Validation of DIAGNOdent laser fluorescence and the International Caries Detection and Assessment System (ICDAS) in diagnosis of occlusal caries in permanent teeth: an in vivo study

The aim of this in vivo study was to validate the DIAGNOdent laser fluorescence method and the International Caries Detection and Assessment System (ICDAS) for caries classification against the gold standard, histological examination, for detecting occlusal caries on permanent molars; the thresholds used were the outer enamel (D1), the inner enamel and outer third of the dentine (D2), and the inner two‐thirds of the dentine (D3). Patients with non‐impacted third molars (n = 43) were recruited from a university clinic. A trained examiner performed the examinations. After the teeth were extracted, the histological criterion was used to determine the severity of the lesions. Intra‐examiner agreement (weighted kappa) for ICDAS was 0.60 and reliability (intraclass correlation coefficient) for DIAGNOdent was 0.968. The correlations with the histological reference were weak for DIAGNOdent (r_s = 0.369) and moderate for ICDAS (r_s = 0.515). The areas under the receiver–operating characteristics (ROC) curve at D1, D2, and D3 were 0.60, 0.69, and 0.91, respectively, for ICDAS and 0.55, 0.65, and 0.92, respectively, for DIAGNOdent. ICDAS and DIAGNOdent proved to be reproducible methods with similar performance in the detection of occlusal carious lesions in dentine. The ability of DIAGNOdent to detect initial enamel lesions was higher than that of ICDAS, but with low specificity. The usefulness of DIAGNOdent as an adjunct method for assessment of initial occlusal caries in permanent molars is questionable.     

Comparison of laser fluorescence devices for detection of caries in primary teeth

The aim of this in vivo study was to evaluate the performance of fluorescence‐based devices in detecting occlusal caries lesions in primary molars compared with conventional methods. Two examiners assessed 44 occlusal surfaces of first and second primary molars in 20 patients using two fluorescence devices: DIAGNOdent (LF) and DIAGNOdent pen (LFpen). Teeth were also assessed by visual examination and bitewing radiograph. Histological examination served as the gold standard after extraction. By using the McNemar test, the sensitivity, specificity, accuracy, and area under the receiver operating curve were calculated as outer enamel (D1), inner enamel (D2) and dentine caries (D3) lesion thresholds. The intra‐ and inter‐examiner reproducibility were calculated using the Cohen's unweighted kappa statistics. At the D1 threshold, the LFpen sensitivity was statistically higher than LF and radiographic examination (P < 0.001), whereas there was no statistically significant difference among the groups at the D2 and D3 thresholds (P > 0.05). All methods demonstrated the highest sensitivity values at D3. At the D1 and D2 thresholds, there were no significant differences between the LFpen specificity and the other methods. All methods presented similar performance in detecting all lesions considering the area under the receiver operating curve. The LFpen showed better performance than LF. Furthermore, visual examination and the LFpen device seem to be sufficient for detection of occlusal caries in primary molars.     

激光龋齿诊断仪诊断早期窝沟龋的体外研究

目的：研究激光龋齿诊断仪（DIAGNOdent)诊断早期窝沟龋的敏感性，特异性，准确性，材料和方法。选择124颗恒磨牙为样本；清洁He面，拍摄He面图像，确定窝沟的某一点为检查位点，以DIAGNOdent检测该位点，记录显示值，并在He面图像上标记被检位点，在检测点的位置切片，磨片，做显微放射照片分析。以显微放射照片分析所得龋损分级结果作为金标准，对DIAGNOdent的检测结果进行统计分析。结果：DIAGNOdent诊断窝沟龋，在D1水平上其敏感性和特异性为58%和89.1%；在D2水平上其敏感性和特异性为；53.8%和94.9%；在D3水平上其敏感性和特异性为：40%和95.6%。结论：DLAGNOdent具有较高的诊断早期窝沟龋的能力。     

Occlusal caries detection in primary teeth: a comparison of DIAGNOdent with conventional methods

