Ação clareadora e microbiológica do enxaguante bucal com peróxido de hidrogênio: ensaio clínico / Whitening and microbiological action of mouthwash with hydrogen peroxide: clinical trial

Introdução: os enxaguantes bucais clareadores tem sido muito utilizados, porém sua eficiência e efeitos colaterais trazem questionamentos. Objetivo: este ensaio clínico teve como objetivo avaliar se o enxaguante bucal clareador, contendo peróxido de hidrogênio a 1,5%, apresenta ação clareadora e se há algum efeito secundário na cavidade bucal. Metodologia: foram selecionados 10 voluntários com idade média de 21,5 anos, submetidos a avaliação da cor dos dentes com auxílio do espectrômetro em 3 momentos: inicial; com 15 e com 30 dias de uso do enxaguante. A avaliação dos efeitos colaterais foi realizada a partir da coleta de saliva estimulada em 4 momentos: antes e depois ao primeiro uso do produto, com 15 e com 30 dias, e realizadas as análises laboratoriais: fluxo salivar; pH; quantidade de Streptococcus mutans e de Lactobacillus. A normalidade dos dados foi verificada pelo teste de Shapiro-Wilk, comparação de cor pelo teste t dependente, comparação dos microrganismos pelos testes ANOVA de medidas repetida e Tukey. Resultados: as análises de cor dos dentes não evidenciaram nenhuma alteração significativa em nenhum dos tempos investigados. No fluxo salivar, pH e Lactobacillus não houveram alterações significativas. Na quantidade de Streptococcus mutans notou-se um aumento significativo quando comparado os valores após o primeiro uso e com 30 dias. Conclusão: a solução de enxague bucal contendo peróxido de hidrogênio a 1,5% não apresentou alteração significativa na coloração dos dentes e nenhum efeito colateral significativo na atividade cariogênica de acordo com os testes e períodos avaliados.

Introduction: whitening mouthwashes have been widely used, but their efficiency and side effects raise questions. Objective: this clinical trial aimed to assess whether the bleaching mouthwash, containing 1.5% hydrogen peroxide, has a bleaching action and whether there are any side effects in the oral cavity. Methods: 10 volunteers were selected, with a mean age of 21.5 years, who underwent tooth color evaluation with the aid of a spectrometer in 3 moments: initial; with 15 and 30 days of using the washes. The evaluation of side effects was performed from the collection of stimulated saliva in 4 moments: before and after the first use of the product, at 15 and 30 days, and laboratory analyzes were carried out: salivary flow; pH; the number of Streptococcus mutans and Lactobacillus. Normal distribution was verified with Shapiro-Wilk test, comparisons of color were performed with t-test, comparisons of the microorganisms were performed with repeated measures ANOVA and Tukey tests. Results: the analysis did not show any significant changes in any of the investigated times. There were no significant changes in the salivary flow, pH and Lactobacillus. The number of Streptococcus mutans, was noted a significant increase when comparing the values after the first use and with 30 days. Conclusion: the mouthwash containing 1.5% hydrogen peroxide was not shown any significant alterations in the color teeth. There were not significant collateral effects on the cariogenic activity according to the tests and periods evaluated.

Materiales de restauración dental / Dental restorative materials

Objetivo: Identificar los efectos que producen la utilización de materiales restauradores en los tejidos dentarios luego de utilizarlos como una solución funcional y estética ante los problemas provocados por cualquier tipo de microorganismo es necesario. Método: de tipo bibliográfica mediante una búsqueda de artículos en base PubMed y Scielo. Resultados: Se encontraron 30 artículos, de los cuales solo se pudieron utilizar 15 de ellos, ya que contribuyeron a cumplir con el objetivo de esta investigación y el resto no. Conclusiones: Los materiales dentales son la base fundamental de la odontología restauradora, protésica y de varias especialidades y procedimientos realizados por parte del odontólogo. Por lo tanto, es necesario tener conocimientos de cómo actúa cada uno de estos materiales restaurativos, con base en su estructura interna, para poder ver cuál va a ser su comportamiento físico, mecánico y fisicoquímico en su uso odontológico.

