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Cagetti MG, Bontà G, Lara JS, Campus G. Caries risk assessment using different Cariogram models. A comparative study about concordance in different populations—Adults and children. PLoS One 2022; 17:e0264945. [PMID: 35749436 PMCID: PMC9231745 DOI: 10.1371/journal.pone.0264945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 02/20/2022] [Indexed: 11/18/2022] Open
Abstract
This methodological survey aimed to verify whether there is concordance among several Cariogram different risk models at different thresholds, comparing both children and adult populations and how each risk/protective factor weight on the overall caries risk profile. Three groups’ data (two in children and one in adults) were obtained from previous studies, while a fourth, in young adults, was ad hoc enrolled. Different caries risk levels were assessed: a) three risk categories with two different thresholds as: “low risk” = 61–100% or 81–100% chance to avoid caries, “moderate risk” = 41–60% or 21–80% and “high risk” = 0–40% or 0–20%, named model 1 and 2; b) four risk categories with two different thresholds as: “low risk” = 61–100% or 76–100%, “moderate/low risk” = 41–60% or 51–75%; “moderate/high risk” = 21–40% or 26–50% and “high risk” = 0–20% or 0–25%, model 3 and 4; c) five risk categories as: “very low risk” = 81–100%; “low risk” = 61–80% “moderate risk” = 41–60%; “high risk” = 21–40% and “very high risk” = 0–20%, model 5. Concordance of the different Cariogram risk categories among the four groups was calculated using Cohen’s kappa. The weight of the association between all Cariogram models toward the Cariogram risk variables was evaluated by ordinal logistic regression models. Considering Cariogram model 1 and 2, Cohen’s Kappa values ranged from 0.40 (SE = 0.07) for the young adult group to 0.71 (SE = 0.05) for the adult one. Cohen’s Kappa values ranged from 0.14 (SE = 0.03 p<0.01) for the adult group to 0.62 (SE = 0.02) for the two groups of children in models 3 and 4. Statistically significant associations were found for all Cariogram risk variables excepting Fluoride program in models 4 and 5 and the overall risk on children’s samples. Caries experience showed a quite variable weight in the different models in both adult groups. In the regression analyses, adult groups’ convergence was not always achievable since variations in associations between caries risk and different risk variables were narrower compared to other samples. Significant differences in caries risk stratification using different thresholds stands out from data analysis; consequently, risk assessments need to be carefully considered due to the risk of misleadingly choosing preventive and research actions.
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Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giuliana Bontà
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Juan Sebastian Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, United States of America
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
- Department of Pediatric, Preventive Dentistry and Orthodontics, School of Dentistry, Sechenov University, Moscow, Russia
- * E-mail:
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Poorni S, Nivedhitha MS, Srinivasan M, Balasubramaniam A. Effect of Probiotic Streptococcus salivarius K12 and M18 Lozenges on the Cariogram Parameters of Patients With High Caries Risk: A Randomised Control Trial. Cureus 2022; 14:e23282. [PMID: 35449617 PMCID: PMC9012604 DOI: 10.7759/cureus.23282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: To evaluate the effect of Probiotic Streptococcus Salivarius K12 and M18 Lozenges on the Cariogram (Cariogram Mobile application Version 1.3 developed by Wong Jung Ming, Faculty of Dentistry, National University of Singapore) parameters of patients with high caries risk. Materials and Methods: Fourty-two subjects were randomly allocated to Group 1 and 2 who received BLIS K12TM and BLIS M18TM probiotics (Blis Probiotics, Dunedin, New Zealand) respectively along with oral hygiene instructions and Group 3 (control) received only oral hygiene instructions with 1:1:1 allocation ratio. Subjects were instructed to follow the instructions and use the probiotics for a period of three months. Their caries risk was assessed using Cariogram software at baseline and 30 days after the use of probiotics. Change in the chance to avoid new cavities was recorded and statistically analysed using appropriate statistical tests. Results: About 38 subjects completed the trial with a drop-out count of eight. Multiple imputations were carried out for the missing data using an expectation-maximization algorithm. The mean percentage of actual chance to avoid new cavities was found to be 47.14 ± 6.837; 41.36 ± 16.04 and 32.50 ± 14.54 among the subjects in Group 1, Group 2, and Group 3 respectively. The mean percentage difference between the three groups was found to be statistically significant (p-value = 0.047). Dunn’s pair-wise comparison showed a significant mean percentage difference between Group 1 (BLIS K12) and Group 3 (control) (p=0.020). Conclusion: It can be concluded that the use of BLIS K12TM and BLIS M18TM probiotics for three months resulted in a considerable decrease in the caries risk. Further long-term clinical trials are needed to evaluate the difference in caries risk following the use of BLIS K12TMand BLIS M18TM among different age and risk groups.