OBJECTIVE: To compare the accuracy and repeatability of three diagnostic systems (DIAGNOdent, visual and radiographic) for occlusal caries diagnosis in primary molars. DESIGN: Two examiner, in vitro, blinded study. Histological gold standard. MATERIALS AND METHODS: 58 occlusal surfaces of primary molars examined in turn by two examiners using each of three diagnostic systems (DIAGNOdent, visual and radiographic). These results were compared with a histological gold standard. Sensitivity and specificity were calculated for each diagnostic system at a range of thresholds. Inter- and intra- examiner repeatability were calculated for each diagnostic system using the kappa statistic. MAIN OUTCOME MEASURES: Sensitivity, specificity, inter and intra examiner repeatability for each diagnostic system. RESULTS: The highest sensitivity values were provided by DIAGNOdent (0.77 and 0.80, examiners 1 and 2 respectively) however this was offset by a lower specificity (0.82 and 0.85) than all other systems with the exception of examiner 1 at V1 visual threshold. The DIAGNOdent gave the highest values of kappa for intra- and inter-examiner repeatability with the exception of intra-examiner repeatability for examiner 2 where visual diagnosis had the highest value of kappa. CONCLUSION: The DIAGNOdent was the most accurate system tested for the detection of occlusal dentine caries in primary molars. The performance of the DIAGNOdent systems was not statistically significantly better than that achieved using visual examination for non-cavitated teeth (V1 and V2 threshold). DIAGNOdent may prove useful as a predictive clinical tool, however with appropriate training visual examination may offer similar results without the need for additional equipment.     

Clinical evaluation of diagnodent in detection of occlusal caries in children

The aim of this in vivo study was to evaluate the effectiveness of DIAGNOdent, visual and radiographic examination in detecting non-invasive diagnosis of occlusal caries in children. In this study, 92 untreated molars with sound occlusal surface or enamel and/or dentin caries were selected from 28 healthy patients, aged 7-17 years. All teeth were examined by two researchers using each of three diagnostic system (DIAGNOdent, visual, radiographic). Interpretation of the DIAGNOdent value and the radiolucency on the bitewing film were combined with the visual examination to decide where the teeth had to be opened. Depth of caries was recorded. Sensitivities and specificities were calculated for each diagnostic method using the biopsy scores as gold standard. Intra- and inter-examiner reproducibility for each method was assessed by calculating Cohen's kappa. The kappa value of inter-examiner reproducibilty was highest for visual examination (0.935), and lowest for DIAGNOdent measurements (0.698). Intra-examiner reproducibilty of DIAGNOdent mesurements was also good (0.745 and 0.665). Sensitivity and specificity for DIAGNOdent, visual examination and bitewing radiography were 0.86/0.80, 0.69/1.00 and 0.36/1.00, respectively. It was concluded that Diagnodent with a high sensitivity may be useful adjunct to visual examination with a high specificity in detecting occlusal caries.     

Reliability and validity issues of laser fluorescence measurements in occlusal caries diagnosis

OBJECTIVES: Recently, a device for detecting occlusal caries lesions based on laser fluorescence measurements (DIAGNOdent) has been introduced. The reliability (reproducibility) and validity of this laser-fluorescence device were investigated. METHODS: In the in vitro part of the study, 49 permanent molars were measured by two observers using two DIAGNOdent devices. In addition, visual inspection was performed. The teeth were sectioned to measure the actual depth and area of the caries lesions. In the in vivo part of the study, 45 sites at the occlusal surfaces of permanent molar teeth in 13 patients were measured by two observers using two DIAGNOdent devices, manufactured in two successive years. RESULTS: The reliability of both DIAGNOdent devices expressed in the intraclass correlation coefficient (ICC=0.90 for observer 1, and 0.88 for observer 2) was high, and so was the interobserver reliability (ICC=0.85 for the 1998-device, ICC=0.90 for the 1999-device). The correlation between DIAGNOdent measurements and the actual depth of the caries lesions was lower than that of visual inspection by one observer, yet higher than that of a second observer. The specificities of visual inspection (0.94 and 0.88) were higher than those of the DIAGNOdent devices, whereas the sensitivities of the DIAGNOdent devices (0.93-1.00) exceeded those of visual inspection The validity of the DIAGNOdent, expressed as the area under the receiver operating characteristic curve, was not statistically significantly different from that of visual inspection (P>0.05). The DIAGNOdent measurements showed a higher association with the enamel part of the caries lesion than with the dentinal part. CONCLUSIONS: The DIAGNOdent is suitable for monitoring small caries lesions. Because of the high reproducibility of DIAGNOdent devices produced in successive years, a DIAGNOdent device may be replaced by a new one. Due to the higher specificity, visual inspection should be preferred to diagnose occlusal caries lesions in populations with a low caries prevalence.     