Objective: To identify the effects produced by the use of restorative materials on dental tissues after using them as a functional and esthetic solution to the problems caused by any type of microorganism. Method: bibliographic type by means of a search of articles in PubMed and Scielo databases. Results: 30 articles were found, of which only 15 of them could be used, since they contributed to fulfill the objective of this research and the rest could not. Conclusions: Dental materials are the fundamental basis of restorative dentistry, prosthetic dentistry and various specialties and procedures performed by the dentist. Therefore, it is necessary to have knowledge of how each of these restorative materials acts, based on their internal structure, in order to be able to see what their physical, mechanical and physicochemical behavior will be in their dental use.

Tratamiento ortopédico funcional y mecánico para la corrección de la clase II esqueletal / Functional and mechanical orthopedic treatment for the correction of skeletal class II

Objetivo: Analizar las distintas alternativas de tratamiento basadas en Ortopedia Funcional y Mecánica, su efecto a nivel esqueletal, sus beneficios. Método: Revisión bibliográfica. Resultados: Se seleccionaron 15 artículos de un universo de 45, por cuanto eran los que tenían relación directa con el tema de investigación. Conclusión: Se ha logrado identificar las distintas alternativas de tratamiento con ortopedia funcional o mecánica que se pueden utilizar para el tratamiento de la Clase II esqueletal, corroboradas con resultados que evidencian Su efectividad tanto en los cambios craneofaciales, de tejidos blandos y dentales obtenidos al final de la terapéutica, los autores recomiendan la correcta evaluación de los pacientes, antes de determinar la aparatología a utilizar así cómo aprovechar los estadios tempranos de maduración y crecimiento para que los cambios en el patrón esqueletal sean más representativos, efectivos y alcancen el objetivo de mejorar la relación maxilo-mandibular.

Objective: To analyze the different treatment alternatives based on Functional and Mechanical Orthopedics, their effect at skeletal level, their benefits. Method: Bibliographic review. Results: 15 articles were selected from a universe of 45, as they were those directly related to the research topic. Conclusions: We have been able to identify the different treatment alternatives with functional or mechanical orthopedics that can be used for the treatment of skeletal Class II, corroborated with results that show their effectiveness in craniofacial, soft tissue and dental changes obtained at the end of the therapy, the authors recommend the correct evaluation of the patients before determining the appliances to be used, as well as taking advantage of the early stages of maturation and growth so that the changes in the skeletal pattern are more representative, effective and achieve the objective of improving the maxillomandibular relationship.

Performance of ICDAS e-learning program in teaching graduate students on the detection of occlusal caries / Desempenho do programa de aprendizagem eletrônico ICDAS no ensino de alunos de pós-graduação na detecção de cáries oclusais

ABSTRACT Objective: The aim was evaluate the validity and reproducibility of the International Caries Detection and Assessment System (ICDAS) in detecting occlusal caries among graduate students after training using the e-learning program. Methods: A sample of forty-two primary teeth with different ranges of occlusal caries was selected. All teeth were mounted on a wax support and standardized photographs (EOS Rebel XTI, Canon, NY, USA) of the occlusal surfaces were taken. An experienced researcher randomly selected one specific site on the occlusal surface of each tooth to be examined later. Fifteen graduate students with no previous experience in the ICDAS scores completed the ICDAS e-learning program in Portuguese. After the training, visual examination of the occlusal surfaces was taken twice, independently, with a two-week interval. After visual examination, the teeth were longitudinally sectioned 1mm away from the previously selected occlusal site. The teeth were fixed on a wax support and photographed. Histological analysis was performed from these photographs by an experienced researcher to evaluate the depth of demineralization. Results: The Intraclass Correlation Coefficient (ICC) inter-examiner values among all participants varied from 0.54 to 0.96 and intra-examiner ICC reproducibility of the examiners ranges from 0.61 to 0.85, showing good to excellent reproducibility. For detection of enamel and dentine lesions (D1), ICDAS obtained sensitivity 0.835 and specificity 0.756. For dentine lesions (D3), the method revealed an increase in sensitivity but specificity was similar to D1. Conclusion: ICDAS e-learning training program was efficient for the training of caries lesions detection among graduate students.