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Trottini M, Campus G, Corridore D, Cocco F, Cagetti MG, Vigo MI, Polimeni A, Bossù M. Assessing the Predictive Performance of Probabilistic Caries Risk Assessment Models: The Importance of Calibration. Caries Res 2020; 54:258-265. [PMID: 32516777 DOI: 10.1159/000507276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 03/10/2020] [Indexed: 11/19/2022] Open
Abstract
Probabilistic caries risk assessment models (P-CRA), such as the Cariogram, are promising tools to planning treatments in order to control and prevent caries. The usefulness of these models for informing patients and medical decision-making depends on 2 properties known as discrimination and calibration. Current common assessment of P-CRA models, however, ignores calibration, and this can be misleading. The aim of this paper was to provide tools for a proper assessment of calibration of the P-CRA models and improve calibration when lacking. A combination of standard calibration tools (calibration plot, calibration in-the-large, and calibration slope) and 3 novel measures of calibration (the Calibration Index and 2 related metrics, E50 and E90) are proposed to evaluate if a P-CRA model is well calibrated. Moreover, an approach was proposed and validated using data from a previous follow-up study performed on children evaluated by means of a reduced Cariogram model; Platt scaling and isotonic regression were applied showing a lack of calibration. The use of the Cariogram overestimates the actual risk of new caries for forecast probabilities <0.5 and underestimates the risk for forecast probabilities >0.6. Both Platt scaling and isotonic regression were able to significantly improve the calibration of the reduced Cariogram model, preserving its discrimination properties. The average specificity and sensitivity for both Platt scaling and isotonic regression using the cut-off point p= 0.5 were >83 and their sum well exceeded 160. The benefits of the proposed calibration methods are promising, but further research in this field is required.
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Affiliation(s)
- Mario Trottini
- Department of Mathematics, University of Alicante, Alicante, Spain
| | - Guglielmo Campus
- Clinic for Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland, .,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy,
| | - Denise Corridore
- Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Fabio Cocco
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Science, University of Milan, Milan, Italy
| | - M Isabel Vigo
- Department of Applied Mathematics, University of Alicante, Alicante, Spain
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Maurizio Bossù
- Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
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Dolic O, Obradovic M, Kojic Z, Trtic N, Sukara S, Knezevic N, Veselinovic V. Validation of Cariogram in Caries Prediction in Women and Their Children 4 Years After Pregnancy - Longitudinal Study. Risk Manag Healthc Policy 2020; 13:549-557. [PMID: 32607023 PMCID: PMC7295109 DOI: 10.2147/rmhp.s243907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cariogram®, an algorithm-based software model, for predicting caries risk has been used to assess the caries risk profile of many different groups. The aims of the study were to evaluate Cariogram caries risk assessment during pregnancy with DMFT/dmft incidence in mothers and their children 4 years after pregnancy and to check if there is an association between children's caries risk profiles using Cariogram and caries risk profiles (by Cariogram) of their mothers during pregnancy. METHODS The study population consisted of 96 pregnant women (average age 27.4±7.2 years at baseline) who completed clinical baseline examination and salivary tests. The follow-up study was initiated 4 years later and the 80 pairs of mother and children (from that pregnancy) were re-examined using the same procedure at baseline. An individual caries risk profile and DMFT/dmft incidence were made for each woman and child. The prediction of the Cariogram was compared to the actual dental experience in 4 years. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for two cut-offs were calculated to express the outcome. RESULTS The results showed a strong association between the risk categories of pregnant women and their offspring as well as between caries development in offspring and the Cariogram risk categories of pregnant women. Sensitivity and PPV for new DMFT (ΔDMFT>0) 4 years after for women were high (>80%) for those participants assessed with 0-60% "chance to avoid caries", as well as diagnostic accuracy (74.00%). High specificity (91.00%), very high PPV (95.00%) and clinically useful values according to Youden's index (0.53) were obtained for moderate-risk and two lowest-risk groups for dmft in children. CONCLUSION Cariogram was valid in the authors' sample only and highly predictive in caries risk assessment in investigated children based on caries risk assessment of their mothers in pregnancy.