A follow-up study of the use of DIAGNOdent for monitoring fissure caries in children

OBJECTIVES: The aim of this study was to evaluate the utility of the laser fluorescence device DIAGNOdent for monitoring occlusal caries longitudinally as part of a routine dental check-up in a public dental clinic. METHODS: Children aged 7-8 and 13-14 years at baseline participated in the study. As part of two consecutive dental check-ups with a mean interval of 1,19, years, 423 permanent molars and 315 primary molars in 81 children were examined visually and using DIAGNOdent by one dentist. In teeth where, as judged by visual examination, caries had emerged or progressed during the follow-up, the DIAGNOdent values had increased significantly from the baseline. RESULTS: In permanent teeth with a change in visual score from sound to enamel or dentin caries, the mean DIAGNOdent value increased from 24 to 37 and in primary teeth from 8 to 40. The increase in DIANGOdent values correlated positively with the increase in visual score. The mean DIAGNOdent value at baseline was significantly higher in teeth that became carious than in those that remained sound during the follow-up. For permanent teeth with a visual reversal from inactive or active enamel caries to a sound surface, the mean DIAGNOdent value decreased from 36 to 24. CONCLUSIONS: These results suggest that DIAGNOdent is useful in monitoring occlusal caries in both permanent and primary molars.     

Clinical evaluation of visual,radiographic, and laser fluorescence methods for detection of occlusal caries

The aim of this clinical study was to test cut-offs for occlusal caries detection by the laser fluorescence device DIAGNOdent (DD) in comparison to visual-ranked inspection (VI) and bitewing radiographs (BW) under condition of a general dental practice. 281 occlusal surfaces of permanent molars from 97 patients were examined with VI, DD and BW. Caries extent was verified by bioptical intervention (gold standard) of 248 molars. Upon biopsy no molar was assessed as caries free, 24 teeth had caries confined to enamel and 224 teeth revealed dentine caries. For dentine caries detection DD achieved the highest values for sensitivity (0.93), specificity (0.63) and agreement (0.89) followed by BW with figures of 0.70, 0.96 and 0.69, respectively. VI exhibited the lowest sensitivity (0.25) and agreement (0.25), but the highest specificity (1.00). It is advised to assess occlusal surfaces by a meticulous VI followed by the use of DD and/or BW as additional diagnostic tool of second choice. A DD value of > 20 could be confirmed as a sensitive cut-off for detection of occlusal dentine caries in first and second permanent molars. For the detection of early signs of enamel caries the DD seems to be less suitable.     

Comparison between a laser fluorescence device and visual examination in the detection of occlusal caries in children

Occlusal surfaces of molars are especially susceptible to the development of caries due to the features, such as pits and deep fissures, of their anatomical structure.AimTo evaluate the efficiency of DIAGNOdent laser fluorescence measurements in comparison with visual examination for occlusal caries detection for first permanent molars in children.MethodsThe study involved 156 permanent molar teeth in 40 children aged 7–12 years. A relatively new technology, the fluorescence laser DIAGNOdent pen, was used for detecting and diagnosing caries on the occlusal surfaces of molars. The visual examination of fissures was based on the Ekstrand classification system.ResultsThe results showed a strong relationship between examination with the DIAGNOdent and visual inspection. DIAGNOdent’s sensitivity and specificity were 97% and 52%, respectively, indicating that the laser fluorescence DIAGNOdent pen is a reproducible and accurate diagnostic tool that may be very helpful in conjunction with visual examination in the detection of occlusal caries in permanent molars in children.     

