牛河梁红山文化人群龋齿的统计与分析

本文通过对牛河梁遗址出土的31例红山文化时期人类牙齿龋病的统计与分析, 获知: 1)牛河梁遗址男女两性的患龋率、龋齿率没有明显的性别差异; 2)他们的患龋率和龋齿率有随年龄增长逐步增高的趋势; 3)上颌的龋齿罹患率高于下颌; 4)龋齿的发生主要集中在臼齿,且以咬合面部位为主; 5)他们的患龋率和龋齿率均较低。牛河梁红山文化人群相对偏低的龋齿率可能暗示出他们的经济生活方式还处在以采集狩猎为主体的模式中, 农耕经济可能处于较低层次的状态。     

郑州青台遗址新石器时代中晚期人群龋齿的统计与分析

本文通过对郑州青台遗址新石器时代中晚期91例个体、1913枚牙齿罹患龋齿的统计与分析可知,青台人群患龋率为71.43%,龋齿率为13.38%。其中,龋齿率女性高于男性,可能与女性孕期生理变化、食物选择及性别分工等有关。上颌龋齿率高于下颌,臼齿及咬合面为龋齿易患齿类及部位。通过对比可知青台人群显示出较高的龋齿罹患率,暗示该人群饮食中应包含较多的碳水化合物类食物,这可能与新石器时代中晚期黄河中游发达的旱作农业有关。此外,龋齿率在黄河及长江中、下游新石器时代农业人群中的区域性差异可能与龋病病因的复杂性和各地区不同的文化面貌、人群生活方式有关。     

Historical perspectives on advertising and the meme that personal oral hygiene prevents dental caries

The consensus of a leading scientific panel in 1930 was that oral hygiene products could not prevent dental caries. Their view was that dental caries prevention required the proper mineralisation of teeth and that vitamin D could achieve this goal. Over a hundred subsequent controlled trials, conducted over seven decades, largely confirmed that this scientific panel had made the right decisions. They had, in 1930, when it comes to dental caries, correctly endorsed vitamin D products as dental caries prophylactics and oral hygiene products as cosmetics. And yet, despite this consistent scientific evidence for close to a century, an opposing conventional wisdom emerged which thrives to this day: oral hygiene habits (without fluoride) protect the teeth from dental caries, and vitamin D plays no role in dental caries prevention. This historical analysis explores whether persistent advertising can deeply engrain memes on dental caries prevention which conflict with controlled trial results. The question is raised whether professional organisations, with a dependence on advertising revenues, can become complicit in amplifying advertised health claims which are inconsistent with the principles of evidence‐based medicine.     

广西敢造遗址史前居民口腔的健康状况

广西扶绥敢造遗址是华南新石器时代一处典型的河岸贝丘遗址,其人骨测年结果的上限为8488 BC,下限为6492 BC。本文对敢造遗址2014年出土的108例个体的999枚恒齿进行观察统计,结果显示居民的饮食结构应是以肉食为主并辅以富含淀粉的块茎类植物。该遗址居民的龋齿率高于部分农业人群,但远低于同为华南渔猎—采集经济的鲤鱼墩、甑皮岩和顶蛳山遗址,其原因应与食用块茎类植物的多寡有关。较高的牙结石罹患率(89.86%)可能与鱼类、贝类等高蛋白饮食有关。相比农业、游牧或狩猎人群,该遗址居民偏重的牙齿磨耗可能与食用含沙量较大的螺类、贝类等有关;肉类食物的食用导致该遗址居民上颌前部牙齿磨耗重于后部牙齿,而“上颌前部牙齿舌侧过度磨耗”现象的出现则与食用块茎类植物有关。     

