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Table 5.3 continued Author Year, reference Country Sample, n Age (yrs) at start Teeth tested, caries prevalence at start, caries increment/ incidence during study period Obs time (yrs) Dropout (%) Explained Diagnostic criteria Examiner (n) Reliability Burt et al 1994 [40] USA All children in Coldwater, Michigan Low caries prevalence population n: 499 Age: 10–15 Permanent All surfaces, proximal and pit & fissures separately Mean DMFS: boys (girls) Age 10: 0.4 (2.4) Age 13: 4.1 (5.5) Age 15: 4.9 (6.0) 3 33 Explained, analysed NIDR 1989 No BW 2 experienced examiners Yes Increment Mean new DMFS=2.7 (boys) 3.1 (girls), NS 30% had 0 new DMFS, 28% had 1–2 new DMFS, 20% had ≥1 new approximal DMFS 248 Karies – diagnostik, riskbedömning och icke-invasiv behandling
Predictor variables Validating criteria Statistical methods Results Sensitivity and specificity Study quality and relevance Comments Total sugar intake, % sugar of total energy intake, between meal sugar consumption (% of total energy intake) age, gender ≥1 new DMFS all surfaces, proximal and pit & fissures separately Proportion high risk: 25% RR for highest versus lowest quartile of sugar consumption Caries incidence poorly related to sugar intake, whether measured as total daily amount, between meal intake or frequency of consumption Consumption of sugar as % of total energy: No difference between age and gender Average total sugar intake related to caries increment: no pattern Medium Important predictors not included. Only RR reported Highest quartile Total sugar (≥30% of total energy/day) RR Any DMFS: 1.2 Any DMFS appr : 1.8 Any DMFS occl : 1.2 (NS) Between meal sugar (as % of total energy/day) RR Any DMFS: 1.2 (NS) Any DMFS appr: 1.7 Any DMFS occl : 1.1 (NS) The table continues on the next page KAPITEL 5 • Riskbedömning 249
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Karies - diagnostik, riskbedömning
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Karies - diagnostik, riskbedömning
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Primärt urval av studier 63 Bedöm
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Resultat 176 FOTI 176 DiFOTI 176 DI
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Metodik 356 Litteratursökning 356
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SBU:s sammanfattning och slutsatser
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Bakgrund Karies är en kronisk sjuk
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Gradering av slutsatsernas evidenss
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Visuell-taktil diagnostik Studier s
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Hur kan kariesskador predikteras me
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Barn (1-3 år) som borstar tändern
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Kostnadseffektivitet för diagnosti
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undersöks. Frekvensen röntgenunde
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sönderfall av tanden, då patiente
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av tandhälsan och har inga symtom.
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ning. Riskbedömning görs rutinmä
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Betydelsen av effektiv tidig behand
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Validitet och reliabilitet Validite
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negativa prediktionsvärdet (NPV) b
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ytterligare i Faktaruta 1.6. Exempe
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Samhällsnivå Sociodemografi och v
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Faktaruta 1.1 Olika aspekter på va
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Faktaruta 1.3 Fyrfältstabell med k
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Faktaruta 1.4 Diagram som illustrer
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Faktaruta 1.6 Beräkning av likelih
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Faktaruta 1.7 Nomogram som visar hu
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Referenser 1. Fiske J, Davis DM, Fr
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2. Metodik för sökning och utvär
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Primärt urval av studier För att
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laget för slutsatserna. En metod s
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• Förklarat/analyserat bortfall
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Otillräckligt vetenskapligt underl
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3. Praxisundersökning avseende bit
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svenska och norska tonåringar unde
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Totalt antal undersökta Stockholm
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Østfold Totalt antal undersökta %
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4. Diagnostik 4.1 Visuell-taktil di
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Bakgrund Den primära metoden för
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undersökare och bedömdes ha ett m
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diagnostik av emaljkaries på tuggy
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Aktiv (pågående) och inaktiv (kro
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Tabell 4.1.1 Inklusionskriterier f
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Dropout/ missing data Method or tec
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Table 4.1.7 continued Author, year,
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Referenser 1. Rocha RO, Ardenghi TM
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tion compared with conventional rad
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63. Banerjee A, Watson TF, Kidd EA.