RESUMO Objetivo: O objetivo foi avaliar a validade e a reprodutibilidade do Sistema Internacional de Detecção e Avaliação de Cárie (ICDAS) na detecção de cárie oclusal entre estudantes de pós-graduação após o treinamento usando o programa de e-learning. Métodos: Foi selecionada uma amostra de 42 dentes decíduos com diferentes faixas de cárie oclusal. Todos os dentes foram montados em um suporte de cera e foram tiradas fotografias padronizadas (EOS Rebel XTI, Canon, NY, EUA) das superfícies oclusais. Um pesquisador experiente selecionou aleatoriamente um local específico na superfície oclusal de cada dente para ser examinado posteriormente. Quinze estudantes de pós-graduação sem experiência anterior com o ICDAS concluíram o programa de e-learning em português. Após o treinamento, o exame visual das superfícies oclusais foi realizado duas vezes, independentemente, com intervalo de duas semanas. Após o exame visual, os dentes foram seccionados longitudinalmente a 1mm do local oclusal previamente selecionado. Os dentes foram fixados em um suporte de cera e fotografados. A análise histológica foi realizada a partir dessas fotografias por um pesquisador experiente para avaliar a profundidade da desmineralização. Resultados: Os valores interexaminadores do Coeficiente de Correlação Intraclasse (ICC) entre todos os participantes variaram de 0,54 a 0,96 e a reprodutibilidade intra-examinador do ICC dos examinadores variou de 0,61 a 0,85, mostrando reprodutibilidade boa a excelente. Para detecção de lesões de esmalte e dentina (D1), o ICDAS obteve sensibilidade 0,835 e especificidade 0,756. Para lesões de dentina (D3), o método revelou um aumento na sensibilidade, mas a especificidade foi semelhante ao D1. Conclusão: O programa de treinamento em e-learning do ICDAS foi eficiente no treinamento de detecção de lesões de cárie em estudantes de pós-graduação.

To investigation the influencing factors of dental caries and caries activity test in children aged 3-5 years in the Yuhua area of Changsha / 中国医师杂志

Objective:To investigate influencing factors of dental caries among 3 to 5-year-old children in the Yuhua District of Changsha by Cariostat detection and provide evidence to prevent caries.Methods:1 032 children aged 3-5 years old from 6 kindergartens in Yuhua District of Changsha were randomly selected for oral health examination. 565 children in 6 large classes, 6 middle classes and 6 small classes were randomly selected from 6 kindergartens were perfected caries activity test (CAT) by Cariostat detection.Results:Among 1 032 children, 626 had caries, the caries rate was 60.66%, the caries was 2.87±3.67, and the caries filling rate was 8.53%. The caries rate of maxillary central incisors was the highest (37.89%), followed by mandibular second primary molars (32.56%) and mandibular first primary molars (32.36%). There was significant difference in caries rate among different age groups (χ 2=9.231, P<0.05). The caries rate of 5-year-old children was the highest (66.50%). 1 032 children were divided into 4 groups according to dmft (decayed, missing, filled teeth) value, and the number of caries free group was the largest; the number of caries in the middle caries group was the least. The number of missing teeth in 1 032 children with caries was 2 959. The number of missing teeth in the high caries group was the most, up to 1 861, accounting for 61.89% of the total number of missing teeth. The analysis of 565 children by CAT showed that the caries rate was different in different CAT grades (χ 2=27.390, P<0.05). The caries rate in the high-risk group was the highest, 90.48%. The CAT value was positively correlated with caries ( r=0.261, P<0.05). Conclusions:The incidence of dental caries in children aged 3-5 years in Yuhua District of Changsha was 60.66%. Cariostat method can truly reflect the situation of caries in children and is helpful to screen the population susceptible to caries in children.

