Journal List > J Korean Acad Oral Health > v.38(3) > 1057601

Park, Lee, and Lee: Validity of caries prediction by caries activity tests using sulfisomidine-containing acidic high sucrose liquid medium

Abstract

Objectives

The purpose of this study was to evaluate the caries prediction validity and between-observer reliability of caries activity tests using sulfisomidine-containing acidic high sucrose liquid medium (SAHS test).

Methods

This longitudinal follow-up study was done for 1 year. The subjects were 188 elementary school children. The caries experience and caries activity of each of the subjects was examined. We adopted both the SAHS test and Dentocult SM test as caries activity tests. We conducted an ROC analysis on the test data, and thereafter calculated the sensitivity, specificity, predictive value, and Kappa statistics.

Results

According to the ROC analysis, it was found that both the SAHS test and Dentocult SM test showed a similar level of AUC (0.5 or higher), which means that both tests have significant caries prediction validity. When the validating criterion was based on 1 or more new caries lesions and the screening criterion was based on a score of 5, it was found that the SAHS test (12 grade) showed a sensitivity value of 0.72-0.73, specificity value of 0.48-0.51, positive predictive value of 0.62-0.63, and negative predictive value of 0.61-0.62, respectively. Based on these 4 values, it was found that the SAHS test had a higher grade of sensitivity and negative predictive value than the Dentocult SM test. However, the latter had a higher grade of specificity and positive predictive value. Despite this, there were no significant differences between both tests. The SAHS test had higher between-observer reliability (kappa value) than the Dentocult SM test (0.90>0.88).

Conclusions

In this study, it was found that both the SAHS test and Dentocult SM test had a similar level of caries prediction validity and between-observer reliability.

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Fig. 1.
ROC curve of test by sulfisomidine containing with acidic high-sucrose liquid medium (12 grade).
jkaoh-38-138f1.tif
Fig. 2.
ROC curve of test by sulfisomidine containing with acidic high-sucrose liquid medium (4 grade).
jkaoh-38-138f2.tif
Fig. 3.
ROC curve of Dentocult SM test.
jkaoh-38-138f3.tif
Table 1.
Correlations between dental caries experience and caries activity test (base line)
Caries activity test Dd of occlusal surface Dd of smooth surface DdS DdMFfS
sulfi-A 12 grade .314** .385** .379** .358**
sulfi-B 12 grade .314** .380** .376** .338**
sulfi-A 4 grade .323** .400** .392** .367**
sulfi-B 4 grade .323** .394** .389** .341**
Dentocult SM A .278** .326** .327** .353**
Dentocult SM B .250** .291** .293** .335**

**P<0.01 (Pearson correlation coefficient). D (d), Decay; M, Missing; F (f), Filled; S, Surface. sulfi, sulfisomidine containing acidic high sucrose liquid medium; A, B, examiner.

Table 2