黑龙江省城乡两居民点龋病的调查

我们对黑龙江省城市和农村两个居民点进行了龋病的调查。结果表明,龋病患病率很高(36.66%),而就诊率很低(9.57%)。     

光敏防龋涂料应用七年报告

本文报告了重庆市市中区某校12－13岁中学生91人无龋双尖牙及磨牙共407只涂布点隙裂沟封闭剂七年后追踪观察46人246牙之结果。涂膜完整保留率为45.52％。上颌双尖牙保留率高于下颌双尖牙、上颌磨牙高于下颌磨牙。(?)涂膜保留率最高，(?)次之、(?)最低。结果符合国内外资料报告。龋病下降相对有效率为63.15％。实际有效率为36.36％。涂布封闭剂对预防龋病为一肯定的有效方法，值得临床推广应用。     

Effect of maternal ethanol ingestion at two dietary levels of zinc on molar composition and dental caries of rat off spring

Pregnant rats were fed liquid diets containing either 2 or 10 μg Zn/ml with or without 30% of kcal from ethanol throughout gestation and lactation. At day 20 of lactation, three male rats from each litter were orally inoculated with Streptococcus mutans and fed a high sucrose-containing diet for six weeks. Maternal ethanol ingestion coinciding with offspring molar development significantly increased offspring dental caries scores and reduced the zinc content of enamel and dentin. Ethanol did not affect molar content of calcium, magnesium or phosphorus which suggests that ethanol is a specific antagonist of zinc utilization during molar development. Ethanol-antagonized zinc content of enamel may be responsible for the development of faulty enamel which has greater susceptibility to acid attack.     

An in vivo evaluation in children of the HPL bitewing device

The HPL bitewing device, a new beam-aiming collimating bitewing film holder, has recently been developed. The aims of this study were to assess the practicability of using the new device clinically and to compare the diagnostic yield obtained with the new technique with those obtained using a conventional freehand method and the Rinn XCP instrument. For each of the three techniques a pair of bitewings was taken of 30 randomly selected patients aged 6–15 years. These bitewings were evaluated for technical errors using seven different criteria, including the number and severity of overlapping contacts. The results show that the HPL method produced the greatest number of unoverlapped surfaces and the smallest proportion of moderate and severe overlaps. For five of the seven criteria, the HPL method produced fewer technical errors than the other two methods. Assessment of the acceptability of the procedures to the children revealed few differences between the three radiographic techniques. Further studies of the new technique, involving larger numbers of patients and sequential radiographs, are indicated.     

非创伤性治疗与常规充填治疗比较治疗儿童龋病效果的系统评价

目的评价非创伤性充填治疗儿童乳牙和恒牙龋的效果。方法计算机检索Cochrane图书馆临床对照试验资料库(CENTRAL)、MEDLINE、EMbase、中国生物医学文献数据库、中国期刊全文数据库和维普科技期刊全文数据库,同时检索中国临床试验注册中心等,检索时间均从建库至2010年4月。搜集非创伤性充填(ART)和常规充填(CRT)比较治疗儿童龋病的随机对照试验(RCT)。由两位研究者独立进行资料提取和质量评价后,采用RevMan 5.0.2软件进行Meta分析。结果共纳入7个RCT。因各研究采用不同的充填材料,受试牙的种类、测量指标及随访年限不一样,故仅进行描述性分析。结果显示:多数研究显示ART组各类洞形的充填体保存率与传统去腐组相当,仅个别研究显示CRT组优于ART组;治疗过程中接受ART治疗的儿童较CRT组儿童感觉舒适;2个研究比较了两组的工作时间,但结果相反。结论由于纳入研究临床异质性较大,无法进行合并分析,故对ART与CRT比较治疗儿童龋病的疗效尚不能得出确切结论,尚需更多高质量的研究加以验证。     

Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis

Aims

To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection.

Materials and methods

A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17″ cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding ±2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves.

Results

Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P = 0.172). Neither significant (range mean z: −0.40 (S520) and −0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor.

