異なる頻度の予防的維持治療がう蝕に及ぼす影響：一般歯科患者における5年間の観察結果

Effect of different frequencies of preventive maintenance treatment on dental caries: five-year observations in general dentistry patients.

• Birgitta Rosén
• Göran Olavi
• Dowen Birkhed
• Stig Edvardsson
• Jan Egelberg

抄録

う蝕と歯周病の進行に対する予防的治療の相対的な効果を評価するために，スウェーデンの公立歯科医院で成人を対象とした長期研究が開始された．本研究では，3ヵ月，6ヵ月，12ヵ月，18ヵ月ごとに治療を行い，3ヵ月群，6ヵ月群，18ヵ月群のう蝕の結果を示すとともに，さまざまなう蝕関連の危険因子の影響を評価した．約5年間のう蝕の増加は、研究期間中に顕在化した一次および二次う蝕の臨床およびX線写真の所見を加えて決定した。105名の参加者全員の全体的なう蝕活動は、低～中程度であった。3つのグループの間で、様々な歯の表面上のう蝕や全体のう蝕に有意な差は認められなかった。5年間のう蝕の増加を従属変数とした重回帰分析の結果，次の因子がう蝕の増加と統計的に有意な関連を示した：ベースライン検査時の充填面の割合，食生活のスコア，プラークスコア，唾液中のミュータンス連鎖球菌と乳酸菌の数。また、5年間の予防処置の回数は有意ではなかった。この長期試験の結果から、う蝕活動が低～中程度の患者の場合、3～6ヵ月ごとの予防処置の頻度は正当化されないことが示唆された。

A long-term study in adults at a public dental clinic in Sweden was initiated to evaluate the relative effectiveness of prophylactic treatments on the progression of dental caries and periodontal discase. With treatments scheduled every 3rd, 6th, 12th or 18th month, this report presents results on caries for the 3-month, 6-month and 18-month groups, and evaluates the impact of various caries-related risk factors. Caries increment over approximately 5 years was determined by adding clinical and radiographic findings of manifest primary and secondary caries during the study. Overall caries activity among all 105 participating individuals was low to moderate. No significant differences for caries on any of the various tooth surfaces or for total caries were observed among the three groups. Multiple regression analysis with 5-year caries increment as dependent variable showed that the following factors had a statistically significant association with caries increment: percentage filled surfaces at baseline examination, dietary score, plaque score, and number of mutans streptococci and lactobacilli in saliva. Non-significant factors included number of preventive treatments provided during the 5-year interval. The results of this long-term trial suggest that preventive treatments as often as every 3 6 months may not be justified in the case of patients with low to moderate caries activity.