| 1. |
- Hellén-Halme, Kristina, et al.
(författare)
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Influence of education level and experience on detection of approximal caries in digital dental radiographs. An in vitro study
- 2010
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Ingår i: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 34:2, s. 63-69
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated whether variations in education level and experience among dental staff influence the diagnostic accuracy of carious lesions on digital radiographs. Three student groups and a fourth group of general practitioners (Dentists) with more than five years of clinical experience participated in this study.The student groups were (i) dental students in their final (tenth) semester (DS-10), (ii) dental students in the sixth semester (DS-6) who just finished dental radiology training, and (iii) dental hygiene students (DHS) in their final (fourth) semester. Seven observers from each group participated. Standard radiographs of 100 extracted teeth (premolars and molars) were taken. The 28 observers evaluated the images for approximal carious lesions on a standard monitor. All evaluations were made in ambient light below 50 lux. Receiver operating characteristic curves were plotted to assess results. The standard criterion for healthy or carious lesions was a histological examination of sliced teeth. Kappa statistics evaluated intra-observer agreement. For carious lesions that had extended into the dentine, significant differences were found between (i) Dentists and all other groups, (ii) Dentists and DS-10 (p < 0.01), and (iii) Dentists and DS-6 and DHS (p < 0.001). Differences between DS-10 and DHS (p < or = 0.05) were also significant. In this study, education level and experience clearly influenced the diagnostic accuracy of approximal carious lesions that had extended into the dentine on digital radiographs.
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| 2. |
- Hänsel Petersson, Gunnel, et al.
(författare)
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Caries risk assessment in schoolchildren using a reduced Cariogram model
- 2010
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Ingår i: BMC Oral Health. - : Springer Science and Business Media LLC. - 1472-6831 .- 1472-6831. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To investigate the caries predictive ability of a reduced Cariogram model without salivary tests in schoolchildren. METHODS: The study group consisted of 392 school children, 10-11 years of age, who volunteered after informed consent. A caries risk assessment was made at baseline with aid of the computer-based Cariogram model and expressed as "the chance of avoiding caries" and the children were divided into five risk groups. The caries increment (DeltaDMFS) was extracted from the dental records and bitewing radiographs after 2 years. The reduced Cariogram was processed by omitting the variables "salivary mutans streptococci", "secretion rate" and "buffer capacity" one by one and finally all three. Differences between the total and reduced models were expressed as area under the ROC-curve. RESULTS: The baseline caries prevalence in the study population was 40% (mean DMFS 0.87 +/- 1.35) and the mean 2-year caries increment was 0.51 +/- 1.06. Both Cariogram models displayed a statistically relationship with caries development (p < 0.05); more caries was found among those assessed with high risk compared to those with low risk. The combined sensitivity and specificity decreased after exclusion of the salivary tests and a statistically significant reduction of the area under the ROC-curve was displayed compared with the total Cariogram (p < 0.05). Among the salivary variables, omission of the mutans streptococci enumeration impaired the predictive ability the most. CONCLUSIONS: The accuracy of caries prediction in school children was significantly impaired when the Cariogram model was applied without enumeration of salivary tests.
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| 3. |
- Hänsel Petersson, Gunnel, et al.
(författare)
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Caries risk assessment in young adults: A 3-year validation of clinical guidelines used in Public Dental Service
- 2013
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 1502-3850 .- 0001-6357. ; 71:6, s. 1645-1650
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To validate a risk classification model according to the Public Dental Service (PDS) guidelines with the actual 3-year caries outcome in terms of predictive values. Materials and methods. All 19-year-old patients registered at eight public dental clinics in Skane, Sweden were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects, representing 10% of the age group attending the public dental care in the region. A risk classification of each patient in four categories was made by the patient's regular team according to the guidelines. At the follow-up 3 years later, 75.8% were accessible. The final examinations included bitewing radiographs and the actual caries increment for 982 patients was calculated. Results. At baseline, 11.9% were assessed as being at 'high' or 'very high' risk. The dropouts had significantly more caries than the remaining patients (p < 0.05). The general disease activity was low, but those grouped into the two highest risk groups displayed significantly more new caries than those at lower risk (p < 0.05). With a cutoff value DDFS > 0 vs DFS = 0, the sensitivity was 81% and the specificity 56% for 'low' risk vs any risk. By combining the 'low' and 'some' risk categories, the PDS model generated an improved specificity (94%). Conclusions. The risk assessment scheme used by the Public Dental Service for young adults relied basically on past and current caries activity and 65-70% of the patients were correctly classified. The model was most effective to screen out patients with low caries risk.
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| 4. |
- Hänsel Petersson, Gunnel, et al.
(författare)
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Caries risk assessment in young adults using Public Dental Service guidelines and the Cariogram-a comparative study
- 2012
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Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 71:3-4, s. 534-540
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objectives. To investigate the caries risk profiles in young adults and to compare the risk classification using the Public Dental Service (PDS) guidelines with a risk assessment program, the Cariogram. Materials and methods. All 19-year-old patients registered at eight public dental clinics were invited to participate (n = 1699). The study group who completed the baseline examination consisted of 1295 subjects representing 10% of all 19 year-olds attending dental care at the PDS in Skåne, Sweden. A risk classification of each patient was made by the patient's regular team according to the PDS guidelines. A research team collected whole saliva samples and information from a questionnaire and a structured interview in order to calculate risk according to the Cariogram model. Results. The mean DFS value was 4.9 and 23% of the patients were registered as caries-free (DFS = 0). The PDS risk classification was predominantly based on past caries and/or present caries activity. The majority was classified as 'some risk', while 16.7% were assessed as being of 'high' or 'very high risk'. The corresponding value for the two highest risk groups in the Cariogram model was 17.4%. The agreement between the two models was found acceptable (77.5%) for those assessed as low risk, while discrepancies were disclosed among those classified with higher risks. Conclusions. Although the proportion of subjects assessed with high or very high risk was similar using the PDS guidelines and the Cariogram model, the agreement between the models was fair. An acceptable agreement was only disclosed for the low risk category.
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| 5. |
- Hänsel Petersson, Gunnel, et al.
(författare)
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Caries risk profiles in schoolchildren over 2 years assessed by Cariogram
- 2010
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Ingår i: International Journal of Paediatric Dentistry. - 0960-7439 .- 1365-263X. ; 20:5, s. 341-346
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Tidskriftsartikel (refereegranskat)abstract
- Background. Caries risk assessment is an important tool in clinical decision making. Aim. To evaluate longitudinal changes in caries risk profiles in a group of schoolchildren in relation to caries development. Design. The Cariogram model was used to create caries risk profiles and to identify risk factors in 438 children being 10-11 years at baseline. The assessment was repeated after 2 years and the caries increment was recorded. The frequency of unfavourable risk factors were compared between those considered at the lowest and the highest risk. Results. Fifty percent of the children remained in the same risk category after 2 years. One third of the children were assessed in a higher-risk category while 18.4% showed a lower risk. Those with increased risk compared with baseline developed significantly more caries than those with an unchanged risk category. The most frequent unfavourable risk factors among those with high risk at baseline were high-salivary mutans streptococci and lactobacilli counts as well as frequent meals. Conclusion. Half of the children showed a changed risk category after 2 years, for better or for worse, which suggests that regular risk assessments are needed in order to make appropriate decisions on targeted preventive care and recall intervals.
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