Cariostat法对成年患者的龋活跃性检测的效果评价

doi:10.13591/j.cnki.kqyx.2024.07.007

摘要/Abstract

摘要：

目的研究Cariostat检测法用于成年患者患龋风险评估的可行性,为不同年龄段成年门诊患者的龋病防治提供参考依据。方法用Cariostat检测法对南京医科大学附属口腔医院门诊就诊的52例不同年龄段成年患者(18~24岁,25~34岁,35~44岁,45~54岁,≥55岁)进行龋活跃性检测。并按照世界卫生组织《口腔健康调查基本方法》第5版的标准进行口腔检查,同时进行现场问卷调查,用于Cariogram系统评估。口腔检查包括牙列状况、患龋情况等,问卷调查包括饮食习惯、口腔保健习惯等。分析不同年龄段成年门诊患者患龋现状,用Cariostat法检测不同年龄段成年门诊患者的龋活跃性,得出其患龋风险等级,并与Cariogram系统评估的患龋风险等级进行比较,评价Cariostat检测法与Cariogram龋风险评估系统的一致性。结果 Cariostat检测法得出的不同龋风险等级的成年门诊患者低风险组与中、高风险组的龋面均有差异(P<0.05),Cariogram不同龋风险等级的成年门诊患者低风险组与中、高风险组的龋均、龋面均有差异(P<0.05);Cariostat检测法与Cariogram龋风险评估系统对成年患者龋风险等级的评估结果表明,在≥55岁组Kappa值为0.467(P<0.05),为中等一致性。结论 Cariostat检测法有利于了解成年门诊患者的龋活跃性,尤其是对55岁及以上患者更为准确有效。

关键词: 成年人, 龋风险评估, Cariostat, Cariogram, 龋病预防

Abstract:

Objective To investigate the feasibility of using Cariostat test for caries risk assessment in adult outpatients and provide a reference basis for caries prevention and treatment in adult outpatients of different ages. Methods Fifty-two adult patients of different ages (18-24, 25-34, 35-44, 45-54, and ≥55 years old) attending outpatient clinics of The Affiliated Stomatological Hospital of Nanjing Medical University were tested for caries activity using the Cariostat test. Oral examinations were conducted according to the criteria of the 5th edition of the Basic Methods of Oral Health Surveys of the World Health Organization, and on-site questionnaire surveys were performed for the Cariogram assessment system. Oral examinations included assessments of dental arch conditions and caries status, while questionnaire surveys covered dietary habits, oral health care habits, etc. The caries status of adult outpatients of different age groups was analyzed, and caries activity was assessed using the Cariostat test. The caries risk levels were determined, and the consistency between the Cariostat test and the Cariogram assessment system was evaluated. Results It was found that there was a difference in mean decayed, missing and filled surfaces (DMFS) between the low-risk group of adult outpatients with different caries risk levels classed by the Cariostat test and the intermediate and high-risk groups (P<0.05). There was a difference in mean decayed, missing and filled teeth (DMFT) and mean DMFS between the low-risk group of adult outpatients with different caries risk levels classed by Cariogram and the intermediate and high-risk groups (P<0.05). The evaluation results of caries risk levels in adult outpatients classed by the Cariostat test and the Cariogram assessment system showed a Kappa value of 0.467 (P<0.05) in the ≥55 years old group, indicating moderate consistency. Conclusion The Cariostat test is useful in understanding the caries activity of adult outpatients and is particularly accurate and effective in patients at the age of 55 or older.

Key words: adults, caries risk assessment, Cariostat, Cariogram, caries prevention

中图分类号:

R781.1

卞成玥, 关卓, 孙思怡, 崔闯, 江飞, 张光东. Cariostat法对成年患者的龋活跃性检测的效果评价[J]. 口腔医学, 2024, 44(7): 522-526.

BIAN Chengyue, GUAN Zhuo, SUN Siyi, CUI Chuang, JIANG Fei, ZHANG Guangdong. Evaluation of the effectiveness of Cariostat test on caries activity in adult patients[J]. Stomatology, 2024, 44(7): 522-526.

图/表 5

表1

不同年龄段成年门诊患者的患龋情况"

年龄/岁	总人数	龋均		龋面均
年龄/岁	总人数	中位数	$x ˉ$ ±s	中位数	$x ˉ$ ±s
18~24	10	2.50	3.50±3.72^a	5.00	6.30±7.45^b
25~34	10	3.50	3.90±2.28^a	7.50	7.10±4.61^b
35~44	10	5.50	5.30±3.56^a	9.50	10.40±7.56^ab
45~54	10	5.00	5.20±3.82^a	11.50	12.80±9.65^ab
≥55	12	4.50	7.17±6.25^a	16.50	24.58±26.25^a
r			0.255		0.419^**
P			0.068		0.002

表1

表2

Cariostat法与Cariogram龋风险评估系统不同患龋风险组患龋情况比较"

龋风险评估方法及等级		总人数	龋均		龋面均
龋风险评估方法及等级		总人数	中位数	$x ˉ$ ±s	中位数	$x ˉ$ ±s
	低	6	2.50	3.17±2.14^a	4.00	5.33±3.88^b
Cariostat	中	39	4.00	4.97±4.61^a	9.00	12.33±16.71^b
	高	7	8.00	7.43±2.76^a	22.00	25.29±14.96^a
r				0.313		0.398
P				0.024^*		0.003^**
	低	4	0.00	0.50±1.00^b	0.00	0.75±1.50^b
Cariogram	中	36	4.50	4.92±4.06^a	9.00	12.39±16.47^a
	高	12	8.00	7.17±4.49^a	14.50	17.67±12.51^a
r				0.415		0.428
P				0.002^**		0.002^**

