Caries risk assessment at children during the dentomaxillary anomalies correction period

Abstract

Introduction. The basic concept of individualized prophylaxis is the recognition of high risk patients and the adjustment of individual behavioral risk factors by establishing an effective preventive treatment. For the constructive prevention of dental caries in children during the correction period of dento-maxillary anomalies (DMA), the complex study of individual cariogenic risk factors is currently progressing. Aim of the study. Assessment of the dental caries occurrence risk in children during the correction of tooth-maxillary anomalies, using the Cariogram software. Materials and methods.. The case-control study was performed on 56 children of different age (between 12 and 18 years). The research group 1 included 14 children with undergoing orthodontic treatment, particularly with a fixed system. Group 2 - 14 children undergoing orthodontic treatment with mobile devices and the control group 3 - 14 children with DMA at the planning stage of orthodontic treatment. To determine the morbidity degree through dental caries, the frequency index of dental caries and the COA index have been estimated. For the assessment of oral hygiene, the OPI index (Orthodontic Plaque Index, Heintze et al., 1998) has been approximated. The risk of tooth decay has been evaluated using the Cariogram software. The study complied with ethical requirements, therefore requesting the written consent of the parents or the legal representative of the children. Epi Info software was applied to analyze the statistical data. Results. For most children during the DMA correction period, the simultan action of several caries risk factors was identified, the most essential being: poor oral hygiene, Mutans Streptococcus concentration > 5x105 UFC/ml of saliva and reduced self-cleaning capacity. The average frequency of very high caries risk in children with DMA was 5.0 times higher compared to children in the control group. The probability of avoiding the appearance of new cavities in children with fixed orthodontic appliances was 29.21 ± 7.44%, as opposed to 74.22 ± 8.17% estimated in the subjects within the control group. Conclusions. For children during DMA correction the chances of avoiding the appearance of new cavities are 2.12 times lower, as opposed to conventionally healthy children, which reflects the increased susceptibility to dental caries. Thus, the study demonstrated the importance of individualized prediction of dental caries in children for the selection of preventive measures targeted on identified cariogenic factors.