重度低龄儿童龋全身麻醉下治疗后再次患龋风险的前瞻性研究

目的对全身麻醉下接受龋齿治疗的重度低龄儿童龋(severe early childhood caries, S-ECC)患儿行前瞻性随访研究, 分析其治疗前后患龋特点, 并探究治疗后再次患龋的风险因素。方法纳入83例2～4岁、于2012年12月至2014年8月在北京大学口腔医学院·口腔医院儿童口腔科接受全身麻醉下龋齿治疗的S-ECC患儿, 在治疗前及治疗后1、7、13个月采集其口腔检查、临床诊疗内容和调查问卷信息。统计分析治疗前龋坏程度、临床诊疗内容、患儿及家长基本情况和口腔保健习惯等在治疗后无龋和再次患龋儿童之间是否存在差异, 统计分析治疗后再次患龋特点及龋坏类型(分为再发龋和继发龋, 前者指对原发龋病灶进行修复后在同一牙齿其他部位发生的龋, 后者指在已有修复体边缘或底部发生的龋)。结果在完成7～13个月随访的70例患儿中, 29例(41%)在13个月观察期内保持无龋, 41例(59%)在13个月观察期内出现个别牙再次龋坏。全身麻醉下龋齿治疗后除下颌乳切牙外其他牙位均有不同程度的再次患龋, 其中上颌乳切牙以继发龋为主(再发龋和继发龋牙数分别为1和12), 上下颌乳尖牙及第一乳磨牙再发...     

惠州市1163名小学生龋病调查

目的了解惠州市7~13岁儿童的患龋情况,为进一步开展预防工作提供指导。方法参照世界卫生组织关于龋病、牙周疾病的调查标准对惠州市某小学学生龋病状况进行调查。结果受检儿童患龋率为47.64%,其中8、9、10岁年龄组儿童的患龋率、受检者龋均较高;第一恒磨牙(六龄牙)龋坏率随年龄增长而增加;龋齿充填率为7.40%;乳牙以上、下颌IV、V龋坏最多,下颌多于上颌。恒牙以上、下颌六龄牙龋坏最多,下颌多于上颌。结论普及防龋知识,降低患龋率,提高充填率是我市龋病防治工作的重点。     

上海市嘉定区幼儿园5岁儿童龋病流行病学抽样调查分析

目的    了解上海市嘉定区儿童的口腔健康状态,为口腔卫生预防工作和儿童的龋病预防提供科学依据。方法    于2009年3月至2010年6月上海市嘉定区牙病防治所对上海市嘉定区城乡8所幼儿园1135名5岁儿童进行了口腔健康状况调查,并对调查数据进行统计分析。结果    受检的1135名5岁儿童中,664名患龋,患龋牙数为3106颗。城区儿童患龋率为53.11%,龋均为2.30;乡村儿童患龋率为64.44%,龋均为3.22。城区、乡村儿童患龋率差异有统计学意义（P＜0.05）。受检儿童中男、女之间差异无统计学意义（P > 0.05）。本次调查中无龋人数为471名,患龋牙数为1～3颗的儿童339名,4～6颗龋齿199名,6颗以上126名。上颌患龋牙数1362颗,下颌1408颗。结论    上海市嘉定区儿童患龋率和龋均仍较高,应加强学龄前儿童的龋病防治工作。     

瓦努阿图儿童乳牙龋病发病情况调查

目的了解瓦努阿图桑托岛居住的3～6岁儿童乳牙龋齿患病情况,为该地区制定学龄前儿童龋病防治措施提供基线资料。方法505名该地区居住的儿童,在室外条件下检查乳牙患龋情况,并记录dmft值,经统计学分析各年龄组之间及各牙位之间的患龋情况。结果儿童乳牙的患病率为35.7%～48.4%,龋均0.57～1.66。各年龄组和性别间乳牙的患龋率和龋均没有显著性差异。患龋最多的为上颌乳切牙,其次为下颌乳磨牙和上颌乳磨牙。发病率最低的是下颌乳切牙、下颌乳尖牙及上颌乳尖牙。乳牙龋坏充填率0.6%。结论瓦努阿图桑托岛居住的儿童乳牙龋齿的患病率较低,可能与当地的生活习惯有关。龋齿充填率很低,应当加大口腔保健的服务力度。     

