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...     

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。     

Caries experience in existing and new nursing home residents in Adelaide,Australia

Objectives: The Adelaide Dental Study of Nursing Homes was instigated to provide comprehensive information concerning oral disease experience, incidence and increments in a random sample of those older South Australians residing in Adelaide nursing homes. Methods: This paper presents caries experience results for existing and new nursing home residents, and caries incidence and increments for existing residents, from dental inspections conducted at the baseline and one‐year data collections. Results: The residents in this study were very functionally dependent, medically compromised, cognitively impaired and behaviourally difficult older adults, the great majority of whom had moderate to severe cognitive impairment. Residents gave their carers many complex and challenging behavioural problems during oral hygiene care provision. Existing and new residents had similar dental history, oral hygiene, and socio‐detnographic characteristics, and similar cognitive, medical, functional, and nutritional status. Oral disease experience was high in both existing and new residents. There were no significant differences between existing and new residents for their dentate status, tooth status, coronal caries experience, or root caries experience, with the exceptions that new residents had significantly greater mean number of teeth, more filled coronal and root surfaces, and also new residents had significantly fewer decayed retained roots. Large numbers of tooth surfaces were covered in plaque and debris that negated more precise assessment of caries. The existing residents had caries increments on both coronal (2.5 surfaces) and root surfaces (1.0 surfaces) over the one‐year period. Coronal caries incidence was 64% and root caries incidence was 49% of existing residents. Conclusions: Oral disease experience was high in both existing and new residents. There were few significant differences between existing and new residents’ oral health status. New residents were being admitted to nursing homes with a compromised oral health status. Coronal and root caries increments and incidence were high for existing residents over the one‐year period.     

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。     

The estimation of dental caries incidence in the presence of diagnostic error.

Diagnostic error in large scale screening programs for dental caries is frequent, as when teeth initially classified as carious are later diagnosed as never having been affected by caries. This paper presents a general formulation of diagnostic error in dental caries screening. The basic parameter of the formulation is the caries incidence rate. The general formulation of this paper permits an explicit comparison, in a common notation, of two specific models of diagnostic error--one due to Carlos and Senning, the other to Lu. Each model gives rise to a consistent estimator of the incidence rate. The distributional properties of these estimators had not previously been examined because of the dependence of teeth in the same mouth with respect to caries experience. Using the present formulation, the sampling scheme may be regarded as a one-stage cluster sample with mouths as clusters. This approach accounts for intracluster dependence thus permitting the derivation of an estimator of the relevant covariance matrix and a confidence interval for the incidence rate.     

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.     

Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals

Objective: The 10‐year incidence of dental caries was related to some associated factors in a random sample of 65, 75 and 85‐year‐old inhabitants of Gothenburg. Subjects: Of the 208 persons examined at baseline, 102 (49%) participated in the follow‐up examination; 56, 37 and nine, respectively, in the different age groups. For the purpose of time‐trend comparisons, a new random sample of 98 individuals aged 55 years was examined. Results: Ninety‐five per cent of the participants had developed one or more carious lesions during the 10‐year period and the incidence of coronal and root caries increased with age. In the 65‐year‐olds, 9% of the root surfaces had decayed during the period, compared with 25% in the 85‐year‐olds. Secondary caries predominated over primary caries and prosthetic crowns accounted for 70% of the restored tooth surfaces. Twenty per cent of the individuals were daily smokers and 61% were taking drugs with hyposalivatory side‐effects. The mean saliva secretion rates were lower in the older groups compared with the ‘younger’ ones. The overall salivary counts of mutans streptococci and lactobacilli had increased during the period and the values were highest in the oldest age groups. Salivary levels of lactobacilli and mutans streptococci, number of teeth, daily numbers of cigarettes and drugs and oral hygiene were the best predictors of the incidence of caries. Conclusion: The findings indicate that there is an increased risk of dental caries with age owing to unfavourable caries‐related factors.     

Caries incidence and increments in community-living older adults with and without dementia

Objectives: The Oral Health of Older Adults with Dementia was instigated in the late 1990s to quantify and compare coronal and root caries incidence and increments in community‐living older Australians with and without dementia. Methods: A longitudinal design was used to conduct dental inspections at baseline and one‐year, for two groups of randomly selected community‐living older adults ‐ one group of 116 people with dementia and a comparison group of 116 people without dementia. Results: At one‐year there were 103 dementia and 113(112 dentate) non‐dementia participants. Coronal and root surface caries incidence was higher for dementia participants (p<0.05). Dementia participants had higher coronal and root caries adjusted caries increments (ADJCI) (p<0.01). Both coronal and root ADJCI were evident in half of dementia participants, compared with one‐quarter of non‐dementia participants. Dementia participants with higher coronal ADJCI were those who had visited the dentist since baseline, who were taking neuroleptics with high anticholinergic adverse effects, and whose carer had high carer burden score (p<0.01). Dementia participants with higher root ADJCI were those needing assistance with oral hygiene care and whose carers had difficulties with oral hygiene care (p<0.05). Baseline characteristics predictive in linear regression for: (1) coronal caries increments among all participants were ‐ dementia participants, those with cognitive testing scores indicative of moderate‐severe dementia, those with private health insurance; (2) root caries increments among all participants were ‐ dementia participants, and those who had 1 decayed/filled root surface at baseline. Among dementia participants, being male was the baseline characteristic predictive in logistic regression for coronal caries increments, and having 1 decayed coronal surface was the baseline characteristic predictive for root caries increments. Conclusions: Coronal and root caries incidence and increments were significantly higher in the community‐living older adults with dementia over the one‐year follow‐up period. Dementia participants had high levels of coronal and root caries increments; characteristics related to high caries increments included sex (males), dementia severity (moderate‐severe), high carer burden, oral hygiene care difficulties, use of neuroleptic medication (with high anticholinergic adverse effects) and previous experience of 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。     

