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,...     

Longitudinal Study of the Caries Susceptibility of Occlusal and Proximal Surfaces of First Permanent Molars

Ten- to 13-year-old children were examined annually for three years to determine the caries activity in the proximal and occlusal surfaces of first permanent molars. Almost every tooth with an unsound (carious or filled) proximal surface also had an unsound occlusal surface. Caries scores in proximal surfaces remained relatively constant and low. The percentage of teeth with occlusal caries or fillings increased throughout the study, even though the teeth had been erupted for seven to ten years by the end of the study. Within the age range studied, the time that teeth were in the mouth had little effect on the vulnerability of occlusal surfaces to caries attack.     

A two-year longitudinal study of dental caries in permanent first molars of Korean elementary schoolchildren

OBJECTIVE: This longitudinal study investigated dental caries increment in permanent first molars of Korean elementary schoolchildren. METHODS: A convenience sample of 722 children aged 7-9 years attending one urban elementary school was examined at baseline, with follow-up examinations at one and two years. Coronal surfaces of permanent first molars were scored with regard to caries experience and sealant status. RESULTS: Among sound occlusal surfaces at baseline, 21 percent of upper and 25 percent of lower surfaces developed caries during the two-year interval. In teeth that erupted between baseline and the first follow-up exam, over 10 percent of occlusal surfaces developed caries. Pit and fissure caries accounted for 93 percent of all new carious surfaces, while sealants had been placed on 16 percent of occlusal surfaces during the study. CONCLUSIONS: Recognizing the limitations of this convenience sample, dental sealants should be used more widely in this Korean population, and should be applied soon after tooth eruption.     

Parameters associated with active caries lesions assessed by two different visual scoring systems on occlusal surfaces of primary molars – a multilevel approach

Braga MM, Martignon S, Ekstrand KR, Ricketts DNJ, Imparato JCP, Mendes FM. Parameters associated with active caries lesions assessed by two different visual scoring systems on occlusal surfaces of primary molars – a multilevel approach. Community Dent Oral Epidemiol 2010; 38: 549–558. © 2010 John Wiley & Sons A/S Abstract – Objective: The aim of this in vivo study was to evaluate the association between several parameters related to children and to their teeth, and the presence of active carious lesions assessed by two different visual indices on occlusal surfaces of primary molars. Methods: Occlusal surfaces of 757 primary molars in 139 children (3–12 years old) were classified as sound, or having inactive or active carious lesions using the Nyvad criteria (NY) and the International Caries Detection and Assessment System (ICDAS‐II) and a supplemental lesion activity assessment system (ICDAS‐LAA). Several parameters related to the tooth and to the child were recorded. Associations between these parameters and the presence of active carious lesions on occlusal surfaces were evaluated using logistic multilevel analysis. Results: Second primary molar teeth and children with high caries experience were more frequently with active occlusal carious lesions compared to sound and inactive occlusal carious lesions classified by both visual scoring systems. Teeth with a mature dental plaque on the occlusal surface and younger children had more active caries than inactive occlusal carious lesions (excluding sound teeth in the analysis). A previous visit to a dentist was related to a lower frequency of active occlusal carious lesions classified by NY only, and upper primary molars presented with higher numbers of active occlusal carious lesions classified by ICDAS‐LAA. Conclusions: Presence of mature dental plaque and tooth type are tooth‐related variables associated with active carious lesions on occlusal surfaces of primary teeth, as well as anterior caries experience and age are variables related to the child.     