甘肃临潭磨沟墓地人骨的牙齿健康状况

本文通过甘肃临潭磨沟齐家文化墓地出土的262例人骨标本的牙病情况尤其是龋病、牙周病、根尖周病以及牙结石情况的统计与分析,得知磨沟墓地古代居民牙齿疾病的基本情况:1)牙病的罹患率性别差异显著,女性龋病和根尖周病的罹患率高于男性,而在牙周病和牙结石的出现率上则是男性高于女性;2)牙病的罹患率随着年龄增长而增高;3)龋病、牙周病及根尖周病多发于臼齿,牙结石多发于门齿;4)重度磨耗牙齿多发牙周病及根尖周病;5)牙病罹患率不仅受到性别、年龄、牙位以及齿冠磨耗程度的影响,而且与磨沟组古代居民农业种植食物和采集食物并重的食物结构有关。     

郑州孙庄遗址仰韶文化人群的龋病

孙庄遗址位于河南省郑州市中原区孙庄村,是分布在黄河中游的一处仰韶文化晚期遗址,该遗址出土的54例仰韶时期的人骨保存状况良好,为我们了解仰韶文化人群的龋患情况提供了珍贵的资料。本文以肉眼观察为主并结合超景深显微镜对遗址出土的846枚牙齿进行鉴定、统计与分析,得出以下结论：孙庄遗址古代人群的龋病患病率70.37%,龋齿率22.93%,龋均3.59;壮年组患龋率最高,为88.89%,不同年龄组之间的龋齿率差异性显著;龋齿率女性为30.55%,男性为16.16%,女性龋齿率显著高于男性,P(0.000)<0.05,两性之间的龋齿率有显著差异;浅龋率为6.70%,中龋率为21.65%,深龋率为27.32%,深龋已穿髓率为19.07%,残冠残根率为25.26%,随着年龄的增长,龋病的病变程度呈加重趋势;龋损范围小于1/2牙冠累龋最常见,占总患龋齿数的42.27%;上颌龋齿率为26.91%,下颌龋齿率为19.70%,上下颌龋齿率差异显著（P<0.05）。龋病在不同牙位上的发生率依次为M3>M2>P2>M1>P1>C>I1>I2;邻面和 面是主要的龋患分布处,分别占患龋牙齿数的46.40%和39.18%。孙庄人群门齿较高的患龋率表明该遗址人群患龋情况已经非常严重,患龋率与龋齿率明显高于其他古代组,较高的龋病罹患率可能与孙庄人群复杂的农业经济模式有关。     

不同去龋技术在乳牙龋病治疗中的应用疗效分析

目的:比较传统机械切割法、非创伤性充填法(atraumatic restorative treatment,ART)和Carisolv化学法在临床乳牙龋病治疗中的应用效果差异。方法:选取2011年1月-2012年6月来我科就诊的5-8岁儿牙患者96名,患牙180颗,随机分为3个不同的治疗组:传统机械去龋组、ART组和Carisolv化学去龋组进行相应牙体充填治疗,通过去龋效果、去龋时间、术中疼痛发生率和术后长期疗效等方面比较不同去龋技术之间的差异。结果:常规机械去龋组和Carisolv组的去龋效果明显优于ART组(P0.05),二者之间无明显差异(P0.05);3种去龋方法的去龋操作时间无明显差异(P0.05);Carisolv组和ART组去龋治疗中患儿术中疼痛发生例数明显低于常规机械去龋组(P0.05),二者之间无明显差异(P0.05);治疗1年后的复诊发现,常规机械去龋组和Carisolv组中患牙继发龋发生率明显低于ART组(P0.05),二者之间无明显差异(P0.05);三种方法治疗后患牙充填物折断/脱落发生率无明显差异(P0.05)。结论:Carisolv化学去龋法能有效减轻术中疼痛和术后复发率,值得在临床乳牙治疗中推广应用;ART的去龋效果和远期疗效可能限制其广泛应用。     

