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Martignon S, Cortes A, Douglas GVA, Newton JT, Pitts NB, Avila V, Usuga-Vacca M, Gamboa LF, Deery C, Abreu-Placeres N, Bonifacio C, Braga MM, Carletto-Körber F, Castro P, P Cerezo M, Chavarría N, Cifuentes OL, Echeverri B, Jácome-Liévano S, Kuzmina I, Lara JS, Manton D, Martínez-Mier EA, Melo P, Muller-Bolla M, Ochoa E, Osorio JR, Ramos K, Sanabria AF, Sanjuán J, San-Martín M, Squassi A, Velasco AK, Villena R, Zandona AF, Beltrán EO. CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol. BMC Oral Health 2021; 21:329. [PMID: 34210281 PMCID: PMC8248759 DOI: 10.1186/s12903-021-01674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time.
Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01674-1.
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Affiliation(s)
- Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.
| | - Andrea Cortes
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Gail V A Douglas
- Dental Public Health, Leeds Dental Institute, University of Leeds, Leeds, UK
| | - J Timothy Newton
- Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Nigel B Pitts
- Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Viviana Avila
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Margarita Usuga-Vacca
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Luis F Gamboa
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Christopher Deery
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Ninoska Abreu-Placeres
- Biomaterials and Dentistry Research Center (CIBO-UNIBE), Academic Research Department, Universidad Iberoamericana UNIBE, Santo Domingo, Dominican Republic
| | - Clarisa Bonifacio
- Department of Pediatric Dentistry, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Mariana M Braga
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fabiana Carletto-Körber
- Comprehensive Children and Adolescents Clinic, Paediatric Dentistry, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Patricia Castro
- School of Dentistry, Corporación Universitaria Rafael Núñez, Cartagena, Colombia
| | - María P Cerezo
- School of Dentistry, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Nathaly Chavarría
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Olga L Cifuentes
- School of Dentistry, Universidad Autónoma de Manizales, Manizales, Colombia
| | - Beatriz Echeverri
- School of Dentistry, Universidad Cooperativa de Colombia, Envigado, Colombia
| | - Sofía Jácome-Liévano
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Irina Kuzmina
- Department of Preventive Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - J Sebastián Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - David Manton
- Centrum Voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, The Netherlands
| | - E Angeles Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Paulo Melo
- EpiUnit, Faculty of Dental Medicine, Institute of Public Health, University of Porto, Porto, Portugal
| | | | - Emilia Ochoa
- School of Dentistry, Universidad Cooperativa de Colombia, Envigado, Colombia
| | | | - Ketty Ramos
- School of Dentistry, Universidad de Cartagena, Cartagena, Colombia
| | - Angie F Sanabria
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Johanna Sanjuán
- Paedriatric Dentistry Department, Fundación Universitaria de Colegios de Colombia (UNICOC), Bogotá, Colombia
| | - Magdalena San-Martín
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia.,School of Dentistry, Universidad Católica de Uruguay, Montevideo, Uruguay
| | - Aldo Squassi
- School of Dentistry, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - A Karina Velasco
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
| | - Rita Villena
- Paediatric Dentistry Department, Universidad San Martín de Porres, Lima, Peru
| | - Andrea Ferreira Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, MA, USA
| | - Edgar O Beltrán
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Av. Cra. 9 No. 131 A - 02, 110121, Bogotá, Colombia
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