Epidemiology of dental caries in the premolar and second molar teeth of Scottish children in relation to pits and fissures

To evaluate the potential benefits from elimination of dental caries in the fissures of teeth, surface patterns of decay were calculated for all surfaces of the premolar and second molar teeth of 98 children followed longitudinally for 5 years, between ages 11 and 15 years. Tooth eruption and susceptibility were also examined in relation to the administration of sealant programs. The children who were part of the control group of a fluoride dentifrice study on the Scottish Isle of Lewis, had low exposure to fluorides, high caries attack and very low restorative treatment levels; so true surface caries distribution was not masked. Variation in tooth eruption and susceptibility suggested that semiannual applications of preventive agents at each year age 10 through 15 might be required. Using hypothetical percentage reductions, the substantial potential benefits for caries control of the early use of completely retained occlusal, as well as buccal and lingual (molars), fissure sealants are conclusively demonstrated. However, improvements in the present technology of fissure sealants and their application are apparently required if these benefits are to be extended to large groups of children.     

Application of life table methodology in determining dental caries rates

Probabilities of caries risk over time measured from eruption of first and second molars are illustrated using life table methodology. Life table rates based on 4,365 children in the National Preventive Dentistry Demonstration Program indicate that both fluoridation and sealants are effective in preventing caries on occlusal and buccal/lingual surfaces of molars. Effectiveness would probably have been greater on occlusal surfaces if sealants had been applied closer to the time of eruption. Similarities and differences between conventional DMFS indices and life table probabilities are discussed.     

Relationships between occlusal or free-smooth and approximal caries in mixed dentition

This cross-sectional study aimed to examine the relationships between free-smooth or occlusal surfaces and approximal caries in 104 schoolchildren between 6 and 8 years of age. Caries diagnosis was clinically and radiographically assessed, and white spot lesions, evident caries lesions or restorations, as well as radiolucence in enamel were considered to be caries. In the studied subjects, the correlations were analyzed in the 1st primary molars (Ds), the 2nd primary molars (Es), the 1st permanent molars (6s), and all molars. The data were statistically analyzed by chi-square test. Significant correlations between occlusal surface caries and approximal surface lesions were observed in Ds and Es teeth and in all molars, but not for 1st permanent molars. For free-smooth surface, these correlations were significant only for Es and all molars. Sensitivity and specificity for occlusal surface as an indicator of approximal caries in the same tooth type ranged from 73% to 83% and 51% to 58%, respectively. Similarly, for free-smooth surface the values varied from 22% to 60% and 57% to 90%, respectively. Sensitivity and specificity for occlusal surface caries in identifying subjects with approximal caries were 78% and 70%, respectively; for free-smooth surface, the corresponding values were 59% and 65%, respectively. The results suggest that visually detected caries lesions are indicative of approximal caries. Thus, if a certain risk limit is defined and the corresponding number of caries lesions in different surfaces is reached, the risk is above the threshold and could be a practical guideline on the need for radiography in this age group of patients with "moderate caries experience".     

Relationships between occlusal or free-smooth and approximal caries in mixed dentition

This cross-sectional study aimed to examine the relationships between free-smooth or occlusal surfaces and approximal caries in 104 schoolchildren between 6 and 8 years of age. Caries diagnosis was clinically and radiographically assessed, and white spot lesions, evident caries lesions or restorations, as well as radiolucence in enamel were considered to be caries. In the studied subjects, the correlations were analyzed in the 1st primary molars (Ds), the 2nd primary molars (Es), the 1st permanent molars (6s), and all molars. The data were statistically analyzed by chi-square test. Significant correlations between occlusal surface caries and approximal surface lesions were observed in Ds and Es teeth and in all molars, but not for 1st permanent molars. For free-smooth surface, these correlations were significant only for Es and all molars. Sensitivity and specificity for occlusal surface as an indicator of approximal caries in the same tooth type ranged from 73% to 83% and 51% to 58%, respectively. Similarly, for free-smooth surface the values varied from 22% to 60% and 57% to 90%, respectively. Sensitivity and specificity for occlusal surface caries in identifying subjects with approximal caries were 78% and 70%, respectively; for free-smooth surface, the corresponding values were 59% and 65%, respectively. The results suggest that visually detected caries lesions are indicative of approximal caries. Thus, if a certain risk limit is defined and the corresponding number of caries lesions in different surfaces is reached, the risk is above the threshold and could be a practical guideline on the need for radiography in this age group of patients with “moderate caries experience”.     