荆门市十二所小学学生第一恒磨牙龋病调查报告

目的：建立7～12岁儿童第一恒磨牙（六龄牙）患龋流行病学资料,为制定本市初级卫生保健发展战略和有效防治龋病提供科学依据。方法：采用世界卫生组织通用的龋齿调查方法,以荆门市城区十二所小学2159名学生为对象,调查第一恒磨牙患龋情况,按PEMS 3.1标准进行数据分析。结果：在2159名学生中,第一恒磨牙患龋人数625人,患龋率为28.95%,龋均1.65;患龋牙数1029颗,以12岁儿童多见;女生患龋356人,高于男生的296人,P〈0.01,有显著意义;患龋率随年龄增长而升高,9岁时达高峰;龋坏主要发生在面;下颌的患龋率高于上颌。结论：该市儿童第一恒磨牙患龋情况符合龋病的一般流行病学特点。充分认识第一恒磨牙患龋对儿童的健康危害,有的放矢地指导小学生良好的口腔卫生习惯和生活饮食习惯,采取窝沟封闭、局部及全身补氟,可有效预防龋病,降低第一恒磨牙患龋率。     

下颌阻生或错位第三磨牙71例拔除远期效果观察

目的　探讨下颌阻生或错位第三磨牙拔除后远期疗效及对邻牙和对牙合牙的影响。方法　通过随机抽样法 ,抽取部分病例作样本 ,通过随访 ,分析拔牙后不同时间对邻牙及对牙合牙食物嵌塞影响 ;对邻牙及对牙合牙龋坏影响及其时效关系等。结果　下颌阻生或错位第三磨牙拔除后治愈了反复发生的冠周炎 ,消除后牙食物嵌塞 ,减少下颌第二磨牙的龋坏因素。拔牙后对口腔内其他牙没有造成明显不良后果。结论　患下颌阻生或错位第三磨牙后要在适当时机及时拔除     

低龄儿童行窝沟封闭术时酸蚀剂选择的临床研究

目的 应用自酸蚀法和磷酸酸蚀法为低龄儿童处理牙面后行窝沟封闭术,比较窝沟封闭剂的保留率,评价自酸蚀粘接剂与全酸蚀粘接剂在低龄儿童行窝沟封闭术中应用的效果.方法 选择4颗第二乳磨牙完全萌出并无龋坏的儿童67例为研究对象,268颗第二乳磨牙作为试验牙.采用自身对照的方法,分为4组,右侧A组(上颌)、B组(下颌)采用自酸蚀法,左侧C组(上颌)、D组(下颌)采用磷酸酸蚀法.术后随诊3、6、12、24个月,比较4组封闭剂的脱落率.结果 A～D四组患牙3、6个月时封闭剂保留率差异无统计学意义(P＞0.05);第12个月时,A、C组均与D组的封闭剂保留率差异有统计学意义(P＜0.05),但B、D组与A、B、C组之间差异无统计学意义(P＞0.05);第24个月检查时,A、B、C组均与D组的封闭剂保留率差异有统计学意义(P＜0.05),但是A、B、C组之间差异无统计学意义(P＞0.05),下颌全酸蚀组的保留率明显低于其他三组.结论 下颌牙齿更易受唾液污染,使用自酸蚀法可以减少唾液污染产生的影响,提高窝沟封闭剂的保留率,推荐临床上为低龄患儿使用.     

重庆市学龄前儿童乳牙龋状况及影响因素分析

目的 探讨重庆市3~5岁学龄前儿童乳牙患龋状况及相关影响因素,为学龄前儿童龋病的预防和干预提供相关资料。方法 参考第四次全国口腔健康流行病学调查,对重庆市4个区学龄前儿童进行抽样调查,同时对家长进行问卷调查。利用Epidata 3.1和SPSS 21.0软件进行结果录入和统计学分析。结果 共计1 350名学龄前儿童纳入调查分析,口腔检查相关数据显示乳牙龋好发牙位是上颌乳中切牙和下颌乳磨牙,乳牙患龋率为51.4%（694/1 350）,龋均为2.34,各年龄组间患龋率和龋均差异有统计学意义（P<0.01）,且二者随着年龄增长而上升（P<0.05）。除5岁组男、女龋均有统计学差异外（P<0.05）,其余患龋率和龋均在不同性别间差异均无统计学意义（P>0.05）。61.7%龋坏集中在36.1%个体口腔中。多因素Logistic回归分析显示年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评对乳牙患龋有重要影响（P<0.05）。结论 重庆地区3~5岁儿童超过半数患龋,多数龋齿集中发生在少数患儿口内。乳牙患龋与年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评有关。     

