Browsing by Author "Fontana, Margherita"

Now showing 1 - 6 of 6
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    Influence of Temperament As a Risk Indicator for Early Childhood Caries
    (Ingenta, 2020-11-15) Quinonez, Rocio B.; Santos, Robert G.; Eckert, George J.; Keels, Martha Ann; Levy, Steven; Levy, Barcey T.; Jackson, Richard; Fontana, Margherita; Biostatistics, School of Public Health
    Purpose: To evaluate the association between temperament and caries. Methods: A total of 408 primary caregiver-child pairs were followed for 36 months; they completed the Early Childhood Behavior Questionnaire Very Short-Form (ECBQ-VSF) at age four years. Demographic, behavioral, and clinical data were obtained at ages one, two-and-a-half, and four years, with caries experience assessed each time using the International Caries Detection and Assessment System (ICDAS). The ECBQ-VSF (36 items) was used to measure three child temperament domains: (1) surgency; (2) negative affect; and (3) effortful control. The associations between cavitated carious lesion experience by age four years (decayed, missing, and filled primary surfaces [dmfs] score greater than zero; d equals ICDAS score greater than or equal to three) and the three ECBQ-VSF temperament domains were analyzed using generalized estimating equation models. Results: Temperament domains predicted the number of carious surfaces (dmfs). After adjusting for covariates, every one-point increase in surgency and one-point increase in negative affect were associated with 77 percent and 31 percent increases in dmfs, respectively (P<0.05), and every one-point increase in effortful control was associated with a 39 percent decrease in dmfs (P<0.05). Conclusions: By age four years, children with higher levels of surgency and negative affect have a higher caries experience, whereas children with greater effortful control have a lower caries experience.
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    Objective and Quantitative Assessment of Caries Lesion Activity
    (Elsevier, 2018) Ando, Masatoshi; Fontana, Margherita; Eckert, George J.; Arthur, Rodrigo A.; Zhang, Hui; Zero, Domenick T.; Cariology, Operative Dentistry and Dental Public Health, School of Dentistry
    Objectives Evaluate the ability of objectively measured specular reflection, roughness, and fluorescence change during dehydration to assess caries lesion activity. Methods One hundred ninety-five ground/polished 3 × 3 × 2 mm sound human enamel specimens were divided into three groups and demineralized using a multispecies microbial caries model for 3, 6, or 9 days; and then remineralized with 1100 ppm-F as NaF solution for 10 days using a pH-cyclic model. Reflection (amplitude: %), roughness (Ra: μm), fluorescence change during dehydration (ΔQ: %×mm2), and microfocus computed tomography [μ-CT: lesion volume (μm3)] were measured for sound, demineralized and remineralized enamel. The surface was hydrated and fluorescence images were acquired at 1 s intervals for 10 s (ΔQ10). During image acquisition, surface was dehydrated with continuous compressed air. Changes-in-ΔQ per second (ΔQD: %×mm2/sec) at 5 (ΔQD5) and 10 s (ΔQD10) were obtained. Results Reflection decreased from sound to demineralized groups (p < 0.0001); remineralized groups were higher than demineralized groups (p < 0.001), but not different from sound (p > 0.32). Roughness increased from sound to demineralized groups (p < 0.0001) and remineralized groups were also higher than sound (p < 0.0001). ΔQ10, ΔQD5 and ΔQD10 increased from sound to demineralized groups (p < 0.0001), and remineralized groups decreased compared to demineralized groups (p < 0.05), but was higher than sound (p < 0.0001). The correlations of μ-CT with reflection, roughness, and ΔQ10 were −0.63, 0.71, and 0.82, respectively (p < 0.0001). Conclusions Reflection, roughness and ΔQ could distinguish between sound and demineralized enamel. Reflection and ΔQ were able to distinguish between demineralized and remineralized enamel. Clinical significance Determination of caries activity, whether a lesion is active or inactive, is an essential and critical component of caries diagnosis. However, especially for enamel lesions, it is difficult to estimate without longitudinal follow-up. Reflection, roughness and fluorescence change during dehydration have the potential to measure caries lesion activity at a-single-appointment.
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    Patterns of radiograph use in a population of commercially insured children
    (Elsevier, 2022-05) Fontana, Margherita; Yepes, Juan F.; Eckert, George J.; Hale, Kevin J.; Benavides, Erika; Pediatric Dentistry, School of Dentistry
    Background The objective of this study was to evaluate differences in number and type of radiographs used among 3 age groups (0-5, 6-12, 13-18 years) by general dentists, pediatric dentists, and other specialists, and to determine the association between number and type of radiographs and clinical need. Methods A retrospective analysis of insurance claims by age group and oral health care provider type included children aged 0 through 8 years in 2005 who had a minimum of 10 years of continuous eligibility. Indicator claim variables were calculated to identify high-risk, high-need patients. Results A total of 6,712,155 records from 105,010 patients and 34,406 providers were analyzed. There was a significant effect (P < .001) of age on the number of radiographs obtained per visit. The estimated rates of radiographs per visit for ages 0 through 5, 6 through 12, and 13 through 18 were 0.373, 0.492, and 0.393, respectively. There was a significant interaction effect between age and provider type. For patients younger than 13 years, general dentists had lower rates of obtaining radiographs than did pediatric dentists, with no significant difference between providers for the 13- through 18-year age group. Treatments received, except for extractions and prosthodontics, were significantly associated with rate of radiographs per visit, with “number of restorations” as an indicator of increased risk, need, or both showing an inverse association with radiograph use. Conclusions Child age and provider type had an effect on number of radiographs obtained per visit. Lack of caries diagnostic codes and uncommon use of risk codes hindered interpretation of whether use, frequency, or both is associated with need. Practical Implications Radiograph use should follow existing guidelines or recommendations based on clinical need.
