A dental caries severity index for primary teeth

Criteria for scoring the caries attack on each surface of an affected primary tooth are described. The score for each carious surface ranges from 1 to 3. The score per tooth is a sum of the surface scores. The caries severity index (csi) is the mean of the scores of all carious teeth in the population examined. Three groups of children aged 5-6.5 yr were examined. In Jerusalem, with a water fluoride concentration of 0.4 ppm, 54 children had a csi of 2.99 and a defs of 10.19. In a semirural African town, Soshanguva, with a 0.2 ppm fluoride concentration, 103 children had a csi of 3.10 and a defs of 5.75. In a nearby rural African area with a water fluoride concentration well above the optimum, 86 children had a csi of 1.93 and a defs of 1.99. Interexaminer and intraexaminer reproducibility of the csi were good. The csi expresses the severity of the caries attack on affected teeth and gives additional information to that of the def indices.     

Surface analysis of dentinal caries in primary teeth using a pH-imaging microscope

The aim of this in vitro study was to evaluate the pH value of intact and carious dentin in primary teeth using a pH-imaging microscope (SCHEM-100, HORIBA Ltd., Kyoto, Japan). Bucco-lingual cut sections of extracted human primary teeth, which had either mild or severe dentinal caries lesions, were placed on the pH-imaging sensor of the microscope. The pH values were compared statistically by Levene's test for equality of variances and Tukey HSD multiple comparison test (p < 0.05). For both mild and severe lesions in primary dentin, the lowest pH values in the carious lesions were lower than those of intact dentin (6.6, range 6.3-6.9). There were statistical differences between the lowest pH value within the mild lesions (6.2, range 5.8-6.4) and that of the severe lesions (6.0, range 5.9-6.2) (p < 0.05). It was concluded that SCHEM-100 was able to distinguish the pH-value distribution of intact and carious dentin in primary teeth.     

Carisolv技术治疗乳牙龋病的临床应用评价

目的:比较和评价Carisolv去龋技术和采用低速牙钻去龋治疗乳牙龋病的效果和患儿接受程度.方法:选择年龄6～10岁,双侧乳牙均患中龋的儿童100名,以自身半口为对照,分别用Carisolv和牙钻去龋,然后用复合体充填,记录去龋时间.采用问卷调查患儿对两种去龋方法的接受程度,1年后复查,观察修复体的情况.结果:Carisolv去龋时间(4.36±1.28)min长于低速牙钻去龋时间(2.60±0.84)min.82%的患儿认为Carisolv去龋疼痛轻于牙钻；多数患儿倾向使用Carisolv去龋.1年后复查表明Carisolv和牙钻去龋的修复体继发龋率、脱落率方面无显著性差异.结论:Carisolv去龋时患儿疼痛程度明显减轻,但去龋时间略长于牙钻去龋,多数患儿倾向于Carisolv去龋.Carisolv修复术后的继发龋率并未增加.     

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。     

口腔尿素分解活性与乳牙龋相关性的研究

目的：调查儿童患龋情况及其唾液和菌斑中的尿素分解活性,探讨儿童口腔内尿素酶活性与乳牙龋齿是否存在相关性。方法：采集98名3~6周岁儿童牙面菌斑和唾液样本,检查患龋情况,并将样本分为无龋、中龋和高龋组,各组对象的性别、年龄等基本信息无显著差异。采用纳氏试剂比色法测定样品中氨氮浓度,分析尿素分解活性。采用SPSS19.0,使用方差分析、相关性检验等方法统计分析调查对象的口腔患龋情况、菌斑和唾液内尿素分解活性,并分析它们之间是否存在相关性。结果：无龋组、中龋组和高龋组的菌斑样品中尿素分解活性差异具有统计学意义（P=0.007）。无龋组、中龋组和高龋组的唾液样品中尿素分解活性无显著差异。龋失补指数与菌斑尿素分解活性具有显著正相关性,Pearson相关系数为0.345;龋失补指数与唾液尿素分解活性无显著相关性。结论：本研究结果显示,口腔细菌产碱能力的下降与患龋风险的上升有相关,为今后口腔内细菌产碱能力与机体健康的相关性研究提供了新的证据。     

Reasons for replacement of restorations in permanent teeth in general dental practice

OBJECTIVE: The analysis of reasons for the replacement of 9,805 amalgam, composite, glass ionomer, resin modified glass ionomer and 'other' restorations in permanent teeth in general dental practice. DESIGN: The data were subdivided on the bases of age and gender of the patients, the types of restorations and the clinicians' gender, experience and practice setting. RESULTS: The clinical diagnosis of secondary caries was the main reason for replacement of all types of restorations studied, followed by fracture of restorations, especially bulk fracture, irrespective of patient's age. Bulk discoloration was the third most common reason for replacement of resin based materials in adults, but it rarely occurred in adolescents 18 years and younger. The reasons for replacement of restorations were not associated with the gender of the patients. Subgroupings based on the clinicians' gender showed that female clinicians diagnosed secondary caries more often than male clinicians. Otherwise, the reasons for replacements were similar for both genders of clinicians. Subdivision of restorations based on the years since graduation of the clinicians resulted in small groups. The youngest group of clinicians diagnosed relatively more secondary caries both for amalgam and composite restorations than the most experienced group. CONCLUSION: The clinical diagnosis secondary caries was the main reason for replacement of all types of restorations studied.     