Clinical performance of a laser fluorescence device for detection of occlusal caries lesions

Children and adolescents must be examined often for occlusal caries. Diagnosis of fissure caries is difficult especially when the tooth surface appears seemingly intact. It has been shown that using traditional clinical methods, as little as 20% of teeth with fissure caries under intact surfaces were correctly recognised as such. Therefore, new methods for increasing the accuracy of diagnosis have been sought for years. Recently, a new device, based on fluorescence measurements, was introduced. The purpose of this study was to test the device under in vivo conditions in order to provide recommendations for its use in the dental office. Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients. Caries extent was determined for each site after operative intervention (='gold standard'). Clinical inspection and analysis of bitewing radiographs exhibited statistically significant lower sensitivities (31-63%) than did the DIAGNOdent device (sensitivity > or = 92%). It is recommended that the laser device is used in the decision-making process in relation to the diagnosis of occlusal caries as a second opinion in cases of doubt after visual inspection.     

Performance of conventional and new methods for the detection of occlusal caries in deciduous teeth

The aim of this study was to compare, in vitro, the performance of different conventional diagnostic techniques with the laser-based device, DIAGNOdent, for diagnosis of occlusal caries in deciduous teeth. 95 deciduous teeth with macroscopically intact occlusal surfaces were selected. All teeth were assessed by the following techniques: visual inspection (VI), visual inspection with magnification (VIM), visual inspection combined with light pressure probing (VIP), bitewing radiography (BW) and the DIAGNOdent (DD). Caries extension was assessed by histology. DIAGNOdent showed, in comparison with the conventional clinical methods, a significantly improved ability (p < 0.05) to detect dentinal lesions (D(3) or D(4)) in deciduous teeth and an overall performance similar to that obtained in previous studies on permanent teeth. There was no statistically significant difference between VIM and DD in detecting caries confined to enamel (D(2)). DD performed better at D(2) level than the other methods. The intraexaminer kappa scores for DIAGNOdent were 0.76-0.86 (D(2)) and 0.77-0.85 (D(3)), respectively. It was concluded that DIAGNOdent could be used as an additional tool in the detection of occlusal caries in deciduous teeth and its good reproducibility should enable the laser device to monitor the caries process over time.     

Performance of a new laser fluorescence device for the detection of occlusal caries in vitro

The new device DIAGNOdent pen based on red laser light induced fluorescence was introduced for the detection of approximal and occlusal caries. The aim of this study was to test its performance on occlusal surfaces. The new device comes with two different sapphire fibre tips: a cylindrical tip and a conical tip. The two new sapphire fibre tips were used and compared with the tip currently available with DIAGNOdent (DD). METHODS: The teeth were selected from a pool of extracted permanent human molars, which were stored frozen at -20 degrees C, until use. Prior to being measured the teeth were defrosted and cleaned. One hundred and nineteen teeth were selected and measured with the old tip and with the two new tips of the new device by two independent assessments. The teeth were histologically prepared and assessed for caries extension. RESULTS: Specificity values for D(1), D(2) and D(3) ranged between 0.69 and 0.89, sensitivity between 0.78 and 0.96. There were no statistically significant differences obtained between the two tips of the new and the one tip of the old device (p>0.05). Intra-examiner reliability with kappa values of >0.83 was high. CONCLUSIONS: In this study, the new laser fluorescence device performed on occlusal surfaces as well as the available device.     

On the retention and effectiveness of fissure sealant in permanent molars after 15-20 years: a cohort study

The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26-27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 13% caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30%, and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla (P<0.001). This longitudinal study showed that pit and fissure sealants--applied during childhood--have a longlasting, caries-preventive effect.     

Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements

This epidemiological study aimed to compare the diagnostic outcome of the WHO criteria, ICDAS II criteria, laser fluorescence measurements, presence of plaque and roughness as activity scores on occlusal fissures and buccal/palatal pits of the first permanent molars. The study involved 311 children between 8 and 12 years of age from the Ennepe-Ruhr District in North Rhine-Westphalia, Germany. The surface-related caries status was registered according to the WHO basic method criteria (1997). Additionally, pit and fissure sealants, the ICDAS II visual criteria, the DIAGNOdent reading, plaque retention and surface roughness were documented. Caries experience was 1.0 (+/-2.5) DMFS. About 70% of the examined students had no obvious dentin caries in the permanent dentition (DMFS = 0). Sealants were registered on 1.4 (+/-1.7) occlusal fissures and 0.4 (+/-0.9) palatal/buccal pits. Noncavitated caries lesions were recorded as ICDAS II score 1-4 on 1.8 (+/-1.6) fissures and 1.5 (+/-1.4) pits. The comparison of the diagnostic methods suggests a relationship between higher ICDAS II scores/DIAGNOdent values and a proportional increase in the occurrence of plaque as well as in the number of rough surfaces. In conclusion, this study showed the diagnostic potential of the ICDAS II criteria in comparison to the traditional WHO criteria by means of the noncavitated caries lesions additionally detected. The DIAGNOdent use in field studies that already apply detailed visual criteria seems to bring limited additional information. While the presence of plaque provides information for the caries activity assessment more work is required to provide information about the contribution of surface roughness.     