Effect of Repeated Oral Health Education on the Oral Health of Preschool Children / 치위생과학회지

This study aimed to investigate the effect of repeated oral health education on the oral health of preschool children. This study classified the control group of children of 5~6 years of age where the oral health education was conducted one time, and the experiment group where the oral health education was conducted 4 times. The oral health conditions of each group and their risk of developing dental caries were also assessed. No significant difference was observed in the participants in terms of general characteristics, oral health conditions, risk of developing dental caries, and oral health behavior after oral health education. The two groups did not show a significant difference (p<0.001) in dental plaque index before and after oral health education, and showed a significant difference (p<0.001) according to the number of education sessions. Before oral health education, the participants in both groups were brushing their teeth incorrectly. However, after the third session, 56.7% of the participants in the experimental group and 9.4% in the control group used the correct method of tooth brushing. A significant difference was observed between the two groups (p<0.05). In addition, when the tooth-brushing time was compared, the two groups showed a significant difference (p<0.001), and a significant difference was observed in terms of the number of education sessions (p<0.05). In summary, repeated oral health education had significant influences on the dental plaque index, tooth-brushing method, brushing occlusal surfaces, and tooth-brushing time. Therefore, when oral health education is carried out, repeated oral health education in children is more effective than one-time oral health education as reflected in the changes in dental plaque index and oral health behavior. Moreover, oral health education is considered effective in changing the oral health behavior of children when conducted at least 3 times.

Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth

Abstract We aimed to investigate the performance of fluorescence-based methods (FBMs), compared to visual inspection after histological validation, in detecting and assessing the activity status of occlusal carious lesions in primary teeth. One examiner evaluated 50 primary molars close to exfoliation in 24 children. Teeth were assessed using quantitative light-induced fluorescence (QLF) and pen-type laser fluorescence (LFpen). After exfoliation, histological validation was performed. Teeth were cut and sections were evaluated for lesion depth and activity status (after utilization of a pH indicator) under a stereomicroscope. Parameters related to the performance of the methods in detecting caries lesions at two thresholds (initial and dentin lesions) were calculated. Regarding the activity status, lesions were classified into sound+inactive or active, and the area under the ROC curve and the diagnostic odds ratio values of the methods were calculated and compared. Evaluation of red fluorescence using QLF presented higher sensitivity but lower specificity than visual inspection in detecting dentin caries lesions. However, QLF considering different parameters and LFpen had similar performance to that obtained with visual inspection. Regarding activity assessment, all FBMs and visual inspection also presented similar performance. In conclusion, FBMs did not prove advantageous for the detection and activity assessment of occlusal caries lesions in primary molars when compared to visual inspection.

Caries prediction using the caries activity test with a sulfisomidine mixture: a 3-year follow-up study / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to evaluate the prediction validity of the caries activity test with a sulfisomidine mixture (SAHS test). METHODS: This longitudinal follow-up study was conducted for 3 years. The subjects were 155 elementary schoolchildren. Oral examination was performed by examining each tooth surface of the subjects. The number of teeth with new caries lesions was calculated by comparing between the baseline data of the initial oral examination and the results of the second oral examination performed after 3 years. The Dentocult SM test was used as the reference in the analysis of the caries prediction validity of the SAHS test. The items of the validity test for carries prediction were as follows: sensitivity, specificity, predictive value, and likelihood ratio. RESULTS: The correlation between new caries lesions and the SAHS test scores was greater than that between new caries lesions and the Dentocult SM test scores. The receiver-operating analysis revealed that the area under the curve of the SAHS test was higher than that of the Dentocult SM test. The caries prediction validity of the SAHS test (grade 12) was as follows: sensitivity, 0.71-0.70; specificity, 0.60-0.58; positive predictive value, 0.79-0.78; negative predictive value, 0.49 (screening criterion 5). The SAHS test scores were similar to or higher than the scores in the items of the Dentocult SM test. CONCLUSIONS: The SAHS test is considered useful for clinical applications.

