北京市密云区4岁儿童患龋状况及其与龋活跃性检测的相关性

doi:10.19723/j.issn.1671-167X.2024.05.013

摘要/Abstract

摘要：

目的: 用国际龋病检查和评估系统(international caries detection and assessment system，ICDAS)标准调查北京市密云区部分4岁儿童患龋情况，检测Cariostat龋活跃性指数，并分析其与患龋情况的关系。方法: 选取北京市密云区7所幼儿园，对园内所有4岁儿童进行检查。由1名检查者采用ICDAS标准对儿童进行口腔检查，1名医生取儿童牙面软垢和菌斑进行Cariostat龋活跃性指数检测，根据龋态值将儿童分为低(0~1.0)、中(1.5)、高(2.0~3.0)龋态值组。对ICDAS龋病检查结果进行性别间比较，同时比较不同龋态值组儿童成洞龋患龋率、成洞龋龋均/龋面均(d_3-6ft/d_3-6fs)、全部龋龋均/龋面均(d_1-6ft/d_1-6fs)。对仅有早期龋的儿童，分析其早期龋在不同龋态值分组间的分布情况。结果: 全部儿童都患有早期龋，78.3%的儿童患有ICDAS分级3级或以上的成洞龋，早期龋龋均(d_1-2t)为9.76±3.65，成洞龋龋均(d_3-6ft)为4.64±4.43，全部龋龋均(d_1-6ft)为14.41±3.42。早期龋分布广泛，占全部龋齿的67.7%，患龋程度在性别间差异无统计学意义(P>0.05)。男童高龋态值的人数构成比(43.6%)高于女童(33.0%)，低龋态值的人数构成比(31.9%)低于女童(34.0%)，差异均有统计学意义(P<0.05)。随着龋态值的增加，儿童成洞龋患病率、成洞龋龋均/龋面均以及全部龋龋均/龋面均呈上升趋势，组间差异有统计学意义(P<0.05)。仅患早期龋的儿童在不同龋态值组中早期龋分布差异无统计学意义(P>0.05)。结论: ICDAS标准能够检测出儿童乳牙早期釉质脱矿情况，本研究中4岁学龄前儿童成洞龋患龋水平较高，早期龋在儿童中分布广泛。Cariostat龋活跃性指数检测方法能较好地反映儿童龋活跃性和成洞龋患病现状，而与儿童早期龋的分布无相关性。ICDAS标准与Cariostat龋活跃性指数检测方法联合应用有助于早期龋的发现以及龋病风险评估，对儿童龋病的综合管理和早期预防措施的制定具有重要意义。

关键词: 龋齿, 儿童, 诊断, 国际龋病检查和评估系统, Cariostat龋活跃性检测

Abstract:

Objective: To investigate the prevalence of dental caries of 4-year-old children in Miyun District of Beijing by international caries detection and assessment system (ICDAS), to detect the caries activity Cariostat value and to analyze the correlation between the Cariostat value and dental caries. Methods: Totally 815 children aged 4 years in 7 kindergartens in Miyun District of Beijing were recruited. The clinical examination of all children was conducted by one examiner using ICDAS. The oral de-birs and plaques were collected by one doctor who recorded the Cariostat scores. The results of clinical examination were compared between genders. At the same time, the prevalence of dental caries, the mean d_3-6ft/d_3-6fs and d_1-6ft/d_1-6fs among high Cariostat scores group (2.0-3.0), medium Cariostat scores group (1.5) and low Cariostat scores group (0-1.0) were compared. The distributions of incipient caries in different Cariostat scores groups were compared among children with incipient caries only. Results: All the children had incipient caries, and 78.3% of the children had cavitated caries with ICDAS score of 3 or above. The mean d_1-2t scores were 9.76±3.65, the mean d_3-6ft scores was 4.64±4.43 and the mean d_1-6ft scores were 14.41±3.42. The incipient caries with ICDAS score of 1-2 were widely distributed, accounting for 67.7% of the total numbers of caries. There was no significant diffe-rence in caries prevalence and caries experience between genders (P>0.05). The proportion of children with high Cariostat scores in boys (43.6%) was higher than that in girls (33%) and the difference was statistically significant (P<0.05). With the increase of Cariostat scores, the prevalence of cavitated caries, the mean d_3-6ft/d_3-6fs and d_1-6ft/d_1-6fs scores in children was on the increase and the difference among the three groups was statistically significant (P<0.05). For children with incipient caries only, the distribution of incipient caries in different Cariostat scores groups was no significant difference (P>0.05). Conclusion: ICDAS can detect early enamel demineralization of deciduous teeth in children. The prevalence of dental caries among 815 4-year-old children in Miyun District of Beijing is more serious, and incipient caries is widely distributed in children. Cariostat value reflects the status of cavi-tated caries and has no correlation with the distribution of incipient caries. Therefore, the combined application of ICDAS and Cariostat caries activity detection method is helpful for the detection of incipient caries and screening of caries high-risk children, which has great significance for the comprehensive ma-nagement of caries in children and the formulation of early preventive measures.