Observations of dental diseases among prehistoric populations of Hungary

The incidence of dental disease among people in developing countries today raises questions about the variation in the oral health of prehistoric populations. Considering these questions, we offer observations describing several types of dental disease which occurred among certain prehistoric populations of Hungary. The dental remains of 162 individuals recovered from seven sites of the Neolithic, Copper, and Bronze Age periods were examined for evidence of caries, hypoplasia, and periodontal disease. Appropriate methods were used to describe and record these dental lesions. The incidence of dental caries was low by comparison to other prehistoric agriculturists except for two forms of root caries: cervical and cemental. These types accounted for 68% of all the carious teeth recorded. Enamel hypoplasia was also lower than expected, occurring on only 4% of the total number of teeth. Periodontal abscesses were rare but other milder forms of periodontal lesions were frequent. Alveolar bone resorption occurred in varying degrees and followed the expected age distribution. The few exceptions were children or adolescents whose crania had other lesions suggesting a mineral metabolic disturbance. The lower incidence of enamel caries is likely due to high fluoride ingestion which also may have influenced the expression of enamel hypoplasia. No clear population trends were seen in dental disease incidence except for cemental caries which were found among Copper and Bronze Age remains.     

The reasons for tooth loss in geriatric patients attending two surgical clinics in Jerusalem,Israel.

Abstract Objectives Numerous studies around the world have been conducted in order to understand the reasons for tooth extractions in various age groups. Most studies have dealt with the general adult population but little attention has been paid to the elderly population. In Israel, as in most of the western countries, the elderly population is growing rapidly and thus demands for its dental needs are also increasing. In order to meet the dental requirements of the geriatric population, data on the main reasons of tooth mortality have been collected. Design Retrospective analysis of reasons for extraction divided into three categories: caries, periodontal disease and “other’’. Subjects The files of 302 consecutive elderly patients aged 65-95 years attending for extraction. The cause for tooth extraction was gathered from the written diagnosis described by the operator as well as from radiographs. Setting Two surgical clinics in Jerusalem serving low income residents. Results Results indicated that 30% of the extractions were due to caries, 65% were due to periodontal disease and only 6.4% related to “other’’ reasons. In both, males and females, periodontal disease was the major cause for tooth loss yet, females exhibited more extractions due to caries than males (35%vs 23% respectively). A relatively high incidence of tooth loss was documented for the 85+ age group. Of the teeth that were extracted, incisors and molars were equally the most frequent (29%) followed by premolars (26%) and canines (17%). Premolars were the teeth most frequently extracted out of the teeth removed due to caries (32%) whereas incisors were the most frequently removed within the group of teeth extracted due to periodontal disease (31%). Conclusions The results of this study point to the importance of prevention and treatment of dental diseases, particularly periodontal disease, in adults aged 0 years and above in order to prevent tooth loss in their later years.     

Dental paleopathology and agricultural intensification in south Asia: new evidence from Bronze Age Harappa.

Patterns of dental disease among Bronze Age people of the Indus Valley Civilization are currently based on early and incomplete reports by non-specialists. This deficiency precludes accurate diachronic analysis of dental disease and its relationship with increasing agriculturalism in the Indian subcontinent. The objective of this paper is to document prevalence of dental disease at Harappa (2500-2000 B.C.), Punjab Province, Pakistan, comparatively evaluate the Harappan dental pathology profile, and use these data to assess theories regarding the dental health consequences of increasingly intensive agricultural dependence. Pathological conditions of the dentition included in the study are abscesses, ante-mortem tooth loss (AMTL), calculus, caries, hypoplasia, hypercementosis, pulp chamber exposure, and alveolar resorption. The Harappan dentition exhibits a dental pathology profile typical of a population whose subsistence base is agriculture. Dental caries at Harappa are present in 6.8% (n = 751) of the teeth and 43.6% (n = 39) of the more completely preserved dental specimens. The use of a caries correction factor is recommended to permit an estimate of caries induced AMTL in calculating the caries prevalence. All dental lesions are present at higher rates in this Harappan study sample than were reported in previous investigations, and important differences in prevalence of dental disease occur between the genders. Prevalence of dental disease increases in the greater Indus Valley as subsistence becomes more intensive and as food preparation and storage technology becomes more efficient.     