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93. Rosén B, Birkhed D, Nilsson K,
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4.2 Röntgendiagnostik Slutsatser G
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antingen med kabel eller via trådl
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Risker med röntgenstrålning Rönt
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När observatörerna skulle bestäm
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Faktaruta 4.2.2 Nomogrammet som byg
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Metodik för litteraturgenomgång E
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procent och specificiteten mellan 9
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0,1 99 0,2 LR+ LR- 0,5 Visuell insp
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Intern och extern validitet Diagnos
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Kommentarer Vilka tänder eller tan
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för att en tvådimensionell bild a
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Method Number of teeth and surfaces
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52 molars and 11 premolars with occ
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Method Comparison method Outcome me
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Referenser 1. Akdeniz BG, Grondahl
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33. Espelid I, Tveit AB. A comparis
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66. Caliskan Yanikoglu F, Östurk F
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in proximal surfaces versus direct
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131. Wenzel A, Hintze H. The choice
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4.3 Tilläggsmetoder för kariesdia
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kariesskada [81,82]. En diagnostisk
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(a) (b) (c) (d) (e) Figur 4.3.1 Eff
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scerar starkt, medan demineralisera
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förhållandet var tvärtom för pr
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Tabell 4.3.1 Inklusionskriterier f
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Dropout/ missing data Comparison me
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Number of individuals Number of tee
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Number of individuals Number of tee
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Referenser 1. Grossman ES, Cleaton-
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30. Hall AF, DeSchepper E, Ando M,
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of occlusal caries in children. Car
Page 195: 4.4. Etiska aspekter Som det framg
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Page 216 and 217: Faktaruta 5.1 Inklusionskriterier f
Page 218 and 219: Table 5.1 Caries prediction in pre-
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Page 228 and 229: Table 5.2 Caries prediction in pre-
Page 236 and 237: Table 5.3 Caries prediction in scho
Page 250 and 251: Table 5.4 Caries prediction in scho
Page 268 and 269: Table 5.5 Caries prediction in adul
Page 274 and 275: Table 5.6 Caries prediction in adul
Page 290 and 291: Table 5.7 Tillförlitligheten hos t
Page 292 and 293: Table 5.8 Post-eruptive age as risk
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Table 5.9 Post-eruptive age as risk
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Table 5.9 continued Author Year, re
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Table 5.10 Excluded studies. Author
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Table 5.10 continued Author, year,
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19. Karjalainen S, Söderling E, Se
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social factors and diseases. Int De
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isk assessment program in an elderl
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121. Demers M, Brodeur JM, Simard P
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study. Community Dent Oral Epidemio
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private practice. Community Dent Or
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221. Schröder U, Granath L. Dietar
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groups. Oral Surg Oral Med Oral Pat
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287. Ravald N, Birkhed D, Hamp SE.
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En nyss frambruten tand är mer mot
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Övriga produkter Ozon De syraprodu
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En studie, som undersökte effekten
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för få för slutsatser om effekti
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Table 6.2 Treatment of early corona
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Table 6.3 Treatment of early corona
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Table 6.4 Treatment of early root s
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Table 6.5 Excluded studies. Author,
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Referenser 1. Abernathy JR, Graves
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composite resin restorations. Acta
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7. Ekonomiska aspekter Slutsatser A
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Kostnaden för visuell-taktil under
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Faktaruta 7.1 Hur beräknas kostnad
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7.1 7.1 1 800 Kronor Kronor 1 600 1
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8. Tänkbara praxisförändringar T
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Referenser 1. Ekstrand K. Faglig vi
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DFS DFT dft DiFOTI Dikotomisering D
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Likelihood-kvot Lingual Makroskopis
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Rotcement Sensitivitet Specificitet
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Svante Twetman Professor, odontolog
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Bilaga 1. Sökstrategier Kapitel 4.
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Kapitel 5 fortsättning NOT Cariost
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Bilaga 2. Granskningsmallar Diagnos
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Studier om riskbedömning Första f
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Studier om behandling av tidiga kar
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Bilaga 3. Sensitivitet, specificite
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9 8 8,0 8,0 LR+ emalj LR- emalj LR
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Sensitivitet och specificitet 2,0 1
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200 Procent 180 160 140 120 100 80
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180 160 140 120 100 80 60 40 20 0 8
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15. Lussi A. Comparison of differen
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49. Kordic A, Lussi A, Luder HU. Pe
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Ont i ryggen, ont i nacken (2000),
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Rapporter på engelska Obstructive
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