Carisolv化学机械去龋技术治疗乳牙龋病的临床评价

目的：评价Carisolv化学机械去龋技术用于乳牙龋病治疗的临床疗效。方法：选取169个龋损乳牙，实验组104个采用Carisolv化学机械去龋，对照组73个采用牙钻去龋。去龋后每组再随机分成A、B两组，分别使用玻璃离子和复合体充填。比较临床治疗效果。结果：与对照组相比，Cafisolv化学机械去龋痛苦小（P〈0．01），在去龋时间、继发龋形成及充填体脱落方面两组无明显差异，而对牙髓的不良影响对照组高于实验组（P〈0．01）。使用不同充填材料的两组在术后并发症方面无明显差异。结论：在乳牙龋病的治疗中，使用Carisolv化学机械去龋较牙钻去龋更具优势。     

Selection of restorative materials in permanent teeth in general dental practice

In this study, we recorded the type of restoration and the materials used in 24,429 restorations in permanent teeth by 243 Norwegian clinicians in general practice. Demographic information included patient's gender and age, and clinician's gender, years since graduation, and practice setting (private or salaried). The overall recorded use of restorative materials in permanent teeth shows that 32% are amalgams, just over 40% composites, and about 25% glass ionomer type materials. Three percent are "other" materials. A marked shift away from amalgam restorations is noted both in the clinician's estimated use during the last 2 decades and by comparing the present use of materials with that in failed restorations. Tooth-colored materials are more commonly used in adolescents, especially glass ionomer materials, and in female patients. In patients < or = 18 years, amalgam is used in 25% of all restorations. The use of amalgam is similar in private practice and in public health service practice, but private practitioners use more composites and salaried dentists more glass ionomers. The clinician's gender does not have any effect on the selection of restorative materials. The change from amalgam to tooth-colored material is particularly noticeable for Class I and Class V restorations. Amalgam is the predominant material in 2- and 3-surface Class II restorations.     

Carisolv 用于乳牙龋病治疗的疗效评价

目的 :评价Carisolv技术用于乳牙龋病的治疗效果。方法 :选取 66个龋病乳牙 ,其中 3 6个龋牙采用Carisolv技术去腐 (治疗组 ) ,3 0个龋牙采用牙钻去腐 (对照组 ) ,两组去腐后均采用光固化材料充填 ,分别观察治疗效果。结果 :与对照组相比 ,治疗组的麻醉剂使用率、继发龋发病率及填充物松动率均明显降低 ,有显著性差异 (P<0 .0 5 )。结论 :Carisolv技术用于乳牙龋病的治疗安全、有效、病人痛苦小。     

Service patterns associated with coronal caries in private general dental practice

OBJECTIVES: To describe the pattern of dental services associated with dental caries by level of carious lesion severity. METHODS: Data were collected by a mailed survey from a random sample of dentists from each State/Territory in Australia in 2003-2004. Dentists provided service data on patients treated on a typical clinical day for patients attending with a diagnosis of dental caries. RESULTS: Restorative rates were higher for insured patients, radiograph rates were higher for emergency visits, prophylaxis and topical fluoride rates were higher for non-emergency visits and at capital city locations with topical fluoride also higher for patients from higher socio-economic status areas, endodontic rates were higher for emergency visits and at non-capital city locations, while extraction rates were higher for males, uninsured patients and for emergency visits. Poisson regression models compared the rates of services from different service areas for initial and cavitated carious lesions with gross carious lesions, controlling for patient demographics, visit type, location and socio-economic status. Restorative services were provided at higher rates (P<0.05) for cavitated carious lesions (RR=2.38), radiographs were provided at lower rates for both initial (RR=0.28) and cavitated carious lesions (RR=0.31), both prophylaxis and topical fluoride services were provided at higher rates for initial carious lesions (RR=2.33 and 3.00, respectively), endodontic services were provided at lower rates for both initial (RR=0.03) and cavitated carious lesions (RR=0.07), and extractions were provided at lower rates for both initial (RR=0.23) and cavitated carious lesions (RR=0.16) compared to the reference category of gross caries. CONCLUSION: Service patterns varied by level of carious lesion severity with initial carious lesions managed by more preventive services, cavitated carious lesions with more restorative services, gross carious lesions with more radiographic, endodontic and extraction services. However, initial carious lesions tend to be managed with restorative rather than preventive service, suggesting scope for increased management by minimum intervention approaches.     