Key words: Dental caries, Child, Diagnosis, International caries detection and assessment system, Cariostat caries activity detection

中图分类号:

R788.1

陈心心, 唐哲, 乔艳春, 荣文笙. 北京市密云区4岁儿童患龋状况及其与龋活跃性检测的相关性[J]. 北京大学学报（医学版）, 2024, 56(5): 833-838.

Xinxin CHEN, Zhe TANG, Yanchun QIAO, Wensheng RONG. Caries experience and its correlation with caries activity of 4-year-old children in Miyun District of Beijing[J]. Journal of Peking University (Health Sciences), 2024, 56(5): 833-838.

图/表 3

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Items	Total (n=815)	Male (n=436)	Female (n=379)	Statistics	P
Mean decay tooth of early caries and cavitated caries
d_1-6t	13.89±3.42	13.95±3.47	13.82±3.37	t=0.55	0.59
ft	0.52±1.45	0.54±1.51	0.49±1.37	t=0.45	0.65
d_1-6ft	14.41±3.42	14.49±3.45	14.31±3.40	t=0.74	0.46
Mean decay tooth surface of early caries and cavitated caries
d_1-6s	43.09±15.31	43.38±15.45	42.77±15.15	t=0.57	0.57
fs	0.78±2.39	0.85±2.63	0.69±2.09	t=0.95	0.34
d_1-6fs	43.87±15.71	44.23±15.86	43.46±15.54	t=0.70	0.49
Mean decay tooth of early caries
d_1-2t	9.76±3.65	9.74±3.84	9.79±3.42	t=0.22	0.83
d_1-2s	35.01±11.45	34.98±11.53	35.05±11.37	t=0.08	0.93
Mean decay tooth of cavitated caries
d_3-6t	4.13±4.02	4.21±4.13	4.03±3.89	t=0.66	0.51
d_3-6ft	4.64±4.43	4.75±4.57	4.52±4.28	t=0.75	0.46
Mean decay tooth surface of cavitated caries
d_3-6s	8.08±9.43	8.39±9.96	7.72±8.78	t=1.03	0.30
d_3-6fs	8.85±10.19	9.24±10.78	8.41±9.44	t=1.18	0.24
Prevalence of cavitated carie	638 (78.3)	345 (79.1)	293 (77.3)	χ²=0.40	0.53
Cariostat scores				χ²=11.25	0.004
Low	268 (32.9)	139 (31.9)	129 (34.0)
Medium	232 (28.5)	107 (24.5)	125 (33.0)
High	315 (38.6)	190 (43.6)	125 (33.0)

Items	Cariostat score			P
Items	Low (n=268)	Medium (n=232)	High (n=315)	P
Mean decay tooth of early caries and cavitated caries
d_1-6t	13.47±3.35	13.74±3.33	14.36±3.51^*#	0.006
ft	0.34±1.18	0.52±1.43	0.66±1.64^*	0.006
d_1-6ft	13.81±3.35	14.26±3.35	15.02±3.45^*#	< 0.001
Mean decay tooth surface of early caries and cavitated caries
d_1-6s	40.62±14.34	42.55±15.36	45.59±15.72^*#	< 0.001
fs	0.51±1.96	0.72±2.15	1.04±2.84^*	0.005
d_1-6fs	41.13±14.52	43.27±15.73	46.64±16.25^*#	< 0.001
Mean decay tooth of cavitated caries
d_3-6t	2.59±3.01	3.84±3.72^*	5.64±4.41^*#	< 0.001
d_3-6ft	2.93±3.36	4.36±4.16^*	6.30±4.83^*#	< 0.001
Mean decay tooth surface of cavitated caries
d_3-6s	4.76±6.34	7.38±8.84^*	11.42±10.86^*#	< 0.001
d_3-6fs	5.27±6.87	8.10±9.56^*	12.46±11.71^*#	< 0.001

Items	Cariostat score			P
Items	Low (n=89)	Medium (n=50)	High (n=38)	P
d_1-2t	11.56±3.25	11.10±3.30	11.16±4.22	0.324
d_1-2s	31.13±11.73	29.68±12.60	27.39±14.63	0.577