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Affiliation(s)
- Olivera Dolic
- Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Marija Obradovic
- Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Zeljka Kojic
- Department of Periodontics and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Natasa Trtic
- Department of Periodontics and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Slava Sukara
- Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Natasa Knezevic
- Department of Endodontics and Restorative Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Valentina Veselinovic
- Department of Prosthodontics, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
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Cagetti MG, Bontà G, Cocco F, Lingstrom P, Strohmenger L, Campus G. Are standardized caries risk assessment models effective in assessing actual caries status and future caries increment? A systematic review. BMC Oral Health 2018; 18:123. [PMID: 30012136 PMCID: PMC6048716 DOI: 10.1186/s12903-018-0585-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Assessing caries risk is an essential element in the planning of preventive and therapeutic strategies. Different caries risk assessment (CRA) models have been proposed for the identification of individuals running a risk of future caries. This systematic review was designed to evaluate whether standardized caries risk assessment (CRA) models are able to evaluate the risk according to the actual caries status and/or the future caries increment. METHODS Randomized clinical trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, reporting caries risk assessment using standardized models (Cariogram, CAMBRA, PreViser, NUS-CRA and CAT) in patients of any age related to caries data recorded by DMFT/S or ICDAS indices, were included. PubMed, Scopus and Embase were searched from 2000 to 2016. A search string was developed. All the papers meeting the inclusion criteria were subjected to a quality assessment. RESULTS One thousand three-undred ninety-two papers were identified and 32 were included. In all but one, the Cariogram was used both as sole model or in conjunction with other models. All the papers on children (n = 16) and adults (n = 12) found a statistically significant association between the risk levels and the actual caries status and/or the future caries increment. Nineteen papers, all using the Cariogram except one, were classified as being of good quality. Three of four papers comprising children and adults found a positive association. For seven of the included papers, Cariogram sensibility and specificity were calculated; sensibility ranged from low (41.0) to fairly low (75.0), while specificity was higher, ranging from 65.8 to 88.0. Wide 95% confidence intervals for both parameters were found, indicating that the reliability of the model differed in different caries risk levels. CONCLUSIONS The scientific evidence relating to standardized CRA models is still limited; even if Cariogram was tested in children and adults in few studies of good quality, no sufficient evidence is available to affirm the method is effective in caries assessment and prediction. New options of diagnosis, prognosis and therapy are now available to dentists but the validity of standardized CRA models still remains limited.
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Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy. .,WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy.
| | - Giuliana Bontà
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy
| | - Fabio Cocco
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy.,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry University of Sassari, Viale San Pietro, 43, Sassari, Italy
| | - Peter Lingstrom
- Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 12 A-G, P.O. Box 450, 405 30, Gothenburg, Sweden
| | - Laura Strohmenger
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy.,WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy
| | - Guglielmo Campus
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Via Beldiletto 1, 20142, Milan, Italy.,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry University of Sassari, Viale San Pietro, 43, Sassari, Italy
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Di Pierro F, Zanvit A, Nobili P, Risso P, Fornaini C. Cariogram outcome after 90 days of oral treatment with Streptococcus salivarius M18 in children at high risk for dental caries: results of a randomized, controlled study. Clin Cosmet Investig Dent 2015; 7:107-13. [PMID: 26491371 PMCID: PMC4598214 DOI: 10.2147/ccide.s93066] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Dental caries is the most common chronic disease of childhood. Cariogram is a well-recognized algorithm-based software program based on different caries-related risk factors and intended to aid clinicians in performing more objective and consistent dental caries risk assessments. This type of approach precedes the diagnosis of caries and allows the dentist to identify at-risk patients and then take appropriate preventive measures before caries develop further. One of the etiological factors favoring the development of dental caries is the mutans streptococci. These acidogenic dental plaque inhabitants can be effectively antagonized by the activity of bacteriocins released by the probiotic Streptococcus salivarius M18 (salivarius M18). Moreover, salivarius M18 after colonizing the human oral mucosa produces the enzymes dextranase and urease that are able to counteract plaque formation and saliva acidity, respectively. Seventy-six subjects at high risk of dental caries were randomized and then either treated or not treated for 90 days with an oral formulation containing the oral probiotic salivarius M18 (Carioblis(®)). The results indicate that the use of salivarius M18 increases the chances of avoiding new dental caries development in children, and its application could be proposed as a new tool in the dentist's armory to be adopted in subjects considered at high risk on the basis of their Cariogram outcome.