上海市789名5岁儿童乳牙患龋状况观察

目的评价1995-2005年上海市儿童乳牙患龋10年变化情况,为政府制订相关政策提供依据。方法采用多阶段、分层、等容量、整群抽样方法,按照2005年第三次全国口腔健康流行病学调查方案和技术要求,对上海市789名5岁儿童的乳牙患龋率、龋均和龋失补构成比进行调查,并与1995年儿童的乳牙患龋情况进行比较。结果2005年上海市5岁儿童的乳牙患龋率、龋均、龋齿充填构成比分别是71.74%、4.17、7.70%,与1995年相比分别下降了6.54%、0.59、1.12%,其差异有统计学意义（P<0.01）。结论上海市5岁儿童乳牙患龋率和龋均呈现下降趋势,儿童口腔健康状况有了明显改善,但是乳牙龋齿充填构成比的下降,提示对儿童口腔卫生防治服务应引起足够的重视。     

Characterization of enamel in primary teeth by optical coherence tomography for assessment of dental caries

International Journal of Paediatric Dentistry 2010; 20: 158–164 Background. Caries is a disease that affects both primary and permanent dentitions, therefore new methods of caries diagnosis need to be tested on primary teeth as well as on permanent teeth. Aim. This study reports the application of optical coherence tomography (OCT) to characterize sound dental structure and detect natural caries of human primary teeth. Design. Six primary teeth were sectioned into thin slices (～1.5 mm), and analysed perpendicular to the enamel surface by two home‐made OCT systems operating around 1280 and 840 nm. The generated images were compared with histology as the gold standard. Results. We demonstrated the efficacy of the OCT technique to measure the depth of the enamel layer, whose result was statistically compared with histology (P = 0.823; P > 0.05) with good agreement. We also determined, through measurement of contrast values, an increase in backscattered intensity of the order of two to three times between sound and caries regions. Conclusions. We employed OCT generated images to characterize the enamel layer. The technique showed great potential to be used on paediatric dentistry clinical on early caries detection with no pain, as it is a noninvasive method.     

同一个体乳牙列龋与恒牙列龋的相关性研究

目的：探讨同一个体乳牙龋与其年轻恒牙龋之间是否具有相关性，是否可以通过乳牙龋预见其恒牙龋的发生。方法：对293名5～6岁替牙期的儿童进行4年的跟踪调查，记录其在1999年和2003年时的乳、恒牙患龋情况，并进行统计学分析。结果：乳牙列龋与恒牙列龋之间相关性存在统计学意义。结论：乳牙列患龋严重的儿童，其恒牙患龋的可能性相对增高，可达乳牙列无龋者的4倍。特别是乳磨牙龋对其恒牙龋更具有预见价值。     

龋患风险预测的方法

龋病是多因素引起的疾病,通过检测个体的各龋危因素或再矿化潜能,测得个体的患龋风险的大小,从而采取针对病因的预防措施可以减少龋病的发病率。本文就龋患风险预测内容及方法作一简要综述。     

Age of restorations at replacement in permanent teeth in general dental practice

The ages of 6,761 restorations replaced in permanent teeth, 6,088 in adults ≥19 years of age and 673 in adolescents ≤18 years, were available for analyses. The results showed that the median age of amalgam restorations in adults was 11 years and that of resin-based composite restorations 8 years. This difference in longevity was significant (P = 0.0001). The median age of failed conventional glass ionomer restorations in adults was 4 years and for resin-modified glass ionomer 2 years. In adolescents, the median longevity of failed amalgam restorations was 5 years and that of composite restorations 3 years, while both types of glass ionomers had a median longevity of 2 years. The data were subdivided based on clinician gender and practice setting. The results showed that the median age of amalgam and composite restorations replaced by male clinicians was higher than that for female clinicians irrespective of clinical setting. The median age of amalgam and composite restorations replaced by salaried dentists was significantly lower than that by private practitioners. Minor differences were noted in longevity of restorations between male and female patients. The age of replaced restorations was shortest for the group of clinicians with the least clinical experience and highest for those that graduated ≥ 30 years ago.

Keywords: Amalgam composite; gender differences; glass; ionomer; practice setting     

Age of restorations at replacement in permanent teeth in general dental practice

The ages of 6,761 restorations replaced in permanent teeth, 6,088 in adults > or =19 years of age and 673 in adolescents < or =18 years, were available for analyses. The results showed that the median age of amalgam restorations in adults was 11 years and that of resin-based composite restorations 8 years. This difference in longevity was significant (P = 0.000 l). The median age of failed conventional glass ionomer restorations in adults was 4 years and for resin-modified glass ionomer 2 years. In adolescents, the median longevity of failed amalgam restorations was 5 years and that of composite restorations 3 years, while both types of glass ionomers had a median longevity of 2 years. The data were subdivided based on clinician gender and practice setting. The results showed that the median age of amalgam and composite restorations replaced Its male clinicians was higher than that for female clinicians irrespective of clinical setting. The median age of amalgam and composite restorations replaced by salaried dentists was significantly lower than that by private practitioners. Minor differences were noted in longevity of restorations between male and female patients. The age of replaced restorations was shortest for the group of clinicians with the least clinical experience and highest for those that graduated > or = 30 years ago.