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Introdução: Embora existam índices para cálculo do risco de cárie, como o CAMBRA, estes não são usados rotineiramente pelos dentistas. Estes índices, ao permitir determinar o risco de cárie, possibilitam a personalização do plano de tratamento do paciente e das medidas preventivas a aplicar. Objetivos: Este estudo visa desenvolver e validar um índice de cálculo do risco de cárie em adultos baseado no CAMBRA, mas com quantificação de bactérias cariogénicas e carioprotetoras. Adicionalmente, procura avaliar se os indicadores microbiológicos, por si só, são suficientes para prever o risco de cárie. Materiais e métodos: Este é um estudo observacional transversal que contou com o exame de 99 pacientes que frequentaram a Clínica Dentária Universitária da Universidade Católica Portuguesa. Todos os pacientes responderam a um questionário, foram submetidos a uma avaliação intraoral e forneceram uma amostra de saliva. Dezassete pacientes foram reavaliados 6-8 meses depois da primeira observação. Resultados: A inclusão de parâmetros microbiológicos no índice de risco CAMBRA e a comparação do risco com e sem indicadores microbianos revelou que não há alteração do risco de cárie na maioria dos pacientes. No entanto, ao usar um índice apenas com a quantificação microbiana, os níveis de risco para os mesmos pacientes aumentaram significativamente. Verificou-se ainda que, embora exista uma associação entre as bactérias cariogénicas e o risco de cárie, não foi possível verificar qualquer associação entre as bactérias carioprotetoras analisadas e o risco de cárie. Conclusão: A inclusão de parâmetros microbiológicos no cálculo de risco usando o CAMBRA não parece acrescentar muito ao cálculo de risco apenas com o CAMBRA. As bactérias cariogénicas quantificadas parecem ser bons indicadores do risco de cárie, mas as bactérias carioprotetoras usadas como indicadores deverão ser reavaliadas em trabalhos futuros.
Introduction: While there are caries risk indices like CAMBRA, they are not routinely used by dentists. These indices, by determining caries risk, allow for the personalization of patient treatment plans and the application of preventive measures. Objectives: This study aims to develop and validate a caries risk assessment index for adults based on CAMBRA, incorporating the quantification of cariogenic and carioprotective bacteria. Additionally, it seeks to evaluate whether microbiological indicators alone can sufficiently predict caries risk. Materials and Methods: This cross-sectional observational study involved the examination of 99 patients attending the Dental Clinic of the Universidade Católica Portuguesa. All participants completed a questionnaire, underwent an intraoral examination, and provided a saliva sample. Seventeen patients were re-evaluated 6-8 months after the initial observation. Results: Incorporating microbiological parameters into the CAMBRA risk index and comparing risk levels with and without microbial indicators revealed that there was no change in caries risk for most patients. However, using an index based solely on microbial quantification significantly increased the risk levels for the same patients. It was also found that while there is an association between cariogenic bacteria and caries risk, no association could be established between the analyzed carioprotective bacteria and caries risk. Conclusion: The inclusion of microbiological parameters in the CAMBRA risk calculation does not significantly enhance the risk assessment compared to using CAMBRA alone. Cariogenic bacteria appear to be good indicators of caries risk, but the use of carioprotective bacteria as indicators should be re-evaluated in future studies.
Introduction: While there are caries risk indices like CAMBRA, they are not routinely used by dentists. These indices, by determining caries risk, allow for the personalization of patient treatment plans and the application of preventive measures. Objectives: This study aims to develop and validate a caries risk assessment index for adults based on CAMBRA, incorporating the quantification of cariogenic and carioprotective bacteria. Additionally, it seeks to evaluate whether microbiological indicators alone can sufficiently predict caries risk. Materials and Methods: This cross-sectional observational study involved the examination of 99 patients attending the Dental Clinic of the Universidade Católica Portuguesa. All participants completed a questionnaire, underwent an intraoral examination, and provided a saliva sample. Seventeen patients were re-evaluated 6-8 months after the initial observation. Results: Incorporating microbiological parameters into the CAMBRA risk index and comparing risk levels with and without microbial indicators revealed that there was no change in caries risk for most patients. However, using an index based solely on microbial quantification significantly increased the risk levels for the same patients. It was also found that while there is an association between cariogenic bacteria and caries risk, no association could be established between the analyzed carioprotective bacteria and caries risk. Conclusion: The inclusion of microbiological parameters in the CAMBRA risk calculation does not significantly enhance the risk assessment compared to using CAMBRA alone. Cariogenic bacteria appear to be good indicators of caries risk, but the use of carioprotective bacteria as indicators should be re-evaluated in future studies.
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Cárie dentária Bactérias cariogénicas Bactérias carioprotetoras Cálculo de risco Dental caries Cariogenic bacteria Cario-protective bacteria Risk calculation