IADR Abstract Archives
Caries-Management Schemes in Children after 3 years: ICCMS™ vs. Colombian-NHS.
Objectives: This study aimed at comparing in a multicentre-RCT setting in Colombian children after three years the effectiveness of the ICCMS™-caries-management scheme (A) with that of the Colombian-National-Health System (B).
Methods: After ethical approval and parent-informed consents, 240 7-year olds from 6 Colombian dental-school clinics were assessed by 6-trained examiners with: clinical and radiographic merged-ICDAS caries systems: Initial-ICDAS-1/2 (In), Moderate-ICDAS-3/4 (M), Extensive-ICDAS-5/6 (E); lesion-clinical Inactive-I/Active-A status; fillings-F, missing-teeth-M, sealants-Se and ICCMS™-caries-lesion likelihood (Low/Intermediate/High).
Children were randomly allocated to trained-dentists-delivered management Scheme-A (caries-lesion-likelihood-based prevention and recalls; non-operative/tooth-preserving-operative treatment) or -B (standardised prevention, 6-month recalls, M/E-operative treatment).
Six months later, clinicians and parents answered validated perceived caries-management satisfaction questionnaires.
Three-year remaining subjects (n=187, 77.9%; A: n=92; B: n=95) were reassessed by 5-blind trained examiners, including child’s total number of appointments. Caries progression was considered as a follow-up score increment: Sound, Se, In-I, M-I, F, E-I, In-A, M-A, E-A, M.
Results: Overall prevalence and mean of ICDAS-dmfs/DMFS was >96% and >14, respectively.
Scheme-A showed higher-parent and -clinician satisfaction (c2; p<0.05).
At 3-year follow-up: Most children’s ICCMS™-caries-lesion likelihood decreased from high/moderate (A: 73.3%; B: 64.7%; p<0.05), significantly within A (p<0.05). Mean number of In/M/E-A caries lesions decreased (A: 11.54±9.86 to 5.17±4.51; B: 12.02±9.56 to 6.12±6.12) (p<0.05) and of Se increased (A: 0.73±1.54 to 1.90±2.37; B: 0.73±1.59 to 2.75±2.74; p<0.05), being higher in B (p<0.05).
Follow-up surfaces (A: n=6269; B: n=5952) showed significant regression (A:7.8%; B:8%) and progression (A:11.8%; B:14.1%) vs. baseline (p<0.05).
Conclusions: Scheme-A showed a higher 3-year caries-management effectiveness than Scheme-B in terms of a higher decrease of subjects’ caries-lesion likelihood, active-caries lesions and sealants’ application, but with more appointments.
Methods: After ethical approval and parent-informed consents, 240 7-year olds from 6 Colombian dental-school clinics were assessed by 6-trained examiners with: clinical and radiographic merged-ICDAS caries systems: Initial-ICDAS-1/2 (In), Moderate-ICDAS-3/4 (M), Extensive-ICDAS-5/6 (E); lesion-clinical Inactive-I/Active-A status; fillings-F, missing-teeth-M, sealants-Se and ICCMS™-caries-lesion likelihood (Low/Intermediate/High).
Children were randomly allocated to trained-dentists-delivered management Scheme-A (caries-lesion-likelihood-based prevention and recalls; non-operative/tooth-preserving-operative treatment) or -B (standardised prevention, 6-month recalls, M/E-operative treatment).
Six months later, clinicians and parents answered validated perceived caries-management satisfaction questionnaires.
Three-year remaining subjects (n=187, 77.9%; A: n=92; B: n=95) were reassessed by 5-blind trained examiners, including child’s total number of appointments. Caries progression was considered as a follow-up score increment: Sound, Se, In-I, M-I, F, E-I, In-A, M-A, E-A, M.
Results: Overall prevalence and mean of ICDAS-dmfs/DMFS was >96% and >14, respectively.
Scheme-A showed higher-parent and -clinician satisfaction (c2; p<0.05).
At 3-year follow-up: Most children’s ICCMS™-caries-lesion likelihood decreased from high/moderate (A: 73.3%; B: 64.7%; p<0.05), significantly within A (p<0.05). Mean number of In/M/E-A caries lesions decreased (A: 11.54±9.86 to 5.17±4.51; B: 12.02±9.56 to 6.12±6.12) (p<0.05) and of Se increased (A: 0.73±1.54 to 1.90±2.37; B: 0.73±1.59 to 2.75±2.74; p<0.05), being higher in B (p<0.05).
Follow-up surfaces (A: n=6269; B: n=5952) showed significant regression (A:7.8%; B:8%) and progression (A:11.8%; B:14.1%) vs. baseline (p<0.05).
Conclusions: Scheme-A showed a higher 3-year caries-management effectiveness than Scheme-B in terms of a higher decrease of subjects’ caries-lesion likelihood, active-caries lesions and sealants’ application, but with more appointments.