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    Primary Caregiver Retention and Perceptions of Retention Strategies in a 36-Month Prospective Childhood Caries Study
    (Sage, 2022) Daly, Jeanette M.; Xu, Yinghui; Yanca, Emily; Levy, Steven M.; Levy, Barcey T.; Talbert, Jennifer; Tran, Jennifer L.; Keels, Martha Ann; Fontana, Margherita; Biomedical and Applied Sciences, School of Dentistry
    Introduction/objectives: This paper reports on participant retention from an ongoing prospective, multi-site cohort caries risk study involving parent/infant pairs. The objectives were to: (1) compare the retention rates at each intermediate contact (every 4 months) and dental visit (every 18 months) across the 3 clinical sites, (2) assess primary caregivers' perceptions at the end of the study about the retention efforts used in this longitudinal study, and (3) determine whether primary caregiver baseline demographic characteristics and child's baseline caries experience were associated with retention. Methods: 1325 primary caregiver-child pairs recruited at the child's first birthday were followed for 36 months at 3 sites. Dental visits occurred at children's ages of approximately 12, 30, and 48 months. Telephone/email intermediate contacts with the primary caregiver occurred 6 times between dental visits. The outcome variable was the retention rates at each dental visit and each intermediate contact. Primary caregivers' perceptions of intermediate contacts were evaluated. Retention rates were compared by maternal age, race, ethnicity, Medicaid status, yearly household income, baseline caries experience (defined as decayed, missing due to caries, or filled tooth surfaces) at 12 months, and the number of teeth erupted. Results: 1325 primary caregiver/infant pairs were enrolled and completed the first in-person dental visit, 1062 pairs (80%) completed the second visit and 985 (74%) completed the third. Most primary caregivers were female (94%), with a mean age of 29 years and 667 (50%) self-identified as White, 544 (41%) as Black, and 146 (11%) as Hispanic. The percentages of successful intermediate contacts were 95% at 4 months decreasing to 82% at 34 months. Almost all 964 (98%) of 985 primary caregivers reported at the last visit that they were comfortable/very comfortable with 4-month intermediate contacts. The multivariable analysis showed that primary caregivers who were older (OR = 1.07; 95% CI, 1.04-1.09) and White (OR = 1.52; 95% CI, 1.12-2.06) were more likely to complete the study. Conclusions: Retention strategies were focused on frequent routine contact and increasing monetary incentives. Those strategies may have resulted in retention exceeding the proposed goals. At the end of the study, primary caregivers were comfortable with the 4-month intermediate contacts.
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    Stainless Steel Crown Success Using the Hall Technique: A Retrospective Study
    (Elsevier, 2014-12) Ludwig, Kevin; Fontana, Margherita; Vinson, LaQuia; Platt, Jeffrey; Dean, Jeffrey; Department of Pediatric Dentistry, IU School of Dentistry
    Background In this retrospective study, the authors evaluated the clinical and radiographic success of stainless steel crowns (SSCs) used to restore primary molars with caries lesions, placed by means of both the traditional technique (involving complete caries removal and tooth reduction before placement of the SSC) and the Hall technique (involving no caries removal, no crown preparation and no use of local anesthetic before placement of the SSC). Methods The authors conducted a retrospective chart review by using the patient records at a private pediatric dental practice at which the Hall technique had been introduced in June 2010 as an alternative treatment to traditional SSC placement. The inclusion criteria were caries lesions on a primary molar with no clinical or radiographic evidence of pulpitis, necrosis or abscess, as well as follow-up of at least six months or until failure, whichever came first. They graded restoration success by using a four-point scale based on presence or loss of the SSC, and whether or not the patient needed further treatment associated with pulpal pathology or secondary caries. They collected and summarized patient demographic information. They used a Kaplan-Meier survival curve along with 95 percent confidence intervals to evaluate clinical success. Results The authors found that 65 (97 percent) of 67 SSCs placed with the Hall technique (mean observation time, 15 months; range, four-37 months) and 110 (94 percent) of 117 SSCs placed with the traditional technique (mean observation time, 53 months; range, four-119 months) were successful. Conclusion Findings of this study show a similar success rate for SSCs placed with the traditional technique or the Hall technique.
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    Tooth Eruption and Early Childhood Caries – A Multi-site Longitudinal Study
    (American Academy of Pediatric Dentistry, 2021) Warren, John J.; Levy, Steven M.; Xu, Yinghui; Daly, Jeanette M.; Eckert, George J.; Clements, Dennis; Hara, Anderson T.; Jackson, Richard; Katz, Barry P.; Keels, Martha Ann; Levy, Barcey T.; Fontana, Margherita; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    Objectives: This study assessed the relationship between the number of teeth present at 12 months and dmfs at 30 and 48 months. Methods: Data are from a longitudinal, multi-site study with clinical dental examinations conducted at 12, 30 and 48 months of age. Spearman correlation, and chi-square tests assessed relationships between teeth present at 12 months and decayed, missing or filled surfaces (dmfs) at 30 (n=1,062) and 48 months (n=985). Results: Spearman correlations were weak but significant for both 30- and 48-month time points (R= 0.066; p=0.032, R= 0.093; p=0.004, respectively). Mantel-Haenszel chi-square analyses of categories of teeth present at 12 months (0, 1–4, 5–8, and 9+) and categories of dmfs at 30 and 48 months (0, 1–2, 3–5, 6–15 and 16+), revealed non-significant (p=0.326) relationship with 30-month dmfs, but a significant (p=0.013) relationship with 48-month dmfs. Conclusion: Results suggest that early tooth eruption is weakly associated with occurrence of early childhood caries.