Effect of mutacin administration on Streptococcus mutans-induced dental caries in rats

A bacteriocin from serotype c Streptococcus mutans strain C3603 was examined for its inhibitory effect on experimental dental caries in rats infected with S. mutans MT8148R (serotype c). Significant reduction in the incidence of dental caries was found only when bacteriocin was incorporated both in the drinking water and in the diet at a high concentration. However, caries reduction was not as great as expected and the addition of bacteriocin to drinking water alone had no effect on the recovery of S. mutans, plaque deposition or caries incidence. The bacteriocin activity must have been reduced in the oral cavity of rats, and the reasons were examined. Bacteriocin-resistant mutants were not detected and the bacteriocin was not inactivated by saliva. Whereas the bacteriocin did not kill the S. mutans cells grown in a sucrose-containing medium, it completely killed the cells grown in a sucrose-free medium.     

Diabetes enhances dental caries and apical periodontitis in caries-susceptible WBN/KobSlc rats

Many epidemiologic studies have suggested that diabetes may be an important risk factor for periodontal disease. To determine whether diabetes induces or enhances periodontal disease or dental caries, dental tissue from diabetic male and nondiabetic female WBN/KobSlc rats and male and female age-matched nondiabetic F344 rats was analyzed morphologically and morphometrically for these 2 types of lesions. Soft X-ray examination revealed that the incidence and severity of both molar caries and alveolar bone resorption were much higher in male WBN/KobSlc rats with chronic diabetes than in nondiabetic female rats of the same strain. Histopathologic examination showed that dental caries progressed from acute to subacute inflammation due to bacterial infections and necrosis in the pulp when the caries penetrated the dentin. In the most advanced stage of dental caries, inflammatory changes caused root abscess and subsequent apical periodontitis, with the formation of granulation tissue around the dental root. Inflammatory changes resulted in resorption of alveolar bone and correlated well with the severity of molar caries. Our results suggest that diabetic conditions enhance dental caries in WBN/KobSlc rats and that periodontal lesions may result from the apical periodontitis that is secondary to dental caries.     

Epidemiology of root caries

Many epidemiological studies have been conducted on a variety of populations. Unfortunately, comparison of the prevalence data, and to a lesser degree of the incidence data, between the various studies is of little use due to the lack of standardised diagnostic criteria, reporting methods and population diversity. In the few incidence studies which have been conducted around 30–40% of people developed root caries, although many adults in the population appear to have been affected by root caries. Many risk factors associated with the occurrence of root caries have been identified and these include oral, medical, mental, behavioural and psychosocial conditions.     

Bacteriological Studies of the Effects of Cow's Milk on Dental Plaque and Dental Caries in Rats

The effects of liquid milk and skim milk powder on the bacterial composition of rat dental plaque and dental caries were examined in two separate experiments. First, groups of rats fed a cariogenic diet plus one or other of three types of liquid milk had. after 28 d. similar plaque flora. Those rats receiving reconstituted spray-dried skim milk had a significantly higher incidence of dental caries than those receiving either pasteurized and homogenized milk or ultra-heat treated milk. The differences in caries scores may be related to differences in inorganic phosphate and calcium levels of the milks. Secondly, rats fed a diet containing 65% phosphate-free sucrose plus 32% spray-dried skim milk in powder form had a significantly lower dental caries score than did rats receiving a diet containing 65% sucrose plus 32% autoclaved roller-dried skim milk powder. At the end of this experiment, the plaque flora had changed significantly and the difference in caries incidence was related to the reduction in the percentage of potentially cariogenic bacteria.
These results indicate that the mechanism by which milk reduces dental caries incidence may be (a) by remineralizing incipient carious lesions or (b) by mediating changes in the bacterial composition of dental plaque.     

Maternal transmission and dental caries induction in Sprague-Dawley rats infected with Streptococcus mutans

Thirty-four female rats (18 days old) were infected with Streptococcus mutans MT8148R (serotype c) or 6715 (g). Diets containing different proportions of sucrose were used to prepare the dams which harbored various levels of S. mutans in their oral cavity. Around 66 days of age, the female rats were bred and 34 dams subsequently bore 322 offspring. The dams were killed upon weaning (20 days of age) of their respective litters. There were positive correlations between the recovery of inoculated S. mutans and the caries incidence in the dams. Transmission of S. mutans from a dam to her offspring was studied in 10-, 15-, 20-, 27-, 34-, 41-, 48-, and 55-day-old rats by evaluating the recover of S. mutans from the offspring. Positive correlation between the magnitudes of recovered S. mutans MT8148R from dams and their offspring was found in all ages of young rats examined. Furthermore, caries incidence in young rats was found to be positively correlated with the recovery of both strains of S. mutans as well as with incidence of caries in their respective dams.     