一例低龄儿童龋的综合防治

低龄儿童龋（early childhood caries,ECC）包含两个主要因素,一个是年龄,即小于6岁的儿童,另外一个是任何一个乳牙的龋（无论是否成为龋洞）、失（因龋所致）、补牙数/牙面数≥1。做好ECC的早期预防,是儿童口腔保健的重要组成部分,对于ECC的综合治疗,结合儿童的生长发育特点,目的是使得患儿患龋高风险的口腔卫生状况得到有效的改善,从而恢复其口腔健康微生态,控制龋病进展和恢复牙齿的结构与功能。本文报道一例低龄儿童龋的综合防治。     

自酸蚀和磷酸酸蚀窝沟封闭术的临床比较

目的应用自酸蚀法和磷酸酸蚀法对低龄高危患龋儿童进行窝沟封闭术,以比较窝沟封闭剂的保留率和龋齿预防情况。方法选择不超过42月龄、患龋牙数不低于4颗的高危患龋儿童43例为研究对象;试验牙为第一乳磨牙患龋患儿的第二乳磨牙,窝沟较深或早期脱矿但没有缺损的第二乳磨牙及第一乳磨牙,共选择试验牙138颗。采用自身半口对照方法,随机选择一侧试验牙应用自酸蚀法,另一侧应用传统磷酸酸蚀法进行窝沟封闭术,分别设为试验组和对照组。定期复查封闭剂保留情况和患龋情况。结果3个月复查时2组窝沟封闭剂的完好保留率没有统计学差异,6、12和18个月复查时自酸蚀组窝沟封闭剂完好保留率低于磷酸酸蚀组,龋齿发生率高于磷酸酸蚀组（P<0.05）。龋坏主要发生在封闭剂脱落的窝沟内,2组均出现了邻面龋。结论自酸蚀法窝沟封闭术的完好保留率低于磷酸酸蚀法,临床上应慎重应用。如果在低龄易患龋齿的儿童中应用该方法,需密切观察。     

Caries prevalence and patterns in 3–6-year-old Beijing children

Abstract A total of 400 Beijing children. 3–6-yr-old. equally distributed by age and sex, were examined for dental cares. Results were analyzed with the traditional dmfs/t index and with the Caries Analysis System. The system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity), and the proportion of total caries each disease pattern represented (Distribution). Over 67% of the children experienced caries, a level comparable to other reports from China and other developing countries, but 50% greater than those seen in United Stales preschool children. Nearly all children with caries experienced fissure caries. In 3-yr-olds maxillary anterior caries was the next most prevalent pattern with 43% affected, whilst in the 6-yr-olds, posterior proximal caries was the second most prevalent pattern with 68% affected. Since maxillary anterior caries was so prevalent, and because the presence of this pattern has been shown to be a risk factor for future caries, preventing the maxillary anterior pattern may markedly reduce caries in this population.     

Dental caries of primary incisors in children with cleft lip and palate

Visual dental examinations were performed on 64 children ages 18 months through 4 years presenting at a Craniofacial Defects Team charged with diagnostic and referral services. Of the 41 children with cleft lip and/or cleft palate, 13 (32%) had dental caries of one or more maxillary primary incisors. One of the remaining 23 children examined experienced caries of the maxillary primary incisors. In incisors of children having clefts of the alveolus, caries tended to correspond to sites of enamel deficiency in caries-free children with alveolar clefts. Caries patterns in children with clefts involving only the palate resembled "nursing carries". Children with clefts are at significant risk for caries of the primary incisors; a dental prevention program is to be emphasized in referring these children for care.     

