国际龋病检查和评估系统Ⅱ与WHO检查方法在低龄儿童龋检查中的应用对比  

A comparative study on early childhood caries detection by using international caries detection and assessment system- Ⅱ and WHO criteria

作　　者：孙鹏[1] 陈薇[1] 艺璇[1] 高培培 杨东梅[2] Sun Peng;Chen Wei;Yi Xuan;Gao Peipei;Yang Dongmei(Department of Preventive Dentistry,Capital Medical University School of Stomatology,Belting 100050,China;Department of Pediatric Dentistry,Capital Medical University School of Stomatology,Beijing 100050,China)

机构地区：[1]首都医科大学口腔医学院预防科,100050 [2]首都医科大学口腔医学院儿童口腔科,100050

出　　处：《中华口腔医学杂志》2018年第11期725-729,共5页Chinese Journal of Stomatology

基　　金：北京市科学技术委员会科技计划（Z151100004015031）

摘　　要：目的比较国际龋病检查和评估系统（international caries detection and assessment system，ICDAS）-Ⅱ与WHO检查方法在低龄儿童龋流行病调查中的应用，评估ICDAS-Ⅱ在指导儿童口腔疾病预防与治疗中的意义。方法对北京市4所幼儿园共449名小班儿童（3岁）分别采用ICDAS-Ⅱ系统和WHO标准进行口腔检查记录。对ICDAS-Ⅱ的检查结果进行龋分级比较：D1（0级为健康，1-6级为龋齿）；D2（0-1级为健康，2-6级为龋齿）；D3（0-2级为健康，3-6级为龋齿）；D4（0-3级为健康，4-6级为龋齿）。对两种龋病评估系统得到的患龋率、龋均及各牙面患龋情况进行统计学分析与比较。结果ICDAS-Ⅱ中D1-D4患龋率分别为76.6%（344/449）、71.3%（320/449）、52.8%（237/449）和46.1%（207/449）；龋均分别为：4.95±4.85、4.41±4.77、2.54±3.69和1.97±3.10；牙面患龋情况显示：在D1、D2水平下颌磨牙区面患龋最多，D3、D4水平上颌前牙区邻面患龋最多。WHO方法检测的患龋率为48.8%（219/449），龋均为2.27±3.54，患龋率显著低于ICDAS-Ⅱ系统检测中D1、D2标准（P=0.00），与D3、D4水平的患龋率相比差异均无统计学意义（P=0.23，P=0.42）。结论ICDAS-Ⅱ龋病评估系统与传统的WHO标准相比能检测出早期釉质脱矿情况，对龋病的早期预防更具有指导意义。Objective To investigate and compare the sensitivities of early childhood caries detection by using international caries detection and assessment system （ICDAS）-Ⅱ and WHO criteria.Methods A total of 449 3-year-old children from four day care kindergartens in Beijing were enrolled in this study. Both ICDAS-Ⅱ and WHO criteria were used to assess the prevalence of caries in the given subjects. The decayed, missing, and filled teeth （dmft） index scores were calculated. In ICDAS-Ⅱ system, four cut-off points （D1, D2, D3 and D4） were employed to differentiate sound and decayed teeth： D1 （score 0 as sound, scores 1-6 as caries）; D2 （0-1 sound, 2-6 caries）; D3 （0-2 sound, 3-6 caries） and D4 （0-3 sound, 4-6 caries）. SPSS software was used to analyze the data to decide the significance of differences.Results The caries prevalence using ICDAS-Ⅱ were 76.6% （344/449）, 71.3% （320/449）, 52.8% （237/449） and 46.1% （207/449） for D1 to D4, respectively; the corresponding mean dmft scores were 4.95±4.85, 4.41±4.77, 2.54±3.69 and 1.97±3.10. The sites with highest caries prevalence were occlusal surface of mandibular molars in groups of D1 and D2 and proximal surface of maxillary anterior teeth in groups D3 and D4. In contrast, the caries prevalence was 48.8% （219/449） and the mean dmft was 2.27±3.54 when using WHO criteria, significantly lower than the detection rates by using ICDAS-Ⅱ （D1-D2） （P=0.00）. This suggested that ICDAS-Ⅱ system was a more sensitive method in detecting early childhood caries.Conclusions ICDAS-Ⅱ system might be superior in detection of incipient caries and be of specific value in prevention of early childhood caries.

关 键 词：龋齿 低龄儿童龋 患龋率 龋均 

分 类 号：R788.1[医药卫生—口腔医学]