Detecção e avaliação da atividade de lesões de cárie primária e secundária em superfícies oclusais: estudos in vitro e in vivo / Detection and activity assessment of primary and secondary caries on occlusal surfaces: in vitro and in vivo studies

O objetivo do presente estudo foi avaliar a efetividade de métodos empregados na detecção e na avaliação da atividade de lesões de cárie primárias e secundárias em superfícies oclusais de dentes decíduos e permanentes. Para tanto, foram realizadas quatro pesquisas. (1) O objetivo desta pesquisa foi avaliar in vitro a influência de métodos de profilaxia profissional nas medidas de fluorescência e no desempenho de três aparelhos baseados na captação da fluorescência induzida por luz na detecção de lesões de cárie oclusal em dentes permanentes. Os exames foram realizados em 110 dentes permanentes por dois examinadores no início, após a profilaxia profissional e lavagem e após uma segunda lavagem. Foram utilizados os aparelhos DD (DIAGNOdent 2095, KaVo, Alemanha), DDpen (DIAGNOdent 2190, KaVo, Alemanha) e VP (VistaProof, Dürr Dental, Alemanha). Os dentes foram aleatoriamente distribuídos de acordo com o método de profilaxia profissional empregado: jato de bicarbonato de sódio ou pasta profilática. Pode-se concluir que a escolha do método de profilaxia professional pode influenciar significativamente as medidas de fluorescência e o desempenho de métodos baseados na captação da fluorescência induzida por luz na detecção de lesões de cárie oclusal. (2) O objetivo deste estudo in vivo foi determinar os pontos de corte ideais para o DD, o DDpen e a VP, e avaliar a validade clínica de métodos convencionais e de métodos baseados na captação da fluorescência induzida por luz na detecção de lesões de cárie oclusal em dentes permanentes. Foram selecionados 105 dentes permanentes posteriores indicados para extração em 88 pacientes adultos. Um examinador experiente avaliou os dentes usando métodos baseados na captação da fluorescência induzida por luz (DD, DDpen e VP), ICDAS e exame radiográfico (Rx). Pode ser concluído que o ICDAS, o DD e o DDpen apresentaram boa validade em detectar lesões de cárie oclusal in vivo. Entretanto, o Rx e a VP foram pouco eficientes em detectar, respectivamente, todas os tipos de lesões e lesões em dentina. Além disso, os pontos de corte dos métodos baseados na captação da fluorescência induzida por luz não devem ser considerados pelos dentistas como limiares exatos na decisão de tratamento. (3) Os objetivos deste estudo foram comparar in vivo dois critérios clínicos para avaliação de atividade de lesões de cárie, comparar esses resultados in vivo com os resultados in vitro obtidos pelo novo método baseado em luminescência e comparar ambos critérios com esse método para determinar o status da atividade de lesões de cárie reexaminadas após 2 meses de acompanhamento clínico. Os dois critérios clínicos foram comparados em 88 molares decíduos de 58 crianças com idade entre 9 e 12 anos. Uma parte da amostra (n=10) foi reexaminada após 2 meses. Após a esfoliação ou extração, os dentes foram analisados por um novo método baseado em luminescência (Carivis, LUX DS, Reino Unido). Em conclusão, os critérios clínicos apresentaram uma alta correlação quando empregados in vivo. Sugere-se que o método de luminescência apresente capacidade em avaliar a atividade de lesões de cárie in vitro. (4) Neste estudo in vitro foi avaliado o desempenho do critério visual ICDAS e de novas tecnologias na detecção de lesões de cárie natural ao redor de restaurações de amálgama e de resina composta em dentes permanentes e determinada a relação entre a presença da lesão de cárie secundária e a presença/ausência de diferentes tamanhos de defeitos marginais. Foram selecionados cento e oitenta dentes com restaurações de amálgama (n=90) e de resina composta (n=90). Dois examinadores analisaram os dentes utilizando o critério visual ICDAS, o aparelho de fluorescência a laser (DD), o aparelho baseado em LED (Midwest Caries I.D., DENTSPLY Professional, EUA), o aparelho QLF (QLF-clin, Inspektor Research Systems BV, Holanda) e um protótipo baseado na tecnologia da imagem da fluorescência do esmalte (PCDS, Therametrics Technologies, EUA). O tamanho do defeito marginal foi analisado por meio de uma sonda exploradora. O padrão outro foi determinado pela microscopia confocal de varredura a laser (CLSM). Em conclusão, o ICDAS e o DD apresentaram bom desempenho na detecção de lesões de cárie ao redor de restaurações de resina composta, e o QLF e o PCDS na detecção de lesões de cárie ao redor de restaurações de amálgama e de resina composta. O tamanho do defeito marginal foi irrelevante na determinação da presença de lesões de cárie ao redor de restaurações. Por meio desta pesquisa, observou-se que os métodos descritos acima para detecção e avaliação da atividade de lesões de cárie parecem contribuir de forma positiva no processo de diagnóstico. No entanto, devem ser considerados como auxiliares aos métodos convencionais nesse processo