广州市991名老年人根面龋RCI值调查分析

目的：调查广州市老年人根面龋的患病状况。方法：采用分层多阶段抽样方法,选取广州市城区的3个区和郊区的2个县级市作为调查点,共调查广州市65-74岁组老年人991名。以根面龋指数（Rootcariesindex,RCI）分析其患病状况。结果：上颌第一磨牙发生根面龋的RCI值最高,其次是下颌第三磨牙和上颌尖牙。上颌近中面RCI值最高（3.99%）,其次为远中面（3.67%）;下颌唇颊面最高（2.33%）;全口远中面最高（2.89%）,其次是近中面（2.87%）。舌腭面RCI值均为最低。上颌各牙面RCI值高于下颌。大部分患根面龋的老年人仅累及1个根面（84.6%）,累及2个根面的占12.0%,累及3个及以上根面的发生率很低。就患牙数目而言,根面龋牙数1颗者占24.8%,2-7颗者占24.7%,8颗及以上者仅有0.6%。结论：在根面暴露的情况下,受根面龋侵袭比例最高的是上颌第一磨牙,其次是下颌第三磨牙和上颌尖牙;易感牙面为上颌邻面和下颌唇颊面;上颌牙患龋危险性高于下颌。     

口腔扁平苔藓患者中医证型与免疫状态的相关研究

目的 通过观察不同证型口腔扁平苔藓( lichen planus,OLP)患者的全身免疫状况,探讨中医证型与免疫的关系,以期为临床判断OLP患者免疫状况提供一种新思路.方法 纳入70例OLP患者,分为心脾蕴热型、肝经实火型、虚火上炎型和气血两虚型,所有患者均行免疫检查并对结果进行统计学分析.结果 在OLP患者中虚火上炎型37例,所占的比例最大[53％ (37/70)];OLP患者的外周血细胞总体表现为CD-3、CD-4与正常参考值相比均显著降低(P＜0.05),降低比例分别为76％ (53/70)和63％( 44/70);与正常参考值相比,心脾蕴热型组CD-3 (55.44±5.57)、CD-8(15.60±3.93)均显著降低(P＜0.05),CD-4/CD-8( 2.40±0.69)显著升高(P＜0.05),IgM(2279.33±729.23)显著升高(P＜0.05);虚火上炎型组CD-4( 30.52±7.50)显著降低(P＜0.05),IgA(2608.70±728.59)显著升高(P＜0.05);气血两虚型组CD-3( 56.10±3.24)显著降低(P＜0.05).结论 OLP患者的全身免疫状态以细胞免疫紊乱为主;不同中医证型的OLP患者其免疫状况存在一定差异性.     

南京市449例乳牙期儿童龋面分布特点

目的 了解南京市乳牙列期儿童龋病的牙面分布规律.方法 抽取南京市449位2～6岁儿童进行口腔检查并记录,分析不同牙面的患龋差异.结果 龋齿牙面分布左右对称,龋面主要集中于上颌乳中切牙近中邻面,其次为乳磨牙邻面和上颌乳前牙唇面及邻面.乳前牙区牙面龋风险向中线递增,乳磨牙区下颌龋风险大于上颌,(牙合)面龋以第二乳磨牙为主,...     

Association between occlusal anomalies and dental caries in 3‐ to 5 year‐old Brazilian children

Abstract

Objective: To investigate the association between certain occlusal anomalies and the occurrence and severity of dental caries in Brazilian preschool children.

Design: Cross‐sectional study.

Setting: Twenty‐eight public nursery schools in Canoas, southern Brazil.

Subjects and methods: The study population comprised 890 three‐ to five‐year‐old children. Five trained and calibrated observers examined children for determination of decayed, missing and filled tooth (dmft) index (World Health Organization criteria including white spots) and orthodontic variables.

Outcome measures: Caries severity (dmft) and caries occurrence (dmft?1).

Statistical analysis: Multivariable analysis was performed using Poisson regression with robust variance in order to determine the occlusal anomalies which represent risk factors for the occurrence of the binary outcome.

Results: Caries severity was significantly higher among children without spacing in the maxillary anterior teeth (P?=?0·001) and mandibular anterior teeth (P?=?0·003) and among children without accentuated overjet (P?=?0·023). The multivariable analysis demonstrated that children without spacing in maxillary anterior teeth had an increased risk of dental caries (prevalence ratio?=?1·43; 95% CI, 1·05–1·93). Open bite, accentuated overjet and posterior cross‐bite were not associated with this outcome in the final model.

Conclusions: Absence of spacing in the maxillary labial segment represents a risk factor for dental caries in preschool children.     

