UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia.
Biomaterials and Dentistry Research Center (CIBO-UNIBE), Research and Innovation Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic.
Community Dent Oral Epidemiol. 2023 Apr;51(2):265-273. doi: 10.1111/cdoe.12735. Epub 2022 Mar 1.
The International Caries Classification and Management System (ICCMS™), a comprehensive, evidence-informed, best clinical practice system, comprises a 4D cycle: 1D-Determine risk; 2D-Detect and assess lesions; 3D-Decide on a personalized care plan; and 4D-Do preventive and tooth-preserving care. The aim of this study was to establish how Colombian dental practitioners, educators and students diagnose and manage caries risk and caries lesions using the COM-B model and the ICCMS™ system.
A total of 1094 participants (practitioners: n = 277; educators: n = 212; students: n = 605) completed a previously validated 79-item questionnaire which explores, based on the COM-B model, the practitioners' self-reported caries diagnosis and management behaviours. Descriptive statistics, Welch's ANOVAs and multiple linear regressions were computed.
All groups generally performed the behaviours within the 4-D categories 'Most of the time' to 'Always' (students: 4.06 ± 0.95; educators: 3.94 ± 0.98; practitioners: 3.86 ± 1.01). The most frequently performed diagnosis behaviours (1D/2D) were for practitioners assessing initial/moderate lesions (4.09 ± 1.01) and for educators and students cleaning teeth before lesion assessment (4.41 ± 0.80 and 4.38 ± 0.77 respectively). The least frequently performed decision/management (3D/4D) behaviour was non-operative care for moderate-caries lesions (when applicable) (practitioners: 2.64 ± 1.23; educators: 2.68 ± 1.17; students: 3.22 ± 1.41). Opportunity (Resources and Relevance) was the best COM-B predictor for diagnostic behaviours, whereas capability and opportunity (Relevance) were the strongest predictors for management behaviours.
Colombian practitioners, educators and students diagnose and manage caries risk and caries lesions implementing best practice with a high to very high frequency.
国际龋分类和管理系统（ICCMS™）是一个全面的、循证的、最佳临床实践系统，由一个 4D 周期组成：1D-确定风险；2D-检测和评估病变；3D-制定个性化的护理计划；4D-进行预防和保留牙齿的护理。本研究旨在利用 COM-B 模型和 ICCMS™系统，确定哥伦比亚的牙医、教育者和学生如何诊断和管理龋病风险和龋病病变。
共有 1094 名参与者（从业者：n=277；教育者：n=212；学生：n=605）完成了一份先前经过验证的 79 项问卷，该问卷基于 COM-B 模型，探讨了从业者自我报告的龋病诊断和管理行为。采用描述性统计、Welch's ANOVA 和多元线性回归进行分析。
所有组的行为表现均为“大部分时间”到“总是”（学生：4.06±0.95；教育者：3.94±0.98；从业者：3.86±1.01）。最常执行的诊断行为（1D/2D）是从业者评估初始/中度病变（4.09±1.01），以及教育者和学生在病变评估前清洁牙齿（4.41±0.80 和 4.38±0.77）。最不常执行的决策/管理行为（3D/4D）是对中度龋病病变（在适用的情况下）进行非手术治疗（从业者：2.64±1.23；教育者：2.68±1.17；学生：3.22±1.41）。机会（资源和相关性）是诊断行为的最佳 COM-B 预测因素，而能力和机会（相关性）是管理行为的最强预测因素。
哥伦比亚的从业者、教育者和学生在诊断和管理龋病风险和龋病病变时，采用最佳实践，其行为表现的频率很高，甚至非常高。