广西顶蛳山遗址人骨的龋齿病理观察

顶蛳山遗址位于广西壮族自治区南宁市邕宁区,保存了丰富的新石器时代文化遗存以及大量的古人类骨骼遗存。本文主要从龋齿研究入手,对顶蛳山二、三期文化(8-7 ka BP)中大于15岁的169个体的2737枚恒齿进行了观察。分别统计了龋齿等级和个体和牙齿患龋率以评估人群患龋情况,进而分析顶蛳山遗址人群的口腔健康状况,并探讨了食物构成、饮食行为与社会经济等。统计结果表明,顶蛳山遗址人群的个体和牙齿患龋率都较高。患龋率在两性、葬式、年龄段间都存在差异,女性患龋程度要高于男性;不同葬式之间差异也显著,随着年龄的增长患龋的比例和程度也随之加深。通过与其他8组新石器时代国内遗址人群的个体和牙齿患龋率的对比,我们看到包含顶蛳山在内的三组华南渔猎采集遗址的个体和牙齿患龋率都要高于其他遗址,农业遗址的人群要低于华南遗址的患龋率,而混合经济遗址的患龋率最低。龋齿的出现与人类饮食中的碳水化合物关系密切。据此,我们推测顶蛳山及其他两组华南遗址的高患龋与碳水化合物的摄入关系密切,但这与一般所认为的农业的出现没有联系。三组遗址都是以渔猎采集主导的社会经济形态,并且这时期农业并未传播至华南地区。因此我们的分析表明高患龋率与农业并没有必然联系,而华南地区当时人群所食用的碳水化合物可能源于当地的块茎类和含蔗糖类植物。     

郑州汪沟遗址仰韶文化居民的牙齿磨耗及口腔健康状况

对汪沟遗址出土的174例仰韶文化居民的2816枚牙齿进行统计与分析,计算出牙齿的平均磨耗等级和前后部牙齿磨耗差别指数,统计特殊磨耗、龋齿、骨质隆起在样本中的出现率。结果显示,汪沟组牙齿平均磨耗等级为3.403262级,男性牙齿平均磨耗等级为3.63级,女性为3.61级;男女两性牙齿磨耗差异不显著(p>0.05);前后部牙齿磨耗差别指数比达到1:1;出现26例由于深覆■导致的特殊磨耗;臼齿咬合面凹坑式磨耗出现率为2.50%;龋齿患病率68.97%,龋齿率26.56%,龋均4.30;骨质隆起的出现率为5.20%,颌骨粗壮程度不显著。汪沟人群的牙齿磨耗程度总体偏轻,牙齿磨耗程度与河南下王岗组居民接近。基于以上特点,我们认为中原地区仰韶文化人群在饮食结构和用牙习惯上存在一定的共性。     

The Epidemiology of Dental Diseases in the Elderly1

This paper summarizes and evaluates epidemiologic evidence on adult dental conditions with a focus on older adults. Information is presented on coronal caries; root caries; loss of teeth, attrition, abrasion, and erosion; periodontal diseases; and oral cancer. The author concludes that the oral health status of the elderly in the United States is essentially unknown. There are no recent, representative population base studies of oral conditions in the elderly. Studies of prevalence or incidence of oral diseases typically include few elderly persons or describe a select group of elderly who are at high risk. Furthermore, it is not really known whether the incidence and prevalence of coronal caries or root caries is actually increasing or is part of a cohort effect. While oral cancers have been shown to increase with age, there is no information as to whether their incidence rates are increasing. While, clinically, there are indications that attrition, abrasion and erosion are characteristics that are more likely to be seen in older adults, there is no information about their distribution in the population. There is evidence that loss of teeth is decreasing but nothing is known about the patterning of that loss. As for periodontal diseases, much work is needed to identify various syndromes that may be distinguished by their distribution in the population as well as determining whether periodontitis is a condition responsible for a majority of tooth loss or just the majority of tooth loss in a small high risk group. In addition, some suggestions are presented for future directions of research in this area.     

