Martignon Stefania, Cortes Andrea, Gamboa Luis Fernando, Jácome-Liévano Sofia, Arango-De-la-Cruz Maria Cristina, Cifuentes-Aguirre Olga Lucia, Fortich-Mesa Natalia, Ramos-Martínez Ketty, Sanjuán-Acero Johanna, Alfaro Lizelia, Mejía Lofthy, Usuga-Vacca Margarita
UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia.
Escuela de Odontología, Facultad de Salud, Programa Universidad de Valle, Cali, Colombia.
Acta Odontol Scand. 2022 Oct;80(7):501-512. doi: 10.1080/00016357.2022.2038263. Epub 2022 Feb 15.
This 3-year multicentre randomised controlled trial compared, in 6-7-year-old Colombian children, the effectiveness of the ICCMS (International Caries Classification and Management System) with a conventional caries-management system (CCMS) in terms of individual caries-risk, caries lesions, and secondarily, oral-health-related knowledge/attitudes/practices, and number of appointments.
With ethical approval, 240 6-7-year olds from six Colombian clinics were recruited. Trained examiners conducted the following baseline/follow-up assessments: Caries risk (Cariogram-ICCMS); caries severity/activity staging (ICDAS-merged combined radiographic/visual); sealants/fillings/missing teeth, and oral-health-related knowledge, attitudes and practices. Children received their randomly allocated (ICCMS/CCMS) care from dental practitioners. Outcomes: caries-risk control (children); caries-progression control (tooth surfaces); oral-health-related knowledge/attitudes/practices improvement (parents/children), and appointments' number (children). Descriptive and non-parametric/parametric bivariate analyses were performed.
Three-year-follow-up: = 187 (77.9%; ICCMS: = 92; CCMS: = 95) disclosed a baseline-to-3-year overall high-caries-risk children decrease (ICCMS: 60.9-0%, < .001; CCMS: 54.7-5.3%, < .001) ( > .05). ICCMS versus CCMS showed: fewer tooth-surface caries progression (6.2% vs 7.1%, = .010) and fewer active-caries lesions (49.8% vs. 59.1%, < .05); higher proportion of children with ≥2/day fluoride-toothpaste tooth-brushing practice ( < .05); similar mean number of appointments (10.9 ± 5.9 vs. 10.0 ± 3.8, = .15).
Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.
这项为期3年的多中心随机对照试验，在6至7岁的哥伦比亚儿童中，比较了国际龋病分类和管理系统（ICCMS）与传统龋病管理系统（CCMS）在个体龋病风险、龋损情况方面的有效性，其次还比较了与口腔健康相关的知识/态度/行为以及就诊次数。
经伦理批准，招募了来自哥伦比亚六家诊所的240名6至7岁儿童。经过培训的检查人员进行了以下基线/随访评估：龋病风险（Cariogram-ICCMS）；龋病严重程度/活动分期（ICDAS合并的影像学/视觉检查）；窝沟封闭/补牙/缺牙情况，以及与口腔健康相关的知识、态度和行为。儿童从牙科医生那里接受随机分配的（ICCMS/CCMS）护理。结果：龋病风险控制（儿童）；龋病进展控制（牙面）；与口腔健康相关的知识/态度/行为改善（家长/儿童），以及就诊次数（儿童）。进行了描述性和非参数/参数双变量分析。
三年随访：n = 187（77.9%；ICCMS组：n = 92；CCMS组：n = 95）显示，从基线到三年，总体高龋病风险儿童数量减少（ICCMS组：60.9%至0%，P <.001；CCMS组：54.7%至5.3%，P <.001）（P >.05）。ICCMS组与CCMS组相比显示：牙面龋病进展更少（6.2%对7.1%，P =.010），活动性龋损更少（49.8%对59.1%，P <.05）；每天使用含氟牙膏刷牙≥2次的儿童比例更高（P <.05）；平均就诊次数相似（10.9 ± 5.9对10.0 ± 3.8，P =.15）。
两种龋病管理系统在龋病风险控制方面显示出相似的有效性，ICCMS在更有效地控制牙面龋病进展和改善刷牙习惯方面表现更佳。