Clinical study of the use of the laser fluorescence device DIAGNOdent for detection of occlusal caries in children

Diagnosis of non-cavitated occlusal caries is generally considered problematic. The aim of this study was to evaluate the utility of the laser fluorescence device DIAGNOdent as part of routine dental check-ups in children. A total of 613 occlusal surfaces on permanent molars and 436 surfaces on primary molars in children aged 7-8 (n = 55) and 13-14 years (n = 54) were examined visually, using DIAGNOdent and for most 13- to 14-year-olds also using radiographs. The teeth were not cleaned professionally before examination. To provide a gold standard for carious teeth, the depth of the caries lesion was determined in those lesions that were judged visually to need opening by drilling (51 teeth). The higher the visual score, the higher were the mean DIAGNOdent values, but in each visual category the variation among values was large. The presence of a clear sealant did not affect DIAGNOdent measurements. The values for permanent and primary molars differed slightly. For permanent teeth, Youden's index value was highest (60%) at a cut-off value of 30, which indicates that the overall performance for DIAGNOdent in detecting dentinal caries was best at this point. Using this cut-off, sensitivity was 92% and specificity 69% with visual examination for validation, while sensitivity was 92% and specificity 82% with validation by fissure opening. Of the three methods, radiographic examination was the least accurate. In routine dental check-ups of children, DIAGNOdent appears to be useful as an adjunct to visual examination.     

The occlusal fissure of unerupted third molars as an experimental caries model in man

abstract — The aim of the present Investigation was to establish an experimental model for the study of fissure caries development under conditions as similar as possible to the in vivo situation. Twenty-one blocks (2×2×3 mm) constituting part of the occlusal fissure were made from unerupted human third molars, and implanted for 60 or 90 d in mandib-ular molars of students. One milliliter of a 50 70 sucrose solution was applied to the fis-sures twice a day. After removal, sections were examined microradiographically in polarized light and in the electron microscope As a control, the morphology and enamel structure of fissures from 10 unerupted third molars were studied. After 90 d a subsurface, radiolucent caries-like lesion was observed in two specimens only. When examined in air in polarized light, however, all sections exhibited caries-like lesions symmetrically located around the fis-sures. The 60-d material showed similar lesions, but not as frequently as the 90-d speci-mens. In the control material, half of the specimens demonstrated subsurface lesions as well. The experimental material processed for electron microscopy revealed that the fissure plaque mainly consisted of cocci and small rods. Most often the bacteria were separated from the enamel surface by a pellicle.     

Performance of fluorescence-based and conventional methods of occlusal caries detection in primary molars - an in vitro study

International Journal of Paediatric Dentistry 2012; 22: 459-466 Aim. This in vitro study aimed to test the performance of fluorescence-based methods in detecting occlusal caries lesions in primary molars compared to conventional methods. Design. Two examiners assessed 113 sites on 77 occlusal surfaces of primary molars using three fluorescence devices: DIAGNOdent (LF), DIAGNOdent pen (LFpen), and fluorescence camera (VistaProof-FC). Visual inspection (ICDAS) and radiographic methods were also evaluated. One examiner repeated the evaluations after one month. As reference standard method, the lesion depth was determined after sectioning and evaluation in stereomicroscope. The area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentine caries (D3) lesions thresholds. The intra and interexaminer reproducibility were calculated using the intraclass correlation coefficient (ICC) and kappa statistics. Results. At D1, visual inspection presented higher sensitivities (0.97-0.99) but lower specificities (0.18-0.25). At D3, all the methods demonstrated similar performance (Az values around 0.90). Visual and radiographic methods showed a slightly higher specificity (values higher than 0.96) than the fluorescence based ones (values around 0.88). In general, all methods presented high reproducibility (ICC higher than 0.79). Conclusions. Although fluorescence-based and conventional methods present similar performance in detecting occlusal caries lesions in primary teeth, visual inspection alone seems to be sufficient to be used in clinical practice.     

