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...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龋和继发龋牙数均较高(上下颌乳尖牙再发龋和继发龋牙数分别为12和6,上下颌第一乳磨牙再发龋和继发龋牙数分别为16和12),上下颌第二乳磨牙以再发龋为主(再发龋和继发龋牙数分别为19和5)。治疗后再次患龋牙面数从高到低依次为乳磨牙邻面(37)、乳磨牙面(28)、乳尖牙邻面(13)、乳磨牙颊舌面(12)、乳前牙唇舌面(10)、乳尖牙唇舌面(8)和乳前牙邻面(5)。治疗前龋坏程度、临床诊疗内容和患儿及家长基本情况在治疗后保持无龋和再次患龋的两组儿童间差异均无统计学意义(P>0.05)。饮食和口腔保健习惯方面,治疗后7和13个月随访时患龋组甜食摄入频率均显著高于无龋组(P<0.05)。结论2~4岁S-ECC患儿全身麻醉�展开更多
目的分析低龄儿童龋风险的影响因素,完善低龄儿童龋风险评估模型,以便辅助诊断低龄儿童龋,提供有效的预防及治疗建议。方法收集来自南京医科大学附属口腔医院儿童牙病预防科临床就诊患者的基线资料,使用CPI探针检查全口牙齿状况,对儿童...目的分析低龄儿童龋风险的影响因素,完善低龄儿童龋风险评估模型,以便辅助诊断低龄儿童龋,提供有效的预防及治疗建议。方法收集来自南京医科大学附属口腔医院儿童牙病预防科临床就诊患者的基线资料,使用CPI探针检查全口牙齿状况,对儿童家长进行问卷调查。所有儿童采集静脉血5 m L。采用单因素及多因素Logistic回归进行相关因素分析。结果本研究纳入199例龋高风险儿童,多因素logistic回归分析结果显示,血液中总蛋白比值比(OR)=1.092,95%可信区间(CI):1.034～1.155、血清钾(OR=2.175,95%CI:1.056～4.48)、二氧化碳(OR=1.32,95%CI:1.194～1.459)及磷酸肌酸激酶水平(OR=1.007,95%CI:1.001～1.014)与低龄儿童龋风险相关。结论龋高风险儿童血检生化指标中总蛋白、血清钾、二氧化碳及磷酸肌酸激酶水平均高于无龋儿童,提示这些指标均可能是低龄儿童龋风险的影响因素。展开更多
Early childhood caries （ECC） is a term used to describe dental caries in children aged 6 years or younger. Oral streptococci, such as Streptococcus mutans and Streptococcus sorbrinus, are considered to be the main e...Early childhood caries （ECC） is a term used to describe dental caries in children aged 6 years or younger. Oral streptococci, such as Streptococcus mutans and Streptococcus sorbrinus, are considered to be the main etiological agents of tooth decay in children. Other bacteria, such as Prevotella spp. and Lactobacillus spp., and fungus, that is, Candida albicans, are related to the development and progression of ECC. Biomolecules in saliva, mainly proteins, affect the survival of oral microorganisms by multiple innate defensive mechanisms, thus modulating the oral microflora. Therefore, the protein composition of saliva can be a sensitive indicator for dental health. Resistance or susceptibility to caries may be significantly correlated with alterations in salivary protein components. Some oral microorganisms and saliva proteins may serve as useful biomarkers in predicting the risk and prognosis of caries. Current research has generated abundant information that contributes to a better understanding of the roles of microorganisms and salivary proteins in ECC occurrence and prevention. This review summarizes the microorganisms that cause caries and tooth-protective salivary proteins with their potential as functional biomarkers for ECC risk assessment. The identification of biomarkers for children at high risk of ECC is not only critical for early diagnosis but also important for preventing and treating the disease.展开更多
文摘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龋和继发龋牙数均较高(上下颌乳尖牙再发龋和继发龋牙数分别为12和6,上下颌第一乳磨牙再发龋和继发龋牙数分别为16和12),上下颌第二乳磨牙以再发龋为主(再发龋和继发龋牙数分别为19和5)。治疗后再次患龋牙面数从高到低依次为乳磨牙邻面(37)、乳磨牙面(28)、乳尖牙邻面(13)、乳磨牙颊舌面(12)、乳前牙唇舌面(10)、乳尖牙唇舌面(8)和乳前牙邻面(5)。治疗前龋坏程度、临床诊疗内容和患儿及家长基本情况在治疗后保持无龋和再次患龋的两组儿童间差异均无统计学意义(P>0.05)。饮食和口腔保健习惯方面,治疗后7和13个月随访时患龋组甜食摄入频率均显著高于无龋组(P<0.05)。结论2~4岁S-ECC患儿全身麻醉�
文摘目的分析低龄儿童龋风险的影响因素,完善低龄儿童龋风险评估模型,以便辅助诊断低龄儿童龋,提供有效的预防及治疗建议。方法收集来自南京医科大学附属口腔医院儿童牙病预防科临床就诊患者的基线资料,使用CPI探针检查全口牙齿状况,对儿童家长进行问卷调查。所有儿童采集静脉血5 m L。采用单因素及多因素Logistic回归进行相关因素分析。结果本研究纳入199例龋高风险儿童,多因素logistic回归分析结果显示,血液中总蛋白比值比(OR)=1.092,95%可信区间(CI):1.034～1.155、血清钾(OR=2.175,95%CI:1.056～4.48)、二氧化碳(OR=1.32,95%CI:1.194～1.459)及磷酸肌酸激酶水平(OR=1.007,95%CI:1.001～1.014)与低龄儿童龋风险相关。结论龋高风险儿童血检生化指标中总蛋白、血清钾、二氧化碳及磷酸肌酸激酶水平均高于无龋儿童,提示这些指标均可能是低龄儿童龋风险的影响因素。
基金supported by the National Natural Science Foundation of China81400502(Qiong Zhang)the Young Teacher Research Start Funding of Sichuan University 2016SCU11049(Yuan Zhou)
文摘Early childhood caries （ECC） is a term used to describe dental caries in children aged 6 years or younger. Oral streptococci, such as Streptococcus mutans and Streptococcus sorbrinus, are considered to be the main etiological agents of tooth decay in children. Other bacteria, such as Prevotella spp. and Lactobacillus spp., and fungus, that is, Candida albicans, are related to the development and progression of ECC. Biomolecules in saliva, mainly proteins, affect the survival of oral microorganisms by multiple innate defensive mechanisms, thus modulating the oral microflora. Therefore, the protein composition of saliva can be a sensitive indicator for dental health. Resistance or susceptibility to caries may be significantly correlated with alterations in salivary protein components. Some oral microorganisms and saliva proteins may serve as useful biomarkers in predicting the risk and prognosis of caries. Current research has generated abundant information that contributes to a better understanding of the roles of microorganisms and salivary proteins in ECC occurrence and prevention. This review summarizes the microorganisms that cause caries and tooth-protective salivary proteins with their potential as functional biomarkers for ECC risk assessment. The identification of biomarkers for children at high risk of ECC is not only critical for early diagnosis but also important for preventing and treating the disease.
