日本語AIでPubMedを検索
原始歯の修復物交換の決定に及ぼす臨床的基準の違いの影響
Influence of different clinical criteria on the decision to replace restorations in primary teeth.
PMID: 32615237 DOI: 10.1016/j.jdent.2020.103421.
抄録
目的:
本研究は、無作為化臨床試験に入れ子にした横断的研究であり、2つの異なる臨床基準と、修復物周囲の齲蝕病変の評価のための他の変数を用いた場合の影響を評価することを目的としている。
OBJECTIVES: This cross-sectional study nested in a randomized clinical trial was designed to evaluate the influence of using two different clinical criteria, and some other variables for the assessment of caries lesion around restorations on decision-making of restorations' replacement in primary posterior teeth.
方法:
1人の訓練を受けた検者が、160人の小児（3～10歳）の550件の修復物を評価した。子供たちは、修復物を評価し、世界歯科連盟（FDI）またはCARS（Caries Associated Associated With Restorations and Sealants）の基準に従って治療を受けるように無作為に割り付けられた。治療の決定に達した後、同じ検査者が他の基準を用いて別の評価を行った。両方の基準で得られたスコアとそれぞれの治療決定との間のスピアマン相関係数と95%信頼区間（95%CI）を計算した。ポアソン多値回帰分析は、子供、修復された歯、修復物の評価に関連する探索的変数との間で行われた。
METHODS: One trained and calibrated examiner assessed 550 restorations of 160 children (3-10 years old). Children were randomized to have their restorations evaluated and subsequently treated according to World Dental Federation (FDI) or Caries Associated with Restorations and Sealants (CARS) criteria. After reaching the treatment decision, the same examiner performed another evaluation using the other criteria. Spearman's correlation coefficients and 95% confidence intervals (95%CI) between the scores obtained with both criteria and respective treatment decisions were calculated. Poisson multilevel regression analysis were performed between the exploratory variables related to children, restored tooth and restoration assessment; the outcome variables were decisions related to restoration replacement, any operative intervention and presence of secondary caries.
結果:
両法の間に観察された最も強い相関関係は齲蝕の再発であった．FDI基準では94件（17.1％）の修復物が再置換の対象となり、CARS基準では30件（5.5％）が再置換の対象となった。使用した診断方法の他に、虫歯の本数、2面および3面修復された修復物は、再置換の決定および再発う蝕病変の有無と関連していた。
RESULTS: The strongest correlation observed between the methods was for recurrence of caries. A total of 94 restorations (17.1%) were indicated for replacement with FDI criteria and 30 (5.5%) were indicated for replacement with CARS. Besides the diagnostic method used, number of decayed teeth and restorations with two and three restored surfaces were associated with the decision of replacement and presence of recurrent caries lesions.
結論:
原始歯の後修復物を交換するかどうかの判断は、修復物の評価に使用される基準、小児の齲蝕経験や多面修復物の有無に影響される。
CONCLUSIONS: The decision to replace posterior restorations in primary teeth is influenced by criteria used for the assessment of the restorations, as well as for children's caries experience and multisurface restorations.
臨床的意義:
原始歯の後修復物交換の決定は、患者のリスク因子だけでなく、評価方法にも強く関係している。
CLINICAL SIGNIFICANCE: The decision to replace posterior restoration in primary teeth is strongly related to the evaluation method and not only by patients' risk factors.
Copyright © 2020. Published by Elsevier Ltd.