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Affiliation(s)
| | | | | | - Paolo Risso
- Department of Health Science, University of Genoa, Genoa, Italy
| | - Carlo Fornaini
- Teleo Laboratory, Faculty of Dentistry, University of Nice, Nice, France
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Sundell AL, Ullbro C, Marcusson A, Twetman S. Comparing caries risk profiles between 5- and 10- year-old children with cleft lip and/or palate and non-cleft controls. BMC Oral Health 2015. [PMID: 26208495 PMCID: PMC4514989 DOI: 10.1186/s12903-015-0067-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model. METHODS The study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10 years). A questionnaire was used to collect data concerning the child's oral hygiene routines, dietary habits and fluoride exposure. Oral hygiene was assessed using Quigley-Hein plaque Index and the caries prevalence and frequency was scored according to the International Caries Detection and Assessment System. Whole saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rate. The risk factors and risk profiles were compared between the groups with aid of Cariogram and the estimated risk for future caries was categorized as "high" or "low". RESULTS Children with CL(P) (the entire study group) had significantly higher counts of salivary lactobacilli (p < 0.05) and displayed less good oral hygiene (p < 0.05). More 10-year-old children in the CL(P) group had low secretion rate but this difference was not significant. The average chance to avoid caries ranged from 59 to 67% but there were no significant differences between the groups. The odds of being categorized with high caries risk in the CL(P) group was significantly elevated (OR = 1.89; 95% CI = 1.25-2.86). In both groups, children in the high risk category had a higher caries experience than those with low risk. CONCLUSION Children with CL(P) displayed increased odds of being categorized at high caries risk with impaired oral hygiene and elevated salivary lactobacilli counts as most influential factors. The results suggest that a caries risk assessment model should be applied in the routine CL(P) care as a basis for the clinical decision-making and implementation of primary and secondary caries prevention.
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Affiliation(s)
- Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Box 1030, SE, 551 11, Jönköping, Sweden.
| | - Christer Ullbro
- Institute for Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Agneta Marcusson
- Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University Hospital, Linköping, Sweden.
| | - Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Doméjean S, Léger S, Rechmann P, White JM, Featherstone JD. How Do Dental Students Determine Patients’ Caries Risk Level Using the Caries Management By Risk Assessment (CAMBRA) System? J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.3.tb05882.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sophie Doméjean
- Department of Operative Dentistry and Endodontics; Faculté d’Odontologie; Clermont-Ferrand France
| | - Stéphanie Léger
- Department of Mathematics; Université Blaise Pascal; Clermont-Ferrand France
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - Joel M. White
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - John D.B. Featherstone
- Department of Preventive and Restorative Dental Sciences and Dean; School of Dentistry; University of California; San Francisco
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CABRAL RN, HILGERT LA, FABER J, LEAL SC. Caries risk assessment in schoolchildren--a form based on Cariogram software. J Appl Oral Sci 2014; 22:397-402. [PMID: 25466473 PMCID: PMC4245751 DOI: 10.1590/1678-775720130689] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/14/2014] [Accepted: 06/13/2014] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram software provides this analysis, and protocols simplifying the method were suggested. OBJECTIVES The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. MATERIAL AND METHODS 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. RESULTS Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. CONCLUSION The use of the form based on the Cariogram software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk.