Bite jumping appliance with lower lip bumper]

The removable bite jumping appliance with lower lip bumper is a new orthodontic appliance designed to correct the abnormal habit of lower lip biting children with mentalis muscle hyperactivity. Upper anterior teeth protrusion, mandible retrusion, lower anterior teeth lingual collapse and anterior deep bite usually are found in association with this lower lip biting habit, especially in the mixed dentition period (7-12 yrs). The function of this appliance is similar to the partial functional appliance. It is made into two parts: upper removable plate with anterior inclined bite plane and lower lip bumper attached to the upper plate. Three cases are discussed and compared before and after treatment. Changes in both skeletal and dental pattern were recorded in the following aspects: increase in the posterior rotation of mandible (increased SN-MP), stimulation of forward growth of the mandible (the increase is SNB value overcomes the increase in SNA, through reduction ANB), retroclination of upper maxillary teeth (reduced 1-NA), proclination of lower anterior teeth (increased 1-NB), the reduction of overjet. Additionally, the normal position of the lower lip provided by this appliance effectively corrects the lip biting with mentalis muscle hyperactivity.     

The Association of Early Dental Caries Patterns with Caries Incidence in Preschool Children

Objectives : This study assessed the development of caries in preschool children over two years according to baseline caries pattern. Methods : Connecticut Head Start children (n=142, mean age=3.8 years) were examined for dental caries at baseline (spring 1991) and once annually for two years. Children were categorized at baseline as caries-free, having pit and fissure (PF) caries, or having maxillary anterior (MA) caries. Results : After two years, children who presented at baseline with MA or PF caries had a mean posterior dmfs of greater than seven and four times, respectively, that of children who were caries-free at baseline. When dental caries of the primary dentition was categorized by specific posterior patterns (i.e., posterior proximal [PPJ] and buccal/lingual [BL]), change in dmfs for the PP and BL patterns in the group that presented with pit/fissure caries at baseline were nearly four and three times greater, respectively, than for those in the caries-free group. The group that presented with maxillary anterior caries at baseline had PP and BL caries increments eight times those of children who began caries-free. Conclusion : Dental caries presentation in 3- to 4-year-old children can identify those children and tooth surfaces that will be at the greatest risk for future caries development.     

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目的了解辽宁省沈阳市铁西区3岁儿童口腔健康行为和口腔健康状况,从而为制定相应的龋齿预防措施提供参考。方法通过临床检查与问卷调查相结合的方式,于2011年11月至2012年2月对随机抽取的沈阳市铁西区10所幼儿园共计473名3岁儿童进行龋病流行病学调查,并对结果进行分析。临床检查参照世界卫生组织口腔健康调查标准。结果本次共抽样调查3岁儿童473人,其中患龋者236人,占调查总人数49.9%。被调查儿童龋面均(DMFS)为3.53。最易患龋的牙面为上颌中切牙近中面。Logistic回归分析显示:儿童缩短使用奶瓶时间和家长协助儿童刷牙可有效降低牙齿患龋率。结论沈阳市铁西区3岁儿童患龋率较高,充填率低。建议加大该区口腔教育宣传,推广牙病防治适宜技术,减少儿童口腔疾病的发生。     

Prevalence and distribution of bone defects in moderate and advanced adult periodontitis

Abstract . The purpose of the present investigation was to evaluate the prevalence and distribution of different forms of bone defects using direct observation during periodontal surgery. 286 patients with moderate or advanced adult periodontitis diagnosed during clinical and radiographic examination provided a sample of 5476 teeth. After full thickness mucoperiosteal flaps were raised, osseous defects were explored and classified according to their morphology as interdental craters, hemisepta and infrabony defects with 1, 2, 3 or 4 osseous walls. 981 defects were detected; 533 were in the maxilla and 448 in the mandible (15.4% and 22.4%, respectively, of the teeth examined). The posterior mandibular segment had the highest % of teeth with defects (33.8%) followed by the posterior maxillary segment (19.9%). The proportions of teeth with defects in the anterior segments of both arches were similar. The comparison between maxilla and mandible showed a highly significant difference for the posterior segments ( p =0.00001) but no difference for the anterior segments ( p =0.88). The distribution of defects differed between the maxilla and the mandible, both for the posterior and anterior segments. Craters accounted for almost half the defects, being more prevalent in posterior segments, while hemisepta formed the lowest proportion. Anatomical variations in shape and the original morphology of the alveolar bone between the maxilla and the mandible and the anterior and posterior regions might have been the reason for the differences observed.