Dolic Olivera, Obradovic Marija, Kojic Zeljka, Trtic Natasa, Sukara Slava, Knezevic Natasa, Veselinovic Valentina
Department of Preventive and Pediatric Dentistry, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina.
Department of Periodontics and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Republic of Srpska, Bosnia and Herzegovina.
Risk Manag Healthc Policy. 2020 Jun 9;13:549-557. doi: 10.2147/RMHP.S243907. eCollection 2020.
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.
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.
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.
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.
Cariogram是一种基于算法的软件模型，用于预测龋齿风险，已被用于评估许多不同群体的龋齿风险状况。本研究的目的是在母亲及其怀孕4年后的子女中，根据DMFT/dmft发病率评估孕期的Cariogram龋齿风险，并检查使用Cariogram得出的儿童龋齿风险状况与母亲孕期龋齿风险状况（通过Cariogram）之间是否存在关联。
研究人群包括96名孕妇（基线时平均年龄27.4±7.2岁），她们完成了临床基线检查和唾液检测。4年后开始随访研究，80对母婴（来自那次怀孕）按照与基线相同的程序重新接受检查。为每位妇女和儿童制定了个人龋齿风险状况和DMFT/dmft发病率。将Cariogram的预测结果与4年后的实际牙科检查结果进行比较。计算两个临界值的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以表达结果。
结果显示，孕妇及其后代的风险类别之间以及后代龋齿发展与孕妇的Cariogram风险类别之间存在密切关联。对于那些被评估为有0-60%“避免患龋机会”的参与者，女性4年后新发生的DMFT（ΔDMFT>0）的敏感性和PPV较高（>80%），诊断准确性为74.00%。对于儿童dmft的中度风险组和两个最低风险组，获得了高特异性（91.00%）、非常高的PPV（95.00%）以及根据约登指数得出的临床有用值（0.53）。
Cariogram仅在作者的样本中有效，并且基于母亲孕期的龋齿风险评估，在对所研究儿童的龋齿风险评估中具有高度预测性。
