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  

A study on the ability of five caries risk assessment methods to discriminate the caries risk levels of outpatients

作　　者：赵梅[1] 李欣[1] 陈薇[1] 任雯 刘敏[1] ZHAO Mei;LI Xin;CHEN Wei;REN Wen;LIU Min(Department of Preventive 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,北京100050

出　　处：《北京口腔医学》2020年第2期82-87,共6页Beijing Journal of Stomatology

基　　金：北京市医院管理局临床医学发展专项经费(ZYLX201703);首都医科大学附属北京口腔医院院基金(16-09-13)。

摘　　要：目的本研究旨在建立一种适合我国门诊病人龋风险评估体系-龋风险窗口(caries risk window,CRW)预测法,并与现有国外龋风险评估系统进行比较,评价其对门诊患者患龋风险等级区分能力和检测结果的一致性。方法选取111名门诊患者,进行临床检查和问卷调查。口腔检查包括患龋状况、口腔卫生状况、牙齿发育缺陷等;问卷调查包括饮食习惯、口腔卫生行为和就医行为。分别用五种龋风险评估方法确定个体的患龋风险等级:CRW预测法、Cariostat法、ADA龋风险评估、CAMBRA(Caries Management by Risk Assessment)、Cariogram系统。采用卡方检验比较五种方法对患者患龋风险水平的区分度;采用加权kappa比较五种方法检测结果的一致性。结果五种方法判断出龋高风险个体的比例从高到低分别是:CAMBRA(93%)、ADA(86%)、Cariogram(77%)、CRW(65%)和Cariostat(56%)。ADA和CAMBRA的一致性最高(加权kappa:0.593,P<0.05),属于中等水平。Cariogram与CAMBRA和ADA,CRW与ADA和Cariogram的一致性属于一般水平(加权kappa:0.221~0.358,P<0.05)。CRW与CAMBRA和Cariostat的一致性属于较差水平(加权kappa:0.150~0.161,P<0.05)。其它方法之间的一致性没有统计学意义。结论CRW和Cariogram对门诊患者患龋风险等级的区分能力优于CAMBRA和ADA龋风险评估方法,Cariostat居中,不同龋风险评估体系结果的一致性不高。需通过纵向研究进一步评价龋风险评估体系的准确性。Objective To establish a caries risk window(CRW)prediction method suitable for the population risk assessment system for outpatients in China and to compare with the existing foreign risk assessment systems.Methods This study included 111 outpatients.The dental caries,oral hygiene status and tooth development were recorded.The associated behavior about diet,oral hygiene and oral health services were obtained through structured questionnaire.Five caries risk assessment tools were applied to grade the caries risk level for each patient,Cariostat,ADA,CAMBRA(Caries Management by Risk Assessment),Cariogram and Caries Risk Window(CRW).The CRW was developed by the present study.Weight kappa was used to evaluate the calibration among the five tools.Results The percentage of high risk grade by these five caries risk assessment tools were 93%(CAMBRA),86%(ADA),77%(Cariogram),65%(CRW)and 56%(Cariostat)respectively.The value of weight kappa for ADA and CAMBRA was 0.593(P<0.05).The results for Cariogram and CAMBRA,ADA,CRW and ADA,Cariogram,were between 0.221 and 0.358(P<0.05).The results for CRW and CAMBRA were between 0.150 and 0.161(P<0.05).The results between other methods were not significantly different.Conclusion CRW and Cariogram are better than CAMBRA and ADA in differentiating caries risk grade of outpatients.Cariostat is in the middle,and the results of different caries risk assessment systems are not consistent.

关 键 词：Cariostat ADA龋风险评估 Cariogram CAMBRA 

分 类 号：R781.1[医药卫生—口腔医学]