Abstract：
BACKGROUND: This consensus paper provides recommendations for oral health professionals on why and how to assess caries activity and progression with special respect to the site of a lesion.
METHODS: An expert panel was nominated by the executive councils of the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD). The steering committee built three working groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity and progression assessment, and (3) obtain individualized caries diagnoses. The experts of work group 2 phrased and agreed on provisional general and specific recommendations on caries lesion activity and progression, based on a review of the current literature. These recommendations were then discussed and refined in a consensus workshop followed by an anonymous Delphi survey to determine the agreement on each recommendation.
RESULTS: The expert panel agreed on general (n = 7) and specific recommendations (n = 6). The specific recommendations cover coronal caries on pits and fissures, smooth surfaces, proximal surfaces, as well as root caries and secondary caries/caries adjacent to restorations and sealants. 3/13 recommendations yielded perfect agreement.
CONCLUSIONS: The most suitable method for lesion activity assessment is the visual-tactile method. No single clinical characteristic is indicative of lesion activity; instead, lesion activity assessment is based on assessing and weighing several clinical signs. The recall intervals for visual and radiographic examination need to be adjusted to the presence of active caries lesions and recent caries progression rates. Modifications should be based on individual patient characteristics.
METHODS: An expert panel was nominated by the executive councils of the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD). The steering committee built three working groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity and progression assessment, and (3) obtain individualized caries diagnoses. The experts of work group 2 phrased and agreed on provisional general and specific recommendations on caries lesion activity and progression, based on a review of the current literature. These recommendations were then discussed and refined in a consensus workshop followed by an anonymous Delphi survey to determine the agreement on each recommendation.
RESULTS: The expert panel agreed on general (n = 7) and specific recommendations (n = 6). The specific recommendations cover coronal caries on pits and fissures, smooth surfaces, proximal surfaces, as well as root caries and secondary caries/caries adjacent to restorations and sealants. 3/13 recommendations yielded perfect agreement.
CONCLUSIONS: The most suitable method for lesion activity assessment is the visual-tactile method. No single clinical characteristic is indicative of lesion activity; instead, lesion activity assessment is based on assessing and weighing several clinical signs. The recall intervals for visual and radiographic examination need to be adjusted to the presence of active caries lesions and recent caries progression rates. Modifications should be based on individual patient characteristics.
摘要：
背景：这份共识文件为口腔卫生专业人员提供了有关为什么以及如何评估龋齿活动和进展的建议，特别是病变部位。
方法：由欧洲龋齿研究组织（ORCA）和欧洲保守牙科联合会（EFCD）的执行委员会提名了一个专家小组。指导委员会成立了三个工作组，要求他们就1）龋齿检测和诊断方法提供建议，2）龋齿活动和进展评估，3）获得个性化的龋齿诊断。工作组2的专家对龋齿病变活动和进展的临时一般和具体建议进行了措辞和商定，基于对当前文献的回顾。然后在共识研讨会上对这些建议进行了讨论和完善，然后进行了匿名的Delphi调查，以确定对每个建议的共识。
结果：专家小组就一般建议（n=7）和具体建议（n=6）达成一致。具体建议涵盖凹坑和裂缝上的冠状龋齿，光滑表面,近端表面,以及与修复体和密封剂（CARS）相邻的根部龋齿和继发性龋齿/龋齿。3/13建议产生了完美的协议。
结论：最适合评估病变活动的方法是视觉触觉方法。没有单一的临床特征表明病变活动；相反，病变活动性评估基于评估和权衡几种临床体征。视觉和影像学检查的召回间隔需要根据活动性龋齿病变的存在和近期龋齿进展率进行调整。修改应基于个体患者特征。
方法：由欧洲龋齿研究组织（ORCA）和欧洲保守牙科联合会（EFCD）的执行委员会提名了一个专家小组。指导委员会成立了三个工作组，要求他们就1）龋齿检测和诊断方法提供建议，2）龋齿活动和进展评估，3）获得个性化的龋齿诊断。工作组2的专家对龋齿病变活动和进展的临时一般和具体建议进行了措辞和商定，基于对当前文献的回顾。然后在共识研讨会上对这些建议进行了讨论和完善，然后进行了匿名的Delphi调查，以确定对每个建议的共识。
结果：专家小组就一般建议（n=7）和具体建议（n=6）达成一致。具体建议涵盖凹坑和裂缝上的冠状龋齿，光滑表面,近端表面,以及与修复体和密封剂（CARS）相邻的根部龋齿和继发性龋齿/龋齿。3/13建议产生了完美的协议。
结论：最适合评估病变活动的方法是视觉触觉方法。没有单一的临床特征表明病变活动；相反，病变活动性评估基于评估和权衡几种临床体征。视觉和影像学检查的召回间隔需要根据活动性龋齿病变的存在和近期龋齿进展率进行调整。修改应基于个体患者特征。
