Effectiveness of the ICCMS caries management system for children: a 3-year multicentre randomised controlled trial

• Published in: Acta odontologica Scandinavica Vol. 80; no. 7; pp. 501 - 512
• Main Authors: Martignon, Stefania, Cortes, Andrea, Gamboa, Luis Fernando, Jácome-Liévano, Sofia, Arango-De-la-Cruz, Maria Cristina, Cifuentes-Aguirre, Olga Lucia, Fortich-Mesa, Natalia, Ramos-Martínez, Ketty, Sanjuán-Acero, Johanna, Alfaro, Lizelia, Mejía, Lofthy, Usuga-Vacca, Margarita
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.10.2022
• Subjects: children; comprehensive dental care; conservative care; Dental caries; guideline; randomised controlled trial; conservative care; Dental caries; randomised controlled trial; children; comprehensive dental care; guideline
• ISSN: 0001-6357; 1502-3850
• DOI: 10.1080/00016357.2022.2038263

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. 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. 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). Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.