The caries-attrition competition

Contradictory reports on the interreation of caries and attrition concerning their destructive activity at the occlusal surface of teeth required more investigation. Some suggested that the abrasive action of attrition worked against the progress of decay. Others proposed that attrition facilitated the development of caries in dentine exposed due to the dental wear. A comparison of the condition of teeth in western societies from an intermediate stage, with the preceding period characterized by excessive attrition, and with the following period of ongoing reduction of dental wear, might elucidate the mutual relationship. For this reason the almost complete dental assemblage of fifty men, whalers buried during their short sojourn in the Arctic in the 17th and 18th centuries at a Dutch whaling station, and the data of their contemporaries, were evaluated. The results confirmed the proposition that the rise in caries incidence from (pre-) medieval times on, was associated with an ongoing fall of dental attrition. Within this sample of an intermediate phase, one sees that the percentage of carious molars decreases considerably when the degree of dental wear increases. Besides, at the occlusal surface the decay was almost exclusively located in the natural fissures and pits of teeth, not in the exposed dentine due to wear. These findings strongly suggest a competitive relationship between progress of caries and attrition. The best impression of the attrition rate is gained by linkage of degree of dental attrition (i.e. functional age) to age at death. The wide age ranges fitting to the degrees of molar wear make it hazardous to use attrition for age determination.     

An effect of zinc deficiency on dental caries.

Rat pups suckled by dams fed a zinc-deficient diet developed higher levels of dental caries following a caries-test challenge than pups suckled by dams fed a zinc-adequate diet. The zinc deficient treatment was administered during the mineralization stage of tooth development before the molars erupted. The data shows that suboptimal zinc nutriture was associated with an increase in dental caries.Fluoride, a trace element, is recognized as a factor in preventing dental caries and its use has had a significant impact on dental health in this country. However, the possible roles of other trace elements have not been closely examined. Zinc is a trace element important to bone mineralization as well as in general nutrition.The effects on dental caries produced by the addition of zinc to rat diets have been reported (1, 2, 3). In those investigations, however, zinc supplements were added to diets that were adequate in zinc. Moreover, zinc supplements were fed after the teeth had appeared in the oral cavity. Because the critical period of tooth maturation occurs before eruption (4), post-eruptive zinc supplements probably should not markedly influence the development and, specifically, the mineralization of the tooth. Therefore, we investigated the influence of pre-eruptive zinc deficiency on caries development in rats.     

Dental health of elderly confederate veterans: evidence from the Texas State Cemetery

Analysis of the skeletal remains of 50 Confederate veterans provided a unique opportunity to explore the dental health of a geriatric sample. These men, who died between 1907-1932, had an average age at death of 76.7 years. Ninety percent were institutionalized at the Confederate Home for Men (Austin, TX) prior to their deaths. This elderly sample was assessed in terms of caries, antemortem tooth loss (AMTL), abscesses, and linear enamel hypoplasias. On a per tooth basis, the AMTL rate was 57.2%. Of 39 dentate men, 33 (84.6%) had dental caries, and 24.4% (121 of 496) of teeth were carious. Ten (25.0%) of the dentate men had hypoplastic teeth. At least one abscess was seen in 14 (28%) of 50 individuals. Results from this geriatric institutionalized sample are compared to contemporaneous historical samples. Disparities in dental health among these groups may be due to differences in average age at death, and these comparisons allow a better understanding of dental changes that occur with age. The sample is also compared to modern elderly samples: modern groups have higher caries rates, possibly because they retained more teeth. This finding may be due in part to diets in the United States becoming increasingly cariogenic over time. In addition, dental care has moved from the reactive practices seen in the nineteenth and early twentieth centuries (such as tooth extractions) to modern proactive solutions dedicated to preserving and restoring teeth (such as tooth brushing, fluoride treatments, and dental fillings).     