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Affiliation(s)
- Renata Nunes CABRAL
- Postgraduate Program of Health Sciences, University of Brasília,
Brasília, DF, Brazil
| | | | - Jorge FABER
- Department of Dentistry, University of Brasília, Brasília, DF,
Brazil
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Mannaa A, Campus G, Carlén A, Lingström P. Caries-risk profile variations after short-term use of 5000 ppm fluoride toothpaste. Acta Odontol Scand 2014; 72:228-34. [PMID: 24175662 DOI: 10.3109/00016357.2013.822550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the caries risk following 6 weeks' use of 5000 ppm F toothpaste using 'Cariogram' software. MATERIALS AND METHODS A total of 34 participants, 17 mothers and their teenage children, were enrolled in a 6-week clinical trial in which they were given 5000 ppm F toothpaste. They were followed consecutively for 6 weeks with visits that were 2 weeks apart (four in total). A clinical examination was done at baseline and salivary chair-side tests to record the buffer capacity and mutans streptococci (MS) and lactobacilli (LB) counts were performed at each visit. Based on these data, seven caries-related variables were collected and inserted into the Cariogram software to calculate the actual chance of avoiding caries. RESULTS The use of 5000 ppm F toothpaste resulted in a statistically significant modification of the caries-risk profile, increasing the actual chance of avoiding caries in the future among the mothers and teenagers at each visit following baseline (p < 0.01). The changes essentially related to the salivary parameters (buffer capacity, MS and LB counts). A statistically significant linear trend was observed for MS counts (p < 0.01) and the number of subjects with a salivary concentration of MS < 10(3) increased at each visit. The same trend was also observed for LB and buffer capacity scores (p = 0.04 and p = 0.03, respectively). CONCLUSIONS The short-term use of 5000 ppm F toothpaste is able to reduce the caries risk, which can be clearly demonstrated using 'Cariogram' software.
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Affiliation(s)
- Alaa Mannaa
- Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
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11
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Aranibar Quiroz EM, Alstad T, Campus G, Birkhed D, Lingström P. Relationship between plaque pH and different caries-associated variables in a group of adolescents with varying caries prevalence. Caries Res 2014; 48:147-53. [PMID: 24401692 DOI: 10.1159/000355614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 09/10/2013] [Indexed: 11/19/2022] Open
Abstract
The pH response of the dental biofilm after a sugar challenge can be considered to mirror the acidogenic potential and thereby the caries risk of an individual. The aim of this cross-sectional study was to evaluate the relationship between plaque pH and different caries variables in adolescents with varying caries prevalence. One hundred individuals, aged 14-15 years, were examined regarding different caries-related variables: (i) caries score (DSm, DSi, DSm + i, DTm), (ii) salivary secretion rate and buffer capacity, (iii) oral microflora of plaque and saliva, (iv) plaque amount, (v) plaque pH and (vi) dietary intake, oral hygiene habits and fluoride use. Plaque pH was assessed using the microtouch method before and after a 1-min mouthrinse with 10 ml 10% sucrose. Depending on the minimum pH, the participants were divided into three groups: low pH (≤5.3), medium pH (>5.3-6.3) and high pH (>6.3). Statistically significant differences between the three groups (p < 0.01) were found for initial caries (DSi) and combined manifest and initial caries (DSm + i). A statistically significant difference was also found in the log values for salivary lactobacilli (p = 0.02) within the three groups, and for the total number of bacteria in plaque (p = 0.04); for both variables, the low-pH group had the highest values. The only covariate significantly associated was the Cariogram score in the medium-pH group (p < 0.01) and the number of meals per day in the high-pH group (p = 0.02). To conclude, plaque pH measured by the microtouch method is a method that can be used for discriminating between individuals with varying caries prevalence.
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Affiliation(s)
- E M Aranibar Quiroz
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Lee JH, Son HH, Kim HY, Chang J. Caries risk profiles of Korean dental patients using simplified Cariogram models. Acta Odontol Scand 2013; 71:899-905. [PMID: 23088581 DOI: 10.3109/00016357.2012.734416] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The objective of this study was to compare the caries risk profiles obtained from the simplified Cariogram models and the conventional Cariogram model of Korean dental patients. MATERIALS AND METHODS Data required for a caries risk assessment with the Cariogram were collected from 80 young adult patients (mean: 23 years old). Three different simplified Cariogram models were produced with exclusion of either or both salivary secretion rate and lactobacilli count: group 1, conventional model; group 2, both salivary secretion rate and lactobacilli count excluded; group 3, salivary secretion rate excluded; group 4, lactobacilli count excluded. RESULTS The mean chance of avoiding caries in group 1 (55.5%) was not significantly different from those in groups 2 and 3. Also four caries-related sectors of the Cariogram (diet, bacteria, susceptibility and circumstance) in group 1 were not significantly different than in groups 2 and 3. Group 4 showed significant differences from group 1 in the mean chance of avoiding caries and the diet, susceptibility and circumstance sectors (p < 0.05). Significant correlations were detected between all risk factors and their corresponding risk sectors (p < 0.05). Also there were significant correlations between each risk factor and the chance of avoiding caries, except for the amount of plaque, in groups 1, 2 and 3 (p < 0.05). CONCLUSIONS The simplified Cariogram model without salivary secretion rate and lactobacilli count did not significantly change the outcome produced from the conventional model. However, single exclusion of lactobacilli count noticeably changed the caries risk profile.