A longitudinal study of occlusal caries among schoolchildren in Dar es Salaam, Tanzania

OBJECTIVES: To describe the clinical caries status and the radiographic progression of occlusal caries lesions in permanent first and second molars among primary schoolchildren in Dar es Salaam over a 3-year period. METHODS: Clinical and radiographic diagnosis of caries in first and second permanent molars in 223 children aged 8-16 years were carried out annually from 1994 to 1997. The drop-out rates from the baseline in 1994 to the follow-up examinations in 1995, 1996 and 1997 were 16.6%, 22.0% and 35.4%, respectively. Twenty-one percent of the dropouts were picked up during the study. RESULTS: Less that 5% of all occlusal surfaces that were sound at the beginning of the study developed new clinical caries lesions over the 3-year study period. The highest rate of new lesions was found in second molars. The mandibular second molars were most frequently affected by new caries lesions followed by the mandibular first molars. Progression of lesions was generally slow. After 1, 2 and 3 years, 30.0%, 47.9% and 52.8% of lesions in occlusal surfaces of first molars had progressed, compared to 47.9%, 71.3% and 100.0% of lesions in second molars. CONCLUSIONS: Dental caries prevalence was low. New occlusal lesions were more likely to appear in mandibular second molars. Carious lesions were progressing slowly, especially in the first molars. Fissure abrasion may play a role in minimizing the risk of developing new occlusal lesions as well as progression of existing lesions.     

Performance of fluorescence‐based and conventional methods of occlusal caries detection in primary molars – an in vitro study

International Journal of Paediatric Dentistry 2012; 22: 459–466 Aim. This in vitro study aimed to test the performance of fluorescence‐based methods in detecting occlusal caries lesions in primary molars compared to conventional methods. Design. Two examiners assessed 113 sites on 77 occlusal surfaces of primary molars using three fluorescence devices: DIAGNOdent (LF), DIAGNOdent pen (LFpen), and fluorescence camera (VistaProof‐FC). Visual inspection (ICDAS) and radiographic methods were also evaluated. One examiner repeated the evaluations after one month. As reference standard method, the lesion depth was determined after sectioning and evaluation in stereomicroscope. The area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentine caries (D3) lesions thresholds. The intra and interexaminer reproducibility were calculated using the intraclass correlation coefficient (ICC) and kappa statistics. Results. At D1, visual inspection presented higher sensitivities (0.97–0.99) but lower specificities (0.18–0.25). At D3, all the methods demonstrated similar performance (Az values around 0.90). Visual and radiographic methods showed a slightly higher specificity (values higher than 0.96) than the fluorescence based ones (values around 0.88). In general, all methods presented high reproducibility (ICC higher than 0.79). Conclusions. Although fluorescence‐based and conventional methods present similar performance in detecting occlusal caries lesions in primary teeth, visual inspection alone seems to be sufficient to be used in clinical practice.     

武汉市6～8岁儿童龋病及第一恒磨牙窝沟形态调查研究

目的调查武汉市6～8岁儿童龋病和第一恒磨牙窝沟形态情况,为儿童患龋风险评估和龋病预防政策的制定提供理论依据。方法选取武汉市区5所小学二年级学生,共检查1043名儿童,平均年龄7.6岁。由两名口腔医师检查龋病和第一恒磨牙窝沟形态。其中,龋指数采用改良世界卫生组织标准,使用单因素方差分析和t检验进行统计学分析。结果恒牙D3水平的患龋率为8.7%,乳牙d3水平的患龋率为68.7%。恒牙龋均和龋面均分别为0.11和0.14,乳牙龋均和龋面均分别为2.8和5.0。其中乳牙龋指数d3占d3mft的73.6%,而乳牙早期釉质龋牙数占乳牙d2水平牙数的36.4%。中窝沟和深窝沟第一恒磨牙的儿童占总受检人数的84.6%。结论武汉市6～8岁儿童的乳牙患龋率高,第一恒磨牙中度和深度窝沟比例较高,因此应对高患龋风险的儿童进行窝沟封闭等预防措施。