Log-linear analysis of dental caries occurrence in four skeletal series.

Four skeletal series (Corinth, Greece; Gran Quivira, New Mexico; Semna South, Sudanese Nubia, and a large group from scattered sites in England) were coded for sex, jaw, tooth group, dental attrition, dental caries, site and time period. Through thec concepts of a basal level of caries and a cariosity gradient, a single model was found which best described the occurrence of this disease in these samples. All factors were found to contribute significantly to the model. Within the possible subsamples the general characteristics are that the profiles of males, of the mandibulae and of those with light attrition are more likely to have lower overall dental caries levels and to be relatively more carious in the back of the mouth than the front when compared to the pooled sample of all teeth and caries. The opposite is also found to be generally true; the teeth of females, maxillae and heavy attrition are associated with more caries, especially toward the front of the mouth. These results imply that samples appearing otherwise homogeneous display much variation. They also reveal distinct regularities in the reactions of diverse human groups to dental caries.     

湖北巨猿牙齿化石龋病观察

本文共调查了267枚从鄂西山区收集的巨猿牙齿化石现发生情况,发现其中有52枚（占19.5%)的颊齿有程度不同的龋蚀现象,其患龋率显著高于古人类,同时也高于广西巨猿的患龋率。巨猿牙齿的这种高频率龋蚀现象,除牙齿结构因素外,可能与该物种食性的狭窄化和营养贫乏导致牙齿不良钙化有关,是伴随巨猿体型的巨型化而趋向该物种衰退和绝灭的病理表征之一。     

Periodontal disease in the Mycenean (1450–1150 BC) population of Aghia Triada, W. Peloponnese, Greece

This study investigates the incidence of periodontitis in a Mycenaean population unearthed at the cemetery of Aghia Triada (West Peloponnese, Greece) during the 1989–1997 field season. The material consists of 172 dry skulls. Demographic parameters of sex and age were difficult to be assigned due to the bad state of preservation of the skeletal material. The ratio was 50 males, 48 females, 65 unidentified and 9 children, and we estimated an average age of 38 years. In this work we used traditional and modern methods to determine the incidence of periodontitis in the archeological human dental bone. We also recorded other dental diseases, such as ante mortem tooth loss, caries and attrition. The results showed that periodontitis has affected 35% of the jaws. A notable percentage of the individuals — 24% — lost three or more teeth during their lifetime and a total 53% of the population had extracted teeth before death. This paper points out that the ancient jaws present a high proportion of ante-mortem tooth loss, attrition and deep caries, whereas the frequency of periodontitis does not seem to differ from that of other prehistoric samples.     

Predictors of caries in old age

This study measured the incidence of dental caries for one year and identified factors associated with the risk of caries in a sample of 156 elderly subjects. The subjects were examined at baseline and after one year to record the number of missing, filled and decayed teeth, to measure oral hygiene and flow of saliva, and to estimate the numbers of Streptococcus mutans and Lactobacilli cultured from samples of saliva. All subjects were interviewed on both occasions for information on their use of medications and dental services and on their ingestion of sugar. At baseline the elders had a mean of 19 natural teeth with 5 decayed surfaces (DS), 38 filled surfaces and a mean Plaque Index (PI) of 1. The independent group, on average, had more teeth and fillings but a lower PI and less caries. At the end of the year more than two-thirds (71%) of the 98 institutionalised subjects and over half (59%) of the 58 independent subjects had at least one new decayed/filled surface (DFS). The mean net DFS increment per subject was 4.6 and 2.0 respectively. Regression analyses on multivariate models identified caries at baseline, residence in long term care facilities, high numbers of Lactobacilli, poor oral hygiene and frequent sugar consumption as the variables contributing most significantly to the risk of caries in old age.