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Affiliation(s)
- Jung-Hyun Lee
- Department of Conservative Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Petersson GH, Ericson E, Isberg PE, Twetman S. Caries risk assessment in young adults using Public Dental Service guidelines and the Cariogram--a comparative study. Acta Odontol Scand 2013; 71:534-40. [PMID: 22746223 DOI: 10.3109/00016357.2012.696696] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. MATERIALS AND METHODS All 19-year-old patients registered at eight public dental clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. RESULTS The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk classification was predominantly based on past caries and/or present caries activity. The majority was classified as 'some risk', while 16.7% were assessed as being of 'high' or 'very high risk'. The corresponding value for the two highest risk groups in the Cariogram model was 17.4%. The agreement between the two models was found acceptable (77.5%) for those assessed as low risk, while discrepancies were disclosed among those classified with higher risks. CONCLUSIONS Although the proportion of subjects assessed with high or very high risk was similar using the PDS guidelines and the Cariogram model, the agreement between the models was fair. An acceptable agreement was only disclosed for the low risk category.
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Giacaman RA, Miranda Reyes P, Bravo León V. Caries risk assessment in chilean adolescents and adults and its association with caries experience. Braz Oral Res 2013; 27:7-13. [DOI: 10.1590/s1806-83242013000100002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 11/21/2012] [Indexed: 11/21/2022] Open
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Hebbal M, Ankola A, Metgud S. Caries risk profile of 12 year old school children in an Indian city using Cariogram. Med Oral Patol Oral Cir Bucal 2012; 17:e1054-61. [PMID: 22926464 PMCID: PMC3505702 DOI: 10.4317/medoral.17880] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 03/11/2012] [Indexed: 11/21/2022] Open
Abstract
Objectives: The present study was conducted with an aim to assess the caries profile of 12 year old Indian children using Cariogram.
Study design: Hundred children were interviewed to record any illness, oral hygiene practices and fluoride exposure after obtaining a three day diet diary. Examination was done to record plaque and dental caries status. Stimulated saliva was collected and salivary flow rate, salivary buffering capacity, Streptococcus mutans and Lactobacillus were assessed. The information obtained was scored and Cariogram was created. Differences between mean decayed, missing and filled teeth ( DMFT) and Cariogram risk groups were assessed using ANOVA. Spearman Correlation coefficients were used to explore correlation among Cariogram scores and individual variables.
Results: It was found that 21, 45, 21 and 13 children had 0-20%, 21-40%, 41-60% and 61-100% chance of avoiding caries respectively in future. Significant correlation was observed between cariogram score and DMFT, diet content, diet frequency, plaque scores, Streptococcus mutans counts and fluoride programme.
Conclusions: Cariogram model can identify the caries-related factors that could be the reasons for the estimated future caries risk, and therefore help the dentist to plan appropriate preventive measures.
Key words:Cariogram, caries risk assessment, risk factors, children, India
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Affiliation(s)
- Mamata Hebbal
- Dept of Public Health Dentistry, KLE VK Institute of dental sciences, Belgaum, Karnataka India.
