Dental and Medical Problems

Dent Med Probl
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Dental and Medical Problems

2013, vol. 50, nr 3, July-September, p. 298–307

Publication type: original article

Language: Polish

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Częstość występowania i rozmieszczenie plam próchnicowych na powierzchniach gładkich zębów mlecznych u dzieci poniżej 6. roku życia

The Incidence and Distribution on Smooth Surface White Spot Lesions in Children Under 6 Years

Anna Turska-Szybka1,A,B,D,E,F, Michał Gefrerer1,B, Dariusz Gozdowski2,C, Dorota O Lczak-Kowalczyk1,A,B,D,E

1 Zakład Stomatologii Dziecięcej WUM, Warszawa, Polska

2 Katedra Doświadczalnictwa i Bioinformatyki, Wydział Rolnictwa i Biologii SGGW, Warszawa, Polska

Streszczenie

Wprowadzenie. Pierwszą kliniczną oznaką próchnicy szkliwa jest plama próchnicowa. Piśmiennictwo nie dostarcza wystarczających informacji na temat częstości występowania wczesnych zmian próchnicowych szkliwa w uzębieniu mlecznym u dzieci polskich.
Cel pracy. Określenie częstości występowania i rozmieszczenie plam próchnicowych na powierzchniach gładkich zębów mlecznych dostępnych w badaniu wzrokiem u dzieci poniżej 6. roku życia.
Materiał i metody. Badaniem objęto dzieci 18–71-miesięczne zgłaszające się do Zakładu Stomatologii Dziecięcej WUM. Badanie przedmiotowe przeprowadzono z użyciem lusterka płaskiego i sondy periodontologicznej WHO. O dnotowywano obecność białych plam próchnicowych na powierzchniach gładkich zębów dostępnych w badaniu wzrokiem widocznych bez osuszenia według kryteriów ICDAS II. Badania przeprowadzało trzech lekarzy dentystów po uprzednim szkoleniu i kalibracji.
Wyniki. Po kalibracji została osiągnięta wartość współczynnika zgodności kappa 0,96. Wśród zbadanych 419 dzieci plamy próchnicowe występowały u 47,7%, z podobną częstością u dziewcząt i chłopców. Stwierdzono 3-krotnie częstsze ich występowanie u dzieci w wieku 37–71 miesięcy (75,5%) niż u 18–36-miesięcznych (24,5%). Plamy obserwowano głównie na powierzchniach wargowych/policzkowych, zwłaszcza kłów i zębów siecznych bocznych szczęki. Odnotowano symetryczne rozmieszczenie plam próchnicowych w szczęce i żuchwie, po prawej i lewej stronie. Średnia liczba powierzchni gładkich z plamami próchnicowymi w całej badanej grupie wynosiła 2,05 ± 2,87, a w grupie dzieci ze stwierdzonymi plamami miała wartość 4,30 ± 2,75.
Wnioski. U prawie co drugiego dziecka poniżej 6. roku życia występują plamy próchnicowe szkliwa, umiejscowione na powierzchniach gładkich zębów mlecznych, najczęściej kłów i zębów siecznych szczęki. Częstość ich występowania i liczba zwiększają się wraz z wiekiem dzieci.

Abstract

Background. The first clinical sign of enamel caries is a white spot carious lesion. Literature does not provide sufficient information on the incidence of early carious lesions in enamel of primary dentition in Polish children.
Objectives. To evaluate incidence and location of white spot carious lesions on smooth surfaces in primary dentition accessible in visual examination in children below 6 years of age.
Material and Methods. The study included children aged 18–71 months presenting at the Department of Paediatric Dentistry, Medical University of Warsaw. Clinical examination was performed using a flat mirror and WHO periodontal probe. Presence of white spot caries on smooth tooth surfaces, which were accessible in visual examination, visible without drying was recorded according to ICDAS II criteria. Examinations were performed by 3 calibrated dentists.
Results. After calibration, kappa concordance correlation coefficient amounted to 0.96. Among all 419 examined children, white spots were observed in 47.7% of children with similar rates in girls and boys. Their incidence was 3 times higher in children aged 37–71 months (75.5%) than in the 18–36 months age group (24.5%). White spots were mainly observed on labial/buccal surfaces, specifically in canines and upper lateral incisors. Symmetrical location of white spots was observed in upper and lower teeth, as well as on the left and right side. Mean number of smooth surfaces affected by white spots in the entire study group was 2.05 ± 2.87, and 4.30 ± 2.75 in children with white spots.
Conclusion. White spot carious lesions on smooth surfaces of primary teeth occur in almost every second child below 6 years of age, and most commonly affect canines and upper incisors. Their incidence and number increases with age.

Słowa kluczowe

białe plamy próchnicowe, próchnica u dzieci, zęby mleczne

Key words

white spot lesions, caries, children, deciduous teeth

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