How combining different caries lesions characteristics may be helpful in short-term caries progression prediction: model development on occlusal surfaces of primary teeth

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Isabela Floriano
  • Elizabeth Souza Rocha
  • Ronilza Matos
  • Juliana Mattos-Silveira
  • Ekstrand, Kim
  • Fausto Medeiros Mendes
  • Mariana Minatel Braga

Background: Few studies have addressed the clinical parameters' predictive power related to caries lesion associated with their progression. This study assessed the predictive validity and proposed simplified models to predict short-term caries progression using clinical parameters related to caries lesion activity status. Methods: The occlusal surfaces of primary molars, presenting no frank cavitation, were examined according to the following clinical predictors: colour, luster, cavitation, texture, and clinical depth. After one year, children were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as the outcome to be predicted. Univariate multilevel Poisson models were fitted to test each of the independent variables (clinical features) as predictors of short-term caries progression. The multimodel inference was made based on the Akaike Information Criteria and C statistic. Afterwards, plausible interactions among some of the variables were tested in the models to evaluate the benefit of combining these variables when assessing caries lesions. Results: 205 children (750 surfaces) presented no frank cavitations at the baseline. After one year, 147 children were reassessed (70%). Finally, 128 children (733 surfaces) presented complete baseline data and had included primary teeth to be reassessed. Approximately 9% of the reassessed surfaces showed caries progression. Among the univariate models created with each one of these variables, the model containing the surface integrity as a predictor had the lowest AIC (364.5). Univariate predictive models tended to present better goodness-of-fit (AICs < 388) and discrimination (C:0.959–0.966) than those combining parameters (AIC:365–393, C:0.958–0.961). When only non-cavitated surfaces were considered, roughness compounded the model that better predicted the lesions' progression (AIC = 217.7, C:0.91). Conclusions: Univariate model fitted considering the presence of cavitation show the best predictive goodness-of-fit and discrimination. For non-cavitated lesions, the simplest way to predict those lesions that tend to progress is by assessing enamel roughness. In general, the evaluation of other conjoint parameters seems unnecessary for all non-frankly cavitated lesions.

OriginalsprogEngelsk
Artikelnummer255
TidsskriftBMC Oral Health
Vol/bind21
Antal sider16
ISSN1472-6831
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
The authors would like to thank São Paulo Research Foundation FAPESP (2011/16415–0 and 2013/27206–8), and the National Council for Technological and Scientific Development – CNPq (448013/2014–2/MMB's and FMM's Research Productivity Scholarship) who supported this study. The funders played no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Funding Information:
The authors are thankful to Prof. Dr Jos? Leopoldo Ferreira Antunes for checking the multilevel analysis for pertinence and correctness and to Editage and Research Proofreading and Editing Services for English language revisions. The authors would also like to thank the Post-Graduation participants in the Pediatric Dentistry Seminar of Dental School, University of S?o Paulo, for their critical comments.

Publisher Copyright:
© 2021, The Author(s).

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