Conclusions

Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment.     

2010年佛山市禅城区小学生恒牙龋病调查分析

目的了解佛山市禅城区小学生的龋病情况,为龋病的防治工作提供参考。方法参照第三次全国口腔健康流行病学调查龋病检查标准,采用多阶段等容量随机抽样方法,对佛山市禅城区小学生进行恒牙龋病调查。结果 2010年佛山市禅城区小学生患龋率7岁组为4.69%,9岁组为12.19%,12岁组为23.13%,龋均分别为0.10、0.22、0.43。患龋率和龋均在不同年龄组间的差异有统计学意义（P〈0.05）,7岁组的最低,12岁组的最高;各年龄组患龋率、龋均的性别差异无统计学意义（P〉0.05）。结论加强口腔卫生知识宣教,降低龋病患病率,提高小学生龋齿充填率是目前工作的重点。     

Technological advances in caries diagnosis

Understanding the nature of the caries lesion, disease activity, and the patient's caries risk are all used in determining the nature of dental care to be delivered. An examination should include a health and social history and clinical examination using appropriate technologies. This allows proper assessment and suggests a logical management intervention. Minimally invasive dentistry is a concept based on an assessment of a patient's caries risk and the application of the current therapies to prevent, control, and treat the disease. The history of the dental examination and the variety of current technologies are discussed.     

The Caries Assessment Spectrum and Treatment (CAST) index: rational and development

Serious difficulties in reporting results were encountered when using ICDAS II and PUFA separately in an epidemiological survey in a child population in Brazil. That necessitated the development of a comprehensive but pragmatic caries assessment index. This publication describes the rationale, development and content of a novel caries assessment index. Strengths and weaknesses of ICDAS II, PUFA and other indices were analysed. The novel caries index developed for use in epidemiological surveys is termed 'Caries Assessment Spectrum and Treatment' (CAST). 'Spectrum' indicates what is considered the main strength of the new index - its usefulness in describing the complete range of stages of carious lesion progression: from no carious lesion, through caries protection (sealant) and caries cure (restoration) to lesions in enamel and dentine, and the advanced stages of carious lesion progression in pulpal and tooth-surrounding tissue. CAST combines elements of the ICDAS II and PUFA indices, and the M- and F-components of the DMF index. A DMF score can easily be calculated from the CAST score, thereby enabling retention of the use of existing DMF scores. The CAST index for use in epidemiological surveys is very promising. It should be validated and its reliability and usefulness be tested in different age groups in different countries and cultures.     

Urease activity as a risk factor for caries development in children during a three-year study period: a survival analysis approach

Recent cross-sectional studies suggest that reduced ability to generate alkali via the urease pathway in dental plaque may be an important caries risk factor, but it has not been assessed prospectively.

Objective

To evaluate the effect of plaque and saliva urease activity on the risk for developing new caries over a three-year period in children.

Methods

A panel of 80 children, three to six years of age at recruitment, was followed prospectively for three years. Plaque urease activity, saliva urease activity and dental caries were measured every six months. Survival analysis methodology was used to evaluate the effect of urease on caries development during the study period adjusted for gender, age, baseline caries levels, sugar consumption, amount of plaque, and mutans streptococci levels.

Results

The risk for developing new caries increased in a dose-responsive manner with increasing levels of urease activity in saliva (adjusted HR_{Q4 vs. Q1}: 4.98; 95% CI: 1.33, 18.69) and with decreasing urease activity in plaque (adjusted HR_{Q4 vs. Q1}: 0.29; 95% CI: 0.11, 0.76). Multiple measurements of urease activity were conducted to overcome the variability of urease activity in this study. Baseline caries and mutans streptococci in saliva were also important predictors of caries risk.

Conclusions

Increased urease activity in saliva can be an indicator of increased caries risk in children, whilst increased urease activity in plaque may be associated with reduced caries risk. The reproducibility of urease measurements must be improved before these findings can be further tested and clinically applied.