride Concentrations: a 10-Year Follow-up Survey

Objectives: This paper presents findings for dental caries and fluorosis from an October 1990 follow-up survey in Illinois and compares results with those obtained from two similar school-based examinations conducted in 1980 and 1985 within the same communities. Methods : The seven study sites were grouped into four categories according to the approximate relation of their water fluoride concentration to the recommended optimal fluoride level for the area. Tests for differences in dental caries and dental fluorosis across the four water fluoride groupings and three examinations were conducted. Results : DMFS scores for children who resided in communities with above-optimal water fluoride levels did not change significantly from 1980 through 1990. At the optimal water fluoride concentration, caries scores did not change substantially from 1980 to 1985; however, the mean DMFS score in 1990, 1.9, was significantly lower than caries levels observed during the two previous exams. In the optimally fluoridated area, the proportion of fluorosed tooth surfaces increased significantly from 1980 to 1985, but then declined by 1990 to the level observed in 1980 for both age groups. Conclusions : The results suggest that: (1) in the optimally fluoridated community, the apparent increase in the prevalence of dental fluorosis observed from 1980 to 1985 did not continue from 1985 to 1990; and (2) at above-optimal water fluoride concentrations, dental fluorosis either remained stable or demonstrated no sustained increase over the decade.     

学龄前儿童乳牙釉质发育缺陷与龋病的关系研究

本研究采用简化的DDE指数,对1074名城乡学龄前儿童进行乳牙釉质发育缺陷和龋齿的现况调查.结果发现农村儿童DDE患病率(19.4%)明显高于城市儿童(8.7%).受检儿童龋齿的患病水平较高,城乡间差异有显著性.研究结果提示:釉质发育缺陷与龋病间有明显的相关性,釉质发育缺陷可以作为评估儿童人群龋病危险性的一个参数.