Diet and dental caries among later stone age inhabitants of the Cape Province, South Africa.

Stable carbon isotope measurements and incidences of dental caries are presented for three groups of prehistoric human skeletons from different regions of the Cape Province, South Africa. The isotopic analyses of bone collagen demonstrate the importance of marine foods in the diet and vary through time, across space, and according to sex. The incidence of dental caries ranges from 0% among heavily marine-dependent individuals from the south-western Cape coast, to 17.7% among skeletons from an archaeological site on the south coast. The extremely high incidence of caries in a hunter-gatherer population may be related to lack of fluoride in the water.     

Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study

The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad’s criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95–0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98–0.99), ferritin (IRR = 0.99, 95%CI 0.98–0.99), erythrocyte (IRR = 0.71, 95%CI 0.50–0.99), hemoglobin (IRR = 0.84, 95%CI 0.73–0.96), hematocrit (IRR = 0.93, 95%CI 0.88–0.98), MCV (IRR = 0.91, 95%CI 0.86–0.96), and MCH (IRR = 0.83, 95%CI 0.74–0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.     

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.     

Root caries incidence and associated risk factors in middle-aged and older adults

Data from population-based longitudinal studies required to assess the incidence of root caries and associated risk factors are sparse in the literature. To this end, a group of 130 middle-aged and older adults were examined for root caries at baseline and at a follow-up visit between nine and 24 months (median: 16 months). Dental examinations were conducted by one examiner at a Tufts dental clinic using NIDR defined diagnostic criteria. Fifty percent of subjects in this study population developed one or more new root caries lesions over the follow-up period. Also, an annualised increment of 0.60 (SD: 0.72) decayed and filled surfaces per person was observed for the 45–59 year old group while the 70+ group showed an annualised increment of 1.38 (SD: 1.97) DFS in this study. Multivariate logistic regression analysis identified past root caries experience, high plaque score, and high number of teeth (>= 22) to be positively associated with new root caries (p < 0.05).     

Detection of Caries-Inducing Microorganisms in Hyposalivated Rats without Infection of Mutans Streptococci

Rampant dental caries was induced in hyposalivated rats fed a high sucrose diet without infection of mutans streptococci, in which increased numbers of lactobacilli and S. aureus were demonstrated in the oral flora. Administration of either penicillin or piperacillin, effective against all isolates of lactobacilli, markedly inhibited the caries induction in these rats, while severe dental caries was induced in hyposalivated rats given vancomycin that is inhibitory against S. aureus. These results suggested that certain lactobacilli might induce dental caries in hyposalivated rats fed a sucrose diet. Three strains of Lactobacillus species isolated from the hyposalivated rats were made resistant to erythromycin. The caries-inducing activity of these erythromycin-resistant lactobacilli was studied in hyposalivated rats giving erythromycin in the drinking water at a concentration of 500 μg/ml. After a 61-day experimental period, severe dental caries was induced in hyposalivated rats infected with L. fermentum TY1R. On the other hand, low caries incidence was found in hyposalivated rats infected with either L. acidophilus TY7R or L. plantarum TY3R. These results indicate that L. fermentum may be one of causative agents of dental caries in hyposalivated rats fed a sucrose diet.     

Relationship between root caries and cardiac dysrhythmia

doi: 10.1111/j.1741‐2358.2010.00367.x
Relationship between root caries and cardiac dysrythmia Background: Cardiac dysrhythmia are frequently found in the elderly population because of conduction system disease and ageing. Recent reports have suggested that dental caries and periodontal disease are predictors of coronary heart events. However, this hypothesis remains largely unproven. Objective: This study investigated the relationship between root caries and cardiac dysrhythmia in an elderly population. Subjects and methods: Among 600 subjects, 233 who were dentate at baseline underwent a baseline examination and subsequent annual investigations, including an oral examination and a 12‐lead electrocardiogram, for a 4‐year period. Analysis of covariance (ancova) was used to assess the number of sites with root caries between subjects with mean C‐reactive protein (CRP) serum level of <3.0 mg/l and those with the mean CRP serum level ≥3.0 mg/l. Logistic regression analysis was performed to assess relationship between root caries and cardiac dysrhythmia. Results: A high mean CRP serum level group had a significantly higher number of sites with root caries than a low CRP group (p < 0.001). Number of sites with root caries events was significantly associated with cardiac dysrhythmia among non‐smokers (odds ratio, 5.84; p = 0.040). These results suggest that root caries is related to the incidence of dysrhythmias in non‐smokers. Conclusions: We conclude that non‐smoking elders with root caries lesions are at an elevated risk for dysrhythmias.