学童永久歯における各種齲蝕性病変の進行速度と齲蝕検出基準についての研究
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A few follow-up studies have been published to determine the advancing speed of early carious lesion by some investigators. However, since they are only concerned with two types of incipient caries, the sticky fissure and the caries of 1st degree, the results obtained are not exhausive or conclusive. This study was therefore performed.<BR>The permanent teeth of elementary school children, 181 boys and 180 girls of six to ten years of age in Asaka of Saitama Prefecture, were thoroughly inspected in April of 1965. At this examination, 42 cases of white spots, 6 cases of brown spots, 163 cases of the browned pits or fissures, 98 cases of the sticky fissures, 261 cases of visible carious cavities restricted within the tooth enamel, 124 cases of carious cavities reached to the dentine, and 40 cases of more advanced cavities suspected the presence of pulpitis were detected. The lesions were re-examined six-monthly for two-years by the same examiner. In case of any alteration was observed, it was noted in a chart as Fig. 1. From counting the cases altered or not, Tables 1 and 2 were made. A number of the cases were treated in every six-months because they were not supervised through the observation period. By the computing method except that the cases were treated, each supposed progressing rates of four six-months were obtained. The cumulative progressing rates for 12 to 24 months were calculated from these four estimates. The results were presented in Tables 3 and 4 or Figures 2 to 8.<BR>1. About ten percent of the withe spots, just one-third of the brown spots, approximate one-third of the browned pits or fissures, and 60 percent of the sticky fissures were progressed into discernible carious cavities in a year. But they did not become the more advanced cavity suspected a diseased pulp in the same period.<BR>2. One year after, 50 percent of the visible cavities resticted within the tooth enamel were become definite dentine caries and 4 percent of them were advanced to the large cavities suspected pulpitis.<BR>3. Approximate one-fourth of the carious cavities reached the dentine were progressed into the large cavities presumed pulpitis and 3 percent were indicated for tooth extraction after a year.<BR>4. More than one-third of the carious cavities suspected pulpitis were become indication for tooth extraction in a year.<BR>5. The supposed progressing rates of four six-months periods vary considerably in every carious lesions. By using chi-square distribution-test, the variations of the white spots, the sticky fissures, and of the large cavities suspected pulpitis showed statistically significant difference at 1 or 5 percent level. The others also had some tendency, however they did not present a significant difference (Tables 5 and 6). Then, it was assumed that the initial caries of school children had a trend to progress in the first year but the clinical cavity did not.<BR>From the consideration of these results, it seems to be apparent that the visible surface breakdown and the sticky fissure in young permanent teeth should be accepted as a clinical caries in order to avoid a serious damage by caries, but the white or brown spot and the browned pit or fissure should not.
- 有限責任中間法人 日本口腔衛生学会の論文