表2

表3

表4

表5

参考文献 26

[1]	GBD 2016 Diseaseand Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet, 2017, 390(10100):1211-1259.
[2]	Vanhoenacker FM, Bosmans F, Vanhoenacker C, et al. Imaging of mixed and radiopaque jaw lesions[J]. Semin Musculoskelet Radiol, 2020, 24(5):558-569. doi: 10.1055/s-0039-3402766 pmid: 33036043
[3]	Mathur VP, Dhillon JK. Dental caries: A disease which needs attention[J]. Indian J Pediatr, 2018, 85(3):202-206. doi: 10.1007/s12098-017-2381-6 pmid: 28643162
[4]	台保军. 中国居民口腔健康状况及防控策略第四次全国口腔健康流行病学调查结果解读[C]// 第十三次全国老年口腔医学学术年会论文汇编, 武汉, 2018: 16-17.
[5]	Wang K, Pang L, Tao Y, et al. Association of genetic and environmental factors with dental caries among adolescents in South China: A cross-sectional study[J]. Eur J Paediatr Dent, 2020, 21(2):129-136. doi: 10.23804/ejpd.2020.21.02.07 pmid: 32567944
[6]	Clark MB, Braun PA. Promotion of oral health and prevention of dental caries among children in primary care[J]. JAMA, 2021, 326(21):2139-2140. doi: 10.1001/jama.2021.20396 pmid: 34874439
[7]	Iqbal A, Siddiqui YD, Chaudhary FA, et al. Caries risk assessment by Caries Management by Risk Assessment (CAMBRA) Protocol among the general population of Pakistan-a multicenter analytical study[J]. Peer J, 2024, 12: e16863.
[8]	李健, 刘璐. 应用Cariogram系统评估龋病风险的研究进展[J]. 中国医科大学学报, 2018, 47(5):461-463.
[9]	Shimono T. A new colorimetric caries activity test[J]. Dental Outlook, 1974, 43(6):829-835.
[10]	Otsugu M, Mikasa Y, Kadono M, et al. The number of erupted teeth as a risk factor for dental caries in eighteen-month-old children: A cross-sectional study[J]. BMC Oral Health, 2023, 23(1):671.
[11]	Bratthall D, Petersson GH. Cariogram: A multifactorial risk assessment model for a multifactorial disease[J]. Community Dent Oral Epidemiol, 2005, 33(4):256-264.
[12]	赵梅, 李欣, 陈薇, 等. 五种龋病风险评估方法对口腔门诊患者患龋风险水平区分能力的研究[J]. 北京口腔医学, 2020, 28(2):82-87.
[13]	侯丽媛, 刘梦佳, 公文, 等. 270名5岁自闭症儿童龋病及其影响因素调查分析[J]. 口腔医学, 2023, 43(12):1081-1085.
[14]	吴小利, 刘敏, 李仕超. Cariostat龋易感检测预测学龄前儿童新发龋病风险的价值[J]. 当代医学, 2022, 28(14):10-13.
[15]	玄松玉, 袁峻伟, 王珏, 等. Cariostat龋易感性检测技术用于评价3岁儿童患龋风险的研究[J]. 中华口腔医学杂志, 2017, 52(11):667-671.
[16]	Featherstone JDB, Crystal YO, Alston P, et al. A comparison of four caries risk assessment methods[J]. Front Oral Health, 2021, 2: 656558.
[17]	Hayes M, Da Mata C, McKenna G, et al. Evaluation of the Cariogram for root caries prediction[J]. J Dent, 2017, 62: 25-30. doi: S0300-5712(17)30094-5 pmid: 28456556
[18]	Tellez M, Gomez J, Pretty I, et al. Evidence on existing caries risk assessment systems: Are they predictive of future caries?[J]. Community Dent Oral Epidemiol, 2013, 41(1):67-78.
[19]	袁敬, 田欢, 龚士强, 等. 武汉市中老年人群口腔健康现况研究[J]. 华中科技大学学报(医学版), 2024, 53(1):105-109.
[20]	Banerjee S. Multimorbidity: Older adults need health care that can count past one[J]. Lancet, 2015, 385(9968):587-589. doi: S0140-6736(14)61596-8 pmid: 25468155
[21]	Lee HS, Lee ES, Kang SM, et al. Clinical assessment of a new caries activity test using dental plaque acidogenicity in children under three years of age[J]. J ClinPediatr Dent, 2016, 40(5):388-392.
[22]	Petersson GH, Fure S, Bratthall D. Evaluation of a computer-based caries risk assessment program in an elderly group of individuals[J]. Acta Odontol Scand, 2003, 61(3):164-171. doi: 10.1080/00016350310002261 pmid: 12868691
[23]	Twetman S, Fontana M. Patient caries risk assessment[J]. Monogr Oral Sci, 2009, 21: 91-101. doi: 10.1159/000224214 pmid: 19494677
[24]	Taqi M, Zaidi SJA. Predictive validity of the reduced Cariogram model for caries increment in non-cavitated and cavitated lesions: Cohort study[J]. BMC Oral Health, 2023, 23(1):790. doi: 10.1186/s12903-023-03479-w pmid: 37875839
[25]	国家统计局. 第七次全国人口普查公报[EB/OL].[2024-03-05]. https://www.gov.cn/guoqing/2021-05/13/content_5606149.htm.
[26]	Griffin SO, Griffin PM, Swann JL, et al. Estimating rates of new root caries in older adults[J]. J Dent Res, 2004, 83(8):634-638. doi: 10.1177/154405910408300810 pmid: 15271973