This study was undertaken to appraise the predictive validity of the Visible Occlusal Plaque Index (VOPI) in assessing occlusal caries lesion activity in adolescents. A total of 618 adolescents aged 10 to 15 y were examined at the beginning of the trial and 511 (82.7%) at the 2-y follow-up. Adolescents and parents answered questionnaires about demographics, oral health behavior, and family sociodemographic variables. The VOPI has a 4-point ordinal scale ranging from no plaque to heavy plaque. Molar teeth were assigned to group VOPI 0–1 (no/thin plaque; n = 2,539) and group VOPI 2–3 (thick/heavy plaque; n = 843). At baseline examination, occlusal surfaces at risk of transition (n = 3,382) were either sound (55%), inactive noncavitated lesions (21%), inactive cavitated lesions (1%), active noncavitated lesions (15%), or active cavitated lesions (7%). The relative risk (RR) for caries lesion transition was estimated. Sound occlusal surfaces with no or thin plaque were significantly more likely to remain sound (RR = 1.3; 95% confidence interval [CI]: 1.1–1.4) than those harboring thick or heavy plaque. Inactive noncavitated occlusal lesions presenting no or thin plaque were significantly less likely to progress to active noncavitated lesions (RR = 0.1; CI: 0.0–0.8) than their counterparts with thick or heavy plaque. Active noncavitated lesions harboring thick and heavy plaque had a significantly lowest chance of becoming sound (RR = 0.7; CI: 0.5–0.9) and a highest risk of remaining active (RR = 1.5; CI: 1.1–1.9). Stepwise logistic regression analyses were run according to surface status at baseline and showed that none of the nonclinical predictors were significant for the outcome. The presence of thick and heavy plaque on occlusal surfaces was a predictor for caries lesion development, progression and activity (P < 0.0001). In conclusion, besides being an additional clinical tool for oral hygiene assessment, the VOPI is a predictor for development, progression, and activity of occlusal caries lesion. This is of particular interest for assessment of occlusal lesions undergoing health-promoting transitions.

本研究旨在评估可见牙合斑指数 (VOPI) 在评估青少年牙合龋活动中的预测有效性。在试验开始时对 618 名 10 至 15 岁的青少年进行了检查，在 2 年的随访中检查了 511 名（82.7%）。青少年和父母回答了有关人口统计、口腔健康行为和家庭社会人口变量的问卷。VOPI 有一个从无斑块到重斑块的 4 点顺序量表。臼齿被分配到 VOPI 0-1 组（无/薄斑块；n  = 2,539）和 VOPI 2-3 组（厚/重斑块；n  = 843）。在基线检查中，有过渡风险的咬合面（n = 3,382) 是健全 (55%)、非活动性非空洞性病变 (21%)、非活动性空洞性病变 (1%)、活动性非空洞性病变 (15%) 或活动性空洞性病变 (7%)。估计了龋病转变的相对风险（RR）。没有斑块或斑块较薄的良好咬合面明显更可能保持良好（RR = 1.3；95% 置信区间 [CI]：1.1-1.4），而不是那些含有厚或重斑块的表面。与具有厚斑块或重斑块的对应物相比，没有斑块或斑块较薄的非活动性非空洞咬合病变进展为活动性非空洞病变的可能性显着降低（RR = 0.1；CI：0.0-0.8）。含有厚而重的斑块的活动性非空洞病变变得健全的机会显着最低（RR = 0.7；CI：0.5-0.9），保持活动的风险最高（RR = 1.5；CI：1.1-1.9）。根据基线时的表面状态进行逐步逻辑回归分析，结果表明没有一个非临床预测因子对结果有显着意义。咬合面上厚而重的斑块的存在是龋损发展、进展和活动的预测因子。P  < 0.0001)。总之，除了作为口腔卫生评估的额外临床工具外，VOPI 还是咬合龋病发展、进展和活动的预测指标。这对于评估正在发生健康促进转变的咬合病变特别有意义。