Impact of caries onset on number and distribution of new lesions in preschool children

International Journal of Paediatric Dentistry 2013; 23: 39–47 Background. Caries in preschool children remains an important public health issue. Aim. To determine (i) which teeth and tooth surfaces are most susceptible to dental caries by age 3, (ii) where do caries lesions develop during 2‐year follow‐up, and (iii) to evaluate the impact of caries onset on the distribution of new caries experience. Design. One thousand and fifty seven consecutively born children were recruited in Flanders (Belgium). Parents completed validated questionnaires on oral health‐related behaviour and trained dentists examined the children at ages 3 and 5. Results. Children with visible caries experience at age 3 were significantly more vulnerable in developing additional caries during follow‐up. In this group, new caries experience developed primarily in the occlusal and distal surfaces of the mandibular first molars and the occlusal surfaces of the maxillary second and first molars, whereas in the caries‐free group, the occlusal surfaces of both mandibular and maxillary second molars ranked first. Conclusions. This paper confirms the higher vulnerability for further caries development in those children with caries experience at age 3. Visible caries develops most frequently in the occlusal surfaces of the second molars: in high‐risk children already by age 3 and in children who were caries free at baseline by age 5.     

Caries preventive efficacy of silver diammine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines

Background

Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries.The objective of the study was to assess and compare the effect of a single application of 38% SDF with ART sealants and no treatment in preventing dentinal (D3) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste.

Methods

The prospective community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program. Children were randomly assigned for SDF application or ART sealant treatment. Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls. SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars. Surfaces that were originally defined as sound at baseline but which changed to dentinal (D3) caries lesions were defined as surfaces with new caries (caries increment). Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children.

Results

In the brushing group, caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 (0.02-0.61). In the non-brushing group, caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group (HR 0.33; 0.20-0.54). Caries increment was lower in toothbrushing children than in non-toothbrushing children. Hazard ratios reached statistical significance for the non-treated children (HR 0.43; 0.21-0.87) and the sealant-treated children (HR 0.15; 0.03-0.072).

Conclusions

A one-time application of 38% SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal (D3) caries lesions. ART sealants significantly reduced the onset of caries over a period of 18 months.

Trial registration number

German Clinical Trial Register DRKS00003427

     

Community effectiveness of fissure sealants and the effect of fluoridated water consumption

OBJECTIVES: This study investigated the effectiveness of fissure sealants in a community-based programme and the relationship between fissure sealants effectiveness and exposure to fluoridated water. DESIGN: Prospective cohort study of children attending the School Dental Service (SDS) of two Australian states, Queensland and South Australia, across a period of between 6 months and 3.5 years (mean = 2 years). METHODS: Oral health data on 4-15-year-olds were obtained as part of regular examinations by the SDS while questionnaire data on residential and water consumption history were provided by children's parents or guardians. PARTICIPANTS: A sub-group of 789 children (mean age = 10.5 years) was selected with one contralateral pair of permanent first molars at baseline where the occlusal surface of one molar had been fissure sealed while the paired surface was diagnosed as sound. RESULTS: The caries incidence of the fissure sealed occlusal surfaces was 5.6% compared to 11.1% for sound surfaces (p < 0.001), demonstrating a 50% reduction in caries incidence for sealed vs non-sealed surfaces. The reduction in caries increment attributable to fissure sealing increased across fluoridated water exposure categories--a 36.4% reduction was found for children with 0% exposure (p > 0.05), a 55.0% reduction for children with intermediate exposure (p < 0.01), and an 82.4% reduction for children with 100% lifetime exposure to fluoridated water (p < 0.001). Differences between odds ratios for fissure sealants across exposure categories were not statistically significant. CONCLUSIONS: The effectiveness of fissure sealants in community-based programmes may be further improved when coupled with increased lifetime exposure to optimally fluoridated water.     

