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Effectiveness of the ICCMS caries management system for children: a 3-year multicentre randomised controlled trial
Stefania Martignon1, Andrea Cortes1, Luis Fernando Gamboa1
1UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia.
Insights
The International Caries Classification and Management System (ICCMS) and conventional caries management systems (CCMS) effectively reduced caries risk in children. ICCMS demonstrated superior control of tooth surface caries progression and improved brushing habits.
Area of Science:
- Pediatric Dentistry
- Dental Public Health
- Caries Management
Background:
- Dental caries remains a significant public health issue in children globally.
- Effective caries management systems are crucial for preventing and controlling disease progression.
- The International Caries Classification and Management System (ICCMS) offers a structured approach to caries diagnosis and treatment planning.
Purpose of the Study:
- To compare the effectiveness of ICCMS versus a conventional caries management system (CCMS) in 6-7-year-old Colombian children.
- To evaluate the impact on individual caries risk, caries lesions, oral-health-related knowledge/attitudes/practices, and treatment appointments.
- To assess long-term outcomes over a 3-year period.
Main Methods:
- A 3-year multicenter randomized controlled trial involving 240 children aged 6-7 years.
- Baseline and follow-up assessments included caries risk (Cariogram-ICCMS), caries severity/activity (ICDAS), and oral health practices.
- Children received care allocated via ICCMS or CCMS, with data analyzed using descriptive and bivariate statistics.
Main Results:
- Both ICCMS and CCMS significantly reduced high caries risk in children (p < .001).
- ICCMS showed a statistically significant reduction in tooth-surface caries progression (6.2% vs 7.1%, p = .010) and active caries lesions (49.8% vs 59.1%, p < .05) compared to CCMS.
- Children in the ICCMS group demonstrated improved daily fluoride toothpaste brushing practices (p < .05).
Conclusions:
- Both ICCMS and CCMS are effective in controlling caries risk in pediatric populations.
- ICCMS demonstrates superior effectiveness in managing tooth-surface caries progression and enhancing oral hygiene practices.
- The findings support the integration of ICCMS into routine pediatric dental care for improved caries control.
Objective:
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.
Material And Methods:
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.
Results:
Three-year-follow-up: n = 187 (77.9%; ICCMS: n = 92; CCMS: n = 95) disclosed a baseline-to-3-year overall high-caries-risk children decrease (ICCMS: 60.9-0%, p < .001; CCMS: 54.7-5.3%, p < .001) (p > .05). ICCMS versus CCMS showed: fewer tooth-surface caries progression (6.2% vs 7.1%, p = .010) and fewer active-caries lesions (49.8% vs. 59.1%, p < .05); higher proportion of children with ≥2/day fluoride-toothpaste tooth-brushing practice (p < .05); similar mean number of appointments (10.9 ± 5.9 vs. 10.0 ± 3.8, p = .15).
Conclusion:
Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.
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