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2.
Int Dent J ; 69(6): 419-427, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31402451

RESUMO

OBJECTIVES: Numerous caries risk assessment tools have been proposed in the literature, with few validated in preschool children especially those receiving oral rehabilitation under general anaesthesia (GA). Past caries experience, the best predictor thus far, may not be a reliable indicator after effective clinical intervention. Hence, this longitudinal study was aimed to explore the potential role of plaque pH in predicting future caries incidence after GA among preschool children. METHODS: Oral examination, plaque pH measurements and questionnaire survey were performed, among pre-schoolers indicated for GA, at baseline (n = 92), 6-month (6M; n = 83), 12-month (12M; n = 79) and 24-month (24M; n = 66) recall visits after GA. Multivariable logistic regression and receiver-operating characteristic analysis were performed to evaluate the predictive value of models with plaque pH and past caries experience. RESULTS: Individuals with low resting plaque pH at 6M and 12M were shown to be at high risk of 1-year caries incidence at 12M [relative risk (RR) 1.41, 95% confidence interval (CI) 1.09-1.48] and 24M (RR 1.61, 95% CI 1.22-1.73) recall visit, respectively. Moreover, plaque pH demonstrated a statistically significant predictive value in the 12M and 24M models (12M/24M: 85%/77%) compared with past caries experience, which was not a significant predictor in both models (both P > 0.05). CONCLUSIONS: Plaque pH may be a promising prognostic and predictive marker for early identification of high-risk children undergoing oral rehabilitation under GA.


Assuntos
Cárie Dentária , Placa Dentária , Anestesia Geral , Pré-Escolar , Índice CPO , Humanos , Concentração de Íons de Hidrogênio , Estudos Longitudinais , Recidiva
3.
Int Dent J ; 68(6): 378-385, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29740814

RESUMO

OBJECTIVES: Oral rehabilitation under general anaesthesia (GA), commonly employed to treat high caries-risk children, has been associated with high economic and individual/family burden, besides high post-GA caries recurrence rates. As there is no caries prediction model available for paediatric GA patients, this study was performed to build caries risk assessment/prediction models using pre-GA data and to explore mid-term prognostic factors for early identification of high-risk children prone to caries relapse post-GA oral rehabilitation. METHODS: Ninety-two children were identified and recruited with parental consent before oral rehabilitation under GA. Biopsychosocial data collection at baseline and the 6-month follow-up were conducted using questionnaire (Q), microbiological assessment (M) and clinical examination (C). RESULTS: The prediction models constructed using data collected from Q, Q + M and Q + M + C demonstrated an accuracy of 72%, 78% and 82%, respectively. Furthermore, of the 83 (90.2%) patients recalled 6 months after GA intervention, recurrent caries was identified in 54.2%, together with reduced bacterial counts, lower plaque index and increased percentage of children toothbrushing for themselves (all P < 0.05). Additionally, meal-time and toothbrushing duration were shown, through bivariate analyses, to be significant prognostic determinants for caries recurrence (both P < 0.05). CONCLUSIONS: Risk assessment/prediction models built using pre-GA data may be promising in identifying high-risk children prone to post-GA caries recurrence, although future internal and external validation of predictive models is warranted.


Assuntos
Anestesia Geral , Cárie Dentária , Conhecimentos, Atitudes e Prática em Saúde , Medição de Risco/métodos , Criança , Pré-Escolar , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Cárie Dentária/terapia , Humanos , Lactente , Higiene Bucal/educação , Pais , Educação de Pacientes como Assunto , Projetos Piloto , Recidiva , Saliva/microbiologia , Prevenção Secundária , Fatores Socioeconômicos , Inquéritos e Questionários
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