The aim of this study was to evaluate the effectiveness of methods for caries detection and caries activity assessment on occlusal surfaces of primary and secondary caries in deciduous and permanent teeth. For this reason, four studies were carried out: (1) The aim of this study was to evaluate the effects of professional prophylaxis procedures on fluorescence measurements and on three fluorescence-based devices in detecting occlusal caries in permanent teeth. All assessments were performed in 110 permanent teeth by two examiners at baseline, after professional prophylaxis and rinsing, and after a second rinsing. The devices LF (DIAGNOdent 2095, KaVo, Germany), LFpen (DIAGNOdent 2190, KaVo, Germany) and FC (VistaProof, Dürr Dental, Germany) were used. The teeth were randomly divided according to the professional prophylaxis used: sodium bicarbonate jet or prophylaxis paste. It can be concluded that the choice of professional prophylaxis method can significantly influence the fluorescence measurements and the performance of fluorescence-based methods for detection of occlusal caries. (2) This in vivo study proposed clinical cut-off limits for three fluorescence-based methods and evaluated the validity of conventional and fluorescencebased methods for occlusal caries detection in permanent teeth. A total of 105 posterior permanent teeth with an indication for extraction were selected in 88 adult patients. One experienced examiner assessed the teeth using fluorescence-based methods (LF, LFpen and FC), ICDAS and bitewing radiographs (BW). It can be concluded that ICDAS, LF and LFpen demonstrated good validity in detecting occlusal caries in vivo. However, BW and FC showed the lowest validity to detect all lesions and dentin lesions, respectively. Besides, the fluorescence-based methods cut-off limits should not be considered as exact thresholds for dentists' treatment decision. (3) The aims of this study were to compare two clinical criteria for caries activity assessment in primary teeth in vivo, to compare these in vivo results with the in vitro results obtained by a novel luminescence assay, and to compare both criteria with the luminescence assay to determine the activity status on lesions subject to a 2-month in vivo follow-up. The two in vivo criteria were compared in 88 primary molars of 58 children aged 9-12 years. A subsample (n=10) was re-examined after 2 months. After exfoliation or extraction, the teeth were evaluated by a novel luminescence assay (Carivis, LUX DS, United Kingdom). In conclusion, the clinical criteria exhibited a high correlation when applied in vivo. It could be suggested that the luminescence assay presents ability to assess caries activity status in vitro. (4) This in vitro study evaluated the performance of the ICDAS visual criteria and new technologies for detecting natural caries around amalgam and composite resin restorations in permanent teeth, and the relationship between the presence of caries around restorations and the presence/absence of different gap sizes. One hundred and eighty teeth with amalgam (n=90) and composite resin (n=90) restorations were selected. Two examiners analyzed the teeth using the ICDAS visual criterion, laser fluorescence (LF), LED device (MID) (Midwest Caries I.D., DENTSPLY Professional, USA), quantitative lightinduced fluore scence system (QLF) (QLF-clin, Inspektor Research Systems BV, The Netherlands) and a prototype system based on the Fluorescence Enamel Imaging (PCDS) (Professional Caries Detection System, Therametrics Technologies, USA). Additionally, gap size was evaluated using an explorer probe. The gold-standard was determined by means of confocal laser scanning microscopy (CLSM). In conclusion, ICDAS and LF presented good ability to detect caries around composite resin restorations, and QLF and PCDS to detect caries around amalgam and composite resin restorations. Gap size was found to be irrelevant to determine the presence of caries around restorations. From this study, it could be observed that the methods described above for detection and activity assessment appear to contribute positively in the diagnosis process. However, they should be considered as adjuncts to conventional methods in this process

