Supervisors info:
Αικατερίνη Καββαδία, Αναπληρώτρια Καθηγήτρια, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Ανδρέας Αγουρόπουλος, Επίκουρος Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Δημήτριος Εμμανουήλ, Επίκουρος Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Summary:
First part: Validation of different Cariogram models
Objective. To validate the predictive ability of Cariogram for caries development, using different combinations of factors and settings in preschool children.
Methods. Children 2-5 yo from areas with high caries prevalence were examined at baseline and after 1st & 2nd years (N=193). Mutans streptococci counts (MS) and saliva buffer capacity (SBC) were measured with chair side tests. Parents completed a questionnaire on diet and oral health attitudes. Caries increment was assessed in the 1st & 2nd year as the sum of cavitated and noncavitated lesions. Cariograms were calculated at baseline using standard and high risk group sets with 9 parameters and reduced versions, extracting MS and SBC, one by one as well as both. Cariogram values, expressed as caries risk, were categorized in 3 and 5 risk groups. Kendall’s tau coefficients, Poisson regression models, ROC analysis and information criteria (AIC and BIC) were used to quantify associations and assess the predictive ability of Cariograms. Statistical significance: 5%.
Results. Standard set Cariogram values ranged from 68-80 while high set values ranged from 75-85. Full Cariogram at Risk level 3 achieved the highest statistically significant Kendall’s τ, thus best predicted caries increment for both time points. Poisson regression indicated that standard set Cariograms with MS had better predictive ability. Cariograms including the MS showed higher sensitivity (67.6-66.2) while those without the MS had higher specificity (67.7-64.7). Overall the sum of specificity + sensitivity ranged from 120.5 to 131.2%. Cariogram showed better prediction for the 2nd year both for ROC and regression analyses and there were no differences between standard and high sets.
Conclusions. Cariogram with various factors and settings combinations displayed a moderate ability to predict caries development in a high risk preschool children population.
Second part: Comparison and validation of Cariogram, CAT & CAMBRA
Objective. The purpose of this study was the assessment of the validity of Cariogram, CAT and CAMBRA in caries risk prediction for a group of preschool children from high caries risk areas, over a 2-year period.
Methods. Children 2-5 yo (N=175) from areas with high caries prevalence were examined at baseline and after 1 and 2 years. Mutans streptococci counts (MS) and saliva buffer capacity (SBC) were measured with chair side tests. Parents completed a questionnaire on diet and oral health attitudes. Caries increment was assessed at 2 years as the sum of cavitated and non cavitated lesions. Cariogram, CAT and CAMBRA caries risk profiles were calculated at baseline with modifications appropriate for this age group. Associations using Kendall’s tau, Poisson regression models and ROC analysis were used to assess the predictive ability of the 3 systems. Statistical significance: 5%
Results. The distribution of the risk profiles for Cariogram, CAT and CAMBRA was respectively: low 20%,3%,3%, medium 26%,4%,61% and high 54%,93%,36%. A statistically significant association with 2 years caries increment was found for Cariogram (Kendall’s tau= 0.260, p=0.003) and CAMBRA (Kendall’s tau=0.342, p<0.001) but not for CAT (Kendall’s tau= -0.004, p=0.930). The ROC curve analysis showed that Cariogram and CAMBRA had the highest AUC values for the 1st and 2nd year, with no statistically significant difference. Poison regression models indicated a higher incidence ratio for caries development according to Cariogram and CAMBRA risk categories compared to CAT.
Conclusions. Cariogram and CAMBRA displayed higher validity in predicting caries increment in this population over a 2-year period, while CAT had the poorest outcome.
Keywords:
Cariogram, CAT, CAMBRA, Preschool children, Risk assessment
