Griffin Susan O, Lin Mei, Naavaal Shillpa, Wei Liang, Scherrer Christina R
Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Department of Pediatric Dentistry and Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA.
Community Dent Oral Epidemiol. 2025 Nov 17. doi: 10.1111/cdoe.70040.
Demonstrate and evaluate methodology to estimate annual probability a sound-unsealed molar develops caries (AP) among US adults, aged 21 and 25 years.
A synthetic birth cohort was created with National Health and Nutrition Examination Survey data from 2001 to 2004 and 2011 to 2014. The synthetic birth cohort was born between 1982 and 1989 and was aged 15 to 19 years in 2001-2004 and 25 to 29 in 2011-2014. Caries increment (difference in per-person decayed, missing and filled molars (DMF) between adolescence and young adulthood) obtained from the synthetic birth cohort was used to estimate AP not adjusted for the presence of sealants. Adjusted estimates were obtained by inputting information on sound-sealed, sound-unsealed and DMF molars among adolescents and DMF among young adults from the synthetic cohort and sealant retention from the literature into a Markov model. AP was estimated by solving for the AP that yielded the DMF for the synthetic cohort in young adults. To evaluate Markov-model performance, longitudinal data from five caries effectiveness trials were used to estimate true AP and adjusted AP. One-way sensitivity analyses of model parameters were also conducted.
The adjusted AP (0.038) was notably higher than the unadjusted AP (0.031). The average and median percentage deviation of adjusted APs relative to their true values were, respectively, 10.1% and 7.1%. The most influential model parameters were DMF in adulthood and annual retention.
This methodology provides reasonable estimates of AP that can be used in cost-effective analyses of providing sealants to young adults.
展示并评估用于估计美国21至25岁成年人中未封闭磨牙发生龋齿的年度概率（AP）的方法。
利用2001年至2004年以及2011年至2014年的国家健康与营养检查调查数据创建了一个合成出生队列。该合成出生队列出生于1982年至1989年之间，在2001 - 2004年时年龄为15至19岁，在2011 - 2014年时年龄为25至29岁。从合成出生队列中获得的龋齿增量（青少年期和青年期之间每人龋齿、缺失和填充磨牙（DMF）的差值）用于估计未根据窝沟封闭剂的存在情况进行调整的AP。通过将合成队列中青少年的封闭完好、未封闭和DMF磨牙信息以及青年期的DMF信息和文献中的窝沟封闭剂保留率输入马尔可夫模型来获得调整后的估计值。通过求解能得出合成队列中青年期DMF的AP来估计AP。为了评估马尔可夫模型的性能，使用了五项龋齿有效性试验的纵向数据来估计真实AP和调整后的AP。还对模型参数进行了单向敏感性分析。
调整后的AP（0.038）显著高于未调整的AP（0.031）。调整后的AP相对于其真实值的平均和中位数百分比偏差分别为10.1%和7.1%。最具影响力的模型参数是成年期的DMF和年度保留率。
该方法提供了合理的AP估计值，可用于对向年轻人提供窝沟封闭剂进行成本效益分析。