Relación entre el grado de infección por Streptococcus mutans y la posterior actividad cariogénica

Se valoró la correspondencia entre el grado de infección por Streptococcus mutans y la actividad cariogénica, para lo cual se estudiaron 355 niños entre 7 y 14 años seleccionados por muestreo estratificado de conglomerados. Se les determinó el grado de infección en saliva en técnica basada en la adherencia de este microorganismo, a la vez que se estableció la prevalencia y la incidencia de caries al año y a los 2 años. Los resultados demostraron que los niños con alto grado de infección tuvieron al año el 60 % de afectación por caries y una incidencia de 1,3. Se evidenció una diferencia significativa en relación con los de bajo grado de infección (X2 = p <0,001 y r = 0,11). A los 2 años los niños de alto grado de infección desarrollaron el 83,5 % de afectación y una incidencia de 2,9, diferencia significativa con respecto a los niños de baja infección (X2 ´= p <0,05 y r = 0,16). Existe correspondencia entre el grado de infección y la actividad de caries, por lo que un estudio de este tipo se considera de estimable valor en el pronóstico de riesgo a caries.

The relationship between the degree of infection caused by Streptococcus mutans and the cariogenic activity was evaluated by studying 355 children aged 7-14 selected by stratified cluster sampling. The infection degree in saliva was determined by using a technique based on the adherence of this microorganism. The prevalence and incidence of caries was established at one year and at two years. The results showed that children with a high infection degree had at one year 60 % of affectation by caries and an incidence of 1.3. A significant difference was observed in relation to those with low infection degree (X2 = p <0.001 and r = 0.11). Two years later, children with a high infection degree developed 83.5 % of affectation and an incidence of 2.9, which represented a marked difference in comparison with the children with low infection and caries activity. This study may be of considerable value in the prognosis of risk for caries.

Relación de la experiencia anterior de caries con la posterior actividad cariogénica en escolares de 7 a 14 años

Se examinó un grupo de 378 niños con edades comprendidas entre 7 y 14 años, a los cuales se les confeccionó un dentigrama con el objetivo de recoger la experiencia anterior de caries. Se utilizó una clasificación de 0-1 y 2. Se empleó el mismo dentigrama en un examen clínico realizado al año y a los 2 años. Los resultados obtenidos muestran que los niños clasificados inicialmente en el grupo 0-1, presentaron menor actividad cariogénica al año (25,1 %), con una incidencia de 0,4, y a los 2 años (50 %), con una incidencia de 1,1. Los niños que presentaron al inicio del estudio una incidencia de caries ³ 2, fueron los más afectados al año (92,1 %), con un índice de 1,9, y a los 2 años (79,2 %), con un índice de 2,8. La diferencia entre los grupos fue significativa (p £ 0,001). La certeza fue de 84,6 % al año y de 69,3 % a los 2 años, por lo que sugerimos la clasificación propuesta para el examen clínico, como método predictivo de caries.

A group of 378 children aged 7-14 was examined and a dental chart was made in order to know the previous caries experience. A classification of 0 - l and 2 was used. The same dental chart was used in a clinical examination made at one year and at two years. The results obtained showed that the children initially classified in the group 0 - 1 had a lower cariogenic activity at one year (25.1 %) with an incidence of 0.4. This activity was higher at 2 years (50 %) with an incidence of 1.1. Those children who had an incidence of caries IV 2 at the beginning of the study were the most affected at one year (92.l %) with an incidence of 1.9. The affection index was 79.2 % with an incidence of 2.8 at two years. The difference between the groups was significant (p £ 0.001). Certainty was 84.6 % at one year and 69.3 % at two years, so we suggest the classification proposed for the clinical examination as a predictive method of caries.