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How did CariesCare International performed under pandemic conditions in children: 1-year multicenter single-group interventional study
Martignon, S.
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Beltrán, E. O.
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Douglas, G. V. A.
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Newton, J. T.
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Pitts, N. B.
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Deery, C.
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Carletto‐Körber, F. P. M.
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Cifuentes, O. L.
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Fortich, N.
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Chavarria, N.
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Echeverri, B.
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Kuzmina, I.
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Muller‐Bolla, M.
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Osorio, J. R.
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Ramos, K.
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Sanjuán, J.
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San-Martín, M.
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Aldo Squassi
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Villena, R.
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Aïem, E.
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Cáceres-Matta, S.
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Marcela Carreño, L.
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Cerezo, M. P.
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Conrado, A.
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Hermida, L.
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Llamas, J. I.
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Oña, J. A.
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Sanabria, A.
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Said, D.
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Sarrazola, A.
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Sorazabal, A.
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Zelada, D.
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Abreu-Placeres, Ninoska
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Braga, M. M.
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Lara, J. S.
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Melo, P.
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Areias, C.
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Falabello de Luca, A. C.
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Rubi Tello, A.
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Yunes Fragoso, Paula M.
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Martínez-Mier, E. A.
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Ferreira Zandona, A.
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Cortes, A.
| Fecha de publicación | Revista | DOI |
2024 |
Resumen
Background: In 2020, CariesCare International (CCI) -derived from ICCMS- was plannedto be tested for caries-control effectiveness in children by means of a multicenter randomized clinical trial (RCT). Nevertheless, due to the pandemic, RCTs proved unfeasible and aerosol-generating procedures (AGP) were associated with a spread of COVID-19. Consequently, the study design required to be modified to a single-interventional study and CCI had to be adapted excluding AGP and reducing on-site consultation (CCI-adapted).
Objective: This 12-month multicenter single-group interventional study aimed at assessing the effect of a pandemic CCI-adapted protocol on caries control in children.
Methods: Twenty-one Latin American and European centers with n³20 3-8-year-old children per center were invited to participate; 17 obtained IRB and signed written informed consents. Trained examiners assessed at baseline (T0) and 1-year follow-up (T1y) (blind to the intervention): CCI-caries risk, oral-health-related practices; dmf/DMFS with ICDAS-merged-Epi visual caries severity and activity criteria; dental sepsis and toothache. Individual- and tooth-surface-level personalized care plan was then performed by dental practitioners previously trained in CCI-adapted. After 5 months, parents’ and dentists’ dental-care-process acceptance (Treatment Evaluation Inventory) was assessed. The one-year caries-control effect of CCI-adapted was assessed in terms of tooth-surface and individual-level caries-progression control; oral-health behavior improvement, and caries-care system acceptability.
Results: Sixteen centers finished the study (94.1%; Latin America: n=13; Europe: n=3), with 337 children (78.6%;mean age of 5.5±1.6 years). There was a T0 to T1y significant decrease (p<0.05) in the mean number of tooth surfaces with caries lesions (7.7±9.1 to 2.8±4.6), with active caries lesions (6.8±8.8 to 0.8±2.2), and a tooth-surface caries-progression control of 99.3%. In the majority of children there was a significant (p<0.05) control of: caries progression (79.5%), high-caries risk (86.6%), and non-adequate oral-health behavior (72.7%). There was a very high (parents) and a high-very high (dentists) acceptability of CCI.
Conclusion: Given the challenge of the pandemic, this single-group interventional CCI-adapted study showed one-year control of caries progression, caries risk, and high parents’ and dentists’ CCI acceptance.