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Campus G, Cagetti MG, Sale S, Petruzzi M, Solinas G, Strohmenger L, Lingström P. Six months of high-dose xylitol in high-risk caries subjects--a 2-year randomised, clinical trial. Clin Oral Investig 2012; 17:785-91. [PMID: 22791282 PMCID: PMC3607712 DOI: 10.1007/s00784-012-0774-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 06/14/2012] [Indexed: 11/23/2022]
Abstract
Objectives The hypothesis was that the daily use of a high dose of a xylitol chewing gum for 6 months would reduce the increment of decayed permanent first molar surfaces (ΔD6S) in high-risk schoolchildren after 2 years. Methods In this randomised, clinical trial, 204 schoolchildren with a high caries risk were assigned to two experimental groups, xylitol and non-xylitol. Caries status, salivary mutans streptococci, and lactobacilli were re-evaluated 2 years later in 74 xylitol-treated and 83 non-xylitol-treated schoolchildren. Differences in mean ∆D6S between groups registered at baseline and at follow-up were evaluated using the nonparametric Mann–Whitney U test. Results Outcome was the development of detectable carious lesions initial (D1–D2) and manifest (D3) in the permanent first molars. In the xylitol group, the difference in proportion of children with decayed first permanent molars at baseline and follow-up was 1.43 % for manifest lesion and 2.86 % for initial lesions; while in the non-xylitol group was 10.26 % (p < 0.01) and 16.66 % (p < 0.01), respectively. A statistically significant difference regarding means was also observed in the non-xylitol group: the ∆D6S for manifest lesion was 0.18 (p = 0.03) and 0.67 (p = 0.02) for initial lesion. Conclusion The use of a chewing gum containing a high dose of xylitol for a period of 6 months has been shown to produce a long-term effect on caries development in high caries-risk children. Clinical relevance A school-based preventive programme based on 6 months’ administration of a high dose of xylitol via chewing gum proved to be efficacious in controlling caries increment in high-risk children.
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Affiliation(s)
- Guglielmo Campus
- Department of Surgery, Microsurgery, Medical Sciences, Dental School, University of Sassari, Viale San Pietro 43/C, 07100, Sassari, Italy.
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Peker I, Mangal T, Erten H, Alp G, Avci E, Akca G. Evaluation of caries risk in a young adult population using a computer-based risk assessment model (Cariogram). J Dent Sci 2012. [DOI: 10.1016/j.jds.2012.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Cagetti MG, Campus G, Sale S, Cocco F, Strohmenger L, Lingström P. Association between interdental plaque acidogenicity and caries risk at surface level: a cross sectional study in primary dentition. Int J Paediatr Dent 2011; 21:119-25. [PMID: 20731733 DOI: 10.1111/j.1365-263x.2010.01099.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In schoolchildren the most commonly decayed primary teeth are molars affecting proximal adjacent surfaces especially. AIM To determine whether a more acidic plaque in response to sucrose challenge is detected in children with more carious lesions. DESIGN Plaque pH measurements, using the microtouch technique, were carried out in interproximal spaces between primary molars, in 157 high caries risk children (314 sites and caries status of the 628 proximal surfaces recorded). The area under the curve (AUC(5.7) and AUC(6.2) ) was analyzed. RESULTS The AUC(5.7) and the AUC(6.2) showed a statistically significant difference between plaque adjacent to proximal surfaces with or without caries. Differences for AUC(5.7) and AUC(6.2) were recorded between one decayed surface compared to two decayed surfaces (P<0.01) whereas a statistical significant difference was only observed for AUC(5.7) , when the areas under the curve were obtained near one decayed surface compared to two sound surfaces (P=0.04). CONCLUSIONS The higher acidogenicity of the dental plaque found in presence of a proximal carious lesion in primary maxillary molars represents an additional risk factor for the adjacent surface. This finding may help clinicians in treatment decisions.
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Affiliation(s)
- Maria Grazia Cagetti
- WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
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Petersson GH, Isberg PE, Twetman S. Caries risk profiles in schoolchildren over 2 years assessed by Cariogram. Int J Paediatr Dent 2010; 20:341-6. [PMID: 20642470 DOI: 10.1111/j.1365-263x.2010.01064.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Caries risk assessment is an important tool in clinical decision making. AIM To evaluate longitudinal changes in caries risk profiles in a group of schoolchildren in relation to caries development. DESIGN The Cariogram model was used to create caries risk profiles and to identify risk factors in 438 children being 10-11 years at baseline. The assessment was repeated after 2 years and the caries increment was recorded. The frequency of unfavourable risk factors were compared between those considered at the lowest and the highest risk. RESULTS Fifty percent of the children remained in the same risk category after 2 years. One third of the children were assessed in a higher-risk category while 18.4% showed a lower risk. Those with increased risk compared with baseline developed significantly more caries than those with an unchanged risk category. The most frequent unfavourable risk factors among those with high risk at baseline were high-salivary mutans streptococci and lactobacilli counts as well as frequent meals. CONCLUSION Half of the children showed a changed risk category after 2 years, for better or for worse, which suggests that regular risk assessments are needed in order to make appropriate decisions on targeted preventive care and recall intervals.
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