Browsing by Author "Cortes, Andrea"

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    CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol
    (BMC, 2021-12) Martignon, Stefania; Cortes, Andrea; Douglas, Gail V. A.; Newton, J. Timothy; Pitts, Nigel B.; Avila, Viviana; Usuga-Vacca, Margarita; Gamboa, Luis F.; Deery, Christopher; Abreu-Placeres, Ninoska; Bonifacio, Clarisa; Braga, Mariana M.; Carletto-Körber, Fabiana; Castro, Patricia; Cerezo, María P.; Chavarría, Nathaly; Cifuentes, Olga L.; Echeverri, Beatriz; Jácome-Liévano, Sofía; Kuzmina, Irina; Lara, J. Sebastián; Manton, David; Martinez-Mier, E. Angeles; Melo, Paulo; Muller-Bolla, Michèle; Ochoa, Emilia; Osorio, Jesús R.; Ramos, Ketty; Sanabria, Angie F.; Sanjuán, Johanna; San-Martín, Magdalena; Squassi, Aldo; Velasco, A. Karina; Villena, Rita; Ferreira Zandona, Andrea; Beltrán, Edgar O.; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time.
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    Tactile perception of roughness to assess activity in artificial initial caries lesions with a novel force-controlled probe
    (SciELO Brazil, 2022) Martignon, Stefania; Castiblanco-Rubio, Gina Alejandra; Braga, Mariana Minabel; Cortes, Andrea; Usuga-Vacca, Margarita; Lara, Juan Sebastian; Mendes, Fausto Medeiros; Avila, Viviana; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Roughness-tactile perception is part of activity assessment in initial-caries-lesions. Hypothesizing that a probe’s design influences this examiner’s assessment, four probes were designed. The aims of this study were to select the probe with highest inter-/intra-examiners’ roughness-assessment agreement and to determine its diagnostic accuracy on artificial initial-caries lesions. A pilot study was conducted with trained dentists to select one controlled-pressure probe design (n = 4) by assessing roughness on known-roughness metal plaques with 5-point Likert scale. Diagnostic accuracy of roughness assessment was conducted with the selected controlled-pressure probe and the WHO-probe on sound and artificial initial-caries-lesion (n = 20) human enamel blocks. Intra-class correlation coefficients (ICCs) and quadratic weighted-Kappa scores were used to assess examiners’ reproducibility and Multilevel Poisson models to determine diagnostic accuracy between both probes controlling for confounding variables. The probe design with the highest inter/intra-examiner’s agreement (ICC = 0.96) was selected for subsequent analyses. Unadjusted sensitivity, specificity and accuracy values were for the controlled-pressure and the WHO probes: 71.1%,90.6%,81.2%, and 67.4%,84.6%,75.8%, respectively (p > 0.05). Examiner remained the most important factor influencing diagnostic accuracy. While this study did not show significantly higher diagnostic accuracy of the designed controlled-pressure vs. the WHO-probe when used by trained dentists, all over roughness-assessment accuracy and reproducibility were high.