Clinical and radiographic judgement of occlusal caries in adolescents

In this study, the clinical and radiographic material of two groups of 17- and 20-yr-old adolescents, born either in 1970 or in 1976, was compared to study changes in the prevalence of occlusal dentine caries and to determine the additional value of the bitewing radiographs. The first and second molars of 478 participants were included. Clinical data were derived from an epidemiological project. Two examiners judged the bitewing radiographs, of which about 10% was examined by both. The overall Cohen's kappa for interexaminer agreement was 0.87. The prevalence of occlusal caries had not changed for the two age groups; after clinical and radiographic examination, around 33% of the occlusal surfaces of the 17 yr olds and around 25% of the 20 yr olds exhibited dentine caries. The clinical prevalence of occlusal caries in first and second molars was highly underestimated when compared with the radiographs. In the 1976 group, more sealants were recorded during the clinical examination. On the bitewing radiographs, radiolucencies were found underneath one-half of the sealants of the 17 yr olds and underneath one quarter of the sealants present in the 20 yr olds.     

Effectiveness of sealants in adolescents with high and low caries experience

The aim of this 3-year longitudinal study was to analyze caries increment and the caries-preventive effect of sealants in adolescents in the setting of the German national health system. 434 pupils (193 male, 241 female) took part in compulsory school examinations at age 12 (mean 12.3 +/- 0.4 years) and 15 (mean 15.6 +/- 0.3 years) according to WHO criteria, including the examination of sealants. Mean DMFT increased from 1.78 (+/- 2.15) to 3.97 (+/- 3.68), mean DMFS from 2.79 (+/-4.07) to 6.94 DMFS (+/- 8.34), respectively. Logistic regression analysis showed that high caries incidence at the individual level was mostly associated with the type of school ('Gymnasium', RR = 0.3), gender (female, RR = 2.08) and high baseline DMFS (RR = 1.2 per surface), but not with the number of sealants. In an interaction model, adolescents with high baseline DMFS values had an even higher risk of caries increment with an increasing number of sealants compared to adolescents with fewer sealants (p = 0.047). At the tooth level, this effect was detected for first permanent molars, while sealants in premolars and second permanent molars did not result in a statistically significant caries-preventive effect due to the low caries incidence on these surfaces. Thus, sealants on occlusal surfaces of first permanent molars were only protective in individuals with low or moderate caries activity (p = 0.006), which indicates the need for other measures to reduce caries activity in high risk adolescents. In addition, rates of 19% lost sealants and 18% carious or filled surfaces in 3 years suggest a discrepancy between sealant retention under real-life conditions and the results of controlled clinical trials.     

Effectiveness of sealant treatment over five years in an insured population

BACKGROUND: The authors analyzed an insurance claim database to evaluate the use and effectiveness of placing sealants on first and second permanent molars of children in private dental practices. METHODS: A retrospective study was conducted using an insured population with sealant coverage at 70 percent of the usual fee in a preferred provider organization than that limited reapplication to once every three years. Children were selected who were eligible for sealant benefits from July 1, 1990, to June 30, 1991. Two groups were selected for analysis, based on age, as determined by permanent molar eruption dates. Children who received sealants were compared with those who did not to determine post-sealant restorative outcomes after five years. RESULTS: During the full year of coverage, sealants were used in only 16.3 percent of first permanent molars and 11.6 percent of second permanent molars. The five-year incidence of an occlusal restoration having been placed was 13.7 percent and 20.8 percent, respectively, on nonsealed first and second molars and 6.5 percent and 10.4 percent, respectively, on sealed first and second molars. From years three to five, sealant placement provided only nominal additional preventive effect. CONCLUSIONS: In the population selected, both the incidence of occlusal caries and the use of sealants were lower than expected for both age groups. However, within these groups, molar occlusal surfaces were only half as likely to have been restored in sealed teeth than in nonsealed teeth after five years. CLINICAL IMPLICATIONS: Based on the five-year data from a population with a low incidence of caries, the authors found that 15 sealed first permanent molars or 10 sealed second permanent molars prevented placement of one occlusal restoration. Therefore, sealants are more effective when placed in patients with risk factors for occlusal caries.     

Retention of a glass ionomer cement and a resin-based fissure sealant and effect on carious outcome after 7 years

Abstract– The aim of this study was to compare the retention and caries preventive efficacy of glass ionomer (Fuji III; GIC) and light-cured resin-based (Delton; LCR) fissure sealants. One hundred and sixty-six 5–14-year-old schoolchildren received sealants on their newly erupted first or second molars; a split mouth design was used. Previously reported 2-year results showed low retention rates for GIC sealants, but no difference in the caries increment between the groups. The same persons were invited to a dental check-up 6.1 to 7.8 (mean 7.1) years after the application of sealants; 111 persons (66.8% of the original group) participated in the study. The retention of sealants, and the caries status of occlusal surfaces and adjacent proximal surfaces was recorded. On the sealed occlusal surfaces, 10% of GIC and 45% of LCR sealants were totally and 9% of GIC and 20% of LCR sealants partially present. Twenty-three (23.5%) of the occlusal surfaces sealed with GIC and 16 (16.5%) of those sealed with LCR were carious or filled. Compared to LCR sealants, the effectiveness of GIC sealants was –44% (95% CI –71%, 16%) and net gain –7% (95% CI –18%, 4%). The relative risk of caries occurring was –44 (95% CI 0.96, 2.14).     

A comparative study of two pit and fissure sealants: three-year results in Augusta, Ga.

A total of 254 children were examined 36 months after a single application of sealant. In 128 children, 201 permanent first molars were treated with Delton, and, in 126 children, 205 permanent first molars were treated with Nuva-Seal. Delton was completely retained on 80% of all paired permanent first molars, partially retained on 10%, and completely lost on 10% of the study teeth. Nuva-Seal was completely retained on 60% of all paired permanent molars, partially retained on 21%, and completely lost on 19% of the study teeth. Delton was 69% effective in preventing occlusal caries on permanent first molars three years after a single application. Nuva-Seal was 39% effective in preventing occlusal caries on permanent first molars three years after a single application. Both sealants have been shown to prevent dental caries on permanent first molars of children three years after a single application.     

Dental caries among children from Solntsevsky – a district in Moscow, 1993

Abstract In order to provide a baseline for planning a caries preventive program for children in a district in Moscow, samples of 6-, 8-, 10-, 12-, and 14-yr-old children were examined. The initial examination included recording of plaque on selected surfaces using a classification from 0 to 2 (thick plaque). After supervised tooth brushing, the children were examined for caries. Each tooth surface was examined and classified in progressive stages of caries involving opaque enamel lesions, increasing stages of cavity formation, fillings with and without caries and extractions due to caries. Gingival status in selected locations was classified from 0 to 2 (severe inflammation). More than 2/3 of the children had surfaces covered with thick plaque (score 2). Gingivitis was observed in one or more places in 2/3 of the children. Caries experience in the primary dentition was high, and low to moderate in the permanent dentition. However, the average number of surfaces with deep dentin cavitation, indicating pulpal involvement in 14-yr-olds, was 1.7. Caries on primary molar teeth accounted for about 80% of the accumulated caries experience among the 8-yr-olds. Caries on permanent first molars accounted for about 70% of the accumulated caries experience among the 14-yr-olds. The occlusal surface on permanent first molars was the most prone to caries in the permanent dentition.     

Progression of proximal caries in the mixed dentition: a 4-year prospective study

PURPOSE: The purpose of this study was to investigate the survival rate and median survival time of different stages of proximal caries in 196 children aged 6 to 8 years at baseline examination. METHODS: Proximal caries and its progression were diagnosed from bitewing radiographs taken at 1-year intervals over a period of 4 years. The mesial surface of the first permanent molars, the mesial and distal surfaces of the first and second primary molars, and the distal surface of the primary canine were examined. Sound surfaces, caries lesions in the external- and internal-half of the enamel and external-, middle-, and internal-third of the dentin, as well as filled, extracted, and exfoliated teeth were recorded. A life table analysis was performed to estimate the annual and cumulative survival rates and the median survival time of each state of proximal lesions. RESULTS: For the sound mesial surfaces of the first permanent molars, the cumulative survival rate was 76% and the median survival time was over 48 months. The corresponding values for the external-half of the enamel lesions were 41% and 45 months. Regarding the sound mesial and distal surfaces of the primary teeth, the cumulative survival rate was 92% and the median survival time was over 48 months. The corresponding values for the external and internal-half of the enamel lesions were 40% and 31 months, and 29% and 22 months, respectively. The value of the cumulative survival rate for the external-third of dentin lesions was 42%, with a median survival time of 34 months, and the value for the middle-third of the dentin was 38% with a median survival time of 17 months. CONCLUSIONS: The risk of developing carious lesions in the sound proximal surfaces of both primary teeth and first permanent molars is low during the mixed dentition period; the progression of the external-half of enamel lesions of the first permanent molars is low for the first 3 years and becomes faster thereafter; and as the time period that the tooth exposed to cariogenic factors increases, the progression of the proximal caries is faster for all stages of the lesion in the primary teeth.     

Three-year study of the effect of fluoride varnish (Duraphat) on proximal caries progression in teenagers

Abstract – The effect of sodium fluoride varnish (Duraphat) applications on proximal caries progression was studied during a 3-yr period in 87 teenagers and compared to a control group (n= 107). In the fluoride varnish group the children were treated with fluoride varnish every third month during the experimental period. Caries lesions on the mesial surfaces of first premolars to the mesial surfaces of second molars were recorded annually on radiographs and an individual progression value was calculated. The study showed that topical application of fluoride varnish every third month significantly (p<0.05) reduced the progression of proximal caries lesions in premolars and molars. The most obvious reduction of caries progression was observed among children who developed between two and eight new proximal lesions during the test period. In the children with the highest caries activity (> nine new proximal lesions) Duraphat treatments did not significantly reduce proximal caries progression in premolars and molars.     

Eruption Pattern of Permanent Molars: Implications for School-based Dental Sealant Programs

Dental caries remains a prevalent, chronic disease of childhood. The preponderance of dental caries is located on the pit and fissure surfaces of teeth, an area where dental sealants are most effective in preventing this malady. In the school year 1987-88, 4,879 Ohio schoolchildren participated in an assessment of dental health. Grades chosen for this assessment included 1, 2, 3, 6, 7, 8, and 11. This study focuses on eruption of first and second permanent molars in development of a timing strategy for placement of occlusal sealants in a school-based program. An eruption score was developed for the determination of the first or second molar eruption status for each child. The data were analyzed for grade, sex, race, locale, fluoridation status, and percent of children on free or reduced-cost lunch programs. Analyses were performed on 2,215 children in grades 1-3 and 1,840 children in grades 6-8. Fifty-seven percent of first graders had all first permanent molars sufficiently erupted for sealant placement on the occlusal surface. Likewise, 23.6 percent of sixth graders had sufficient occlusal exposure on the second molar. Females showed an earlier eruption pattern than males for both first (P less than .05) and second (P less than .001) molars. Black children preceded white children only in the eruption of the second molar (P less than .001). This study provides dental public health decision makers with state-specific information on the earliest time to initiate a school-based occlusal sealant program.(ABSTRACT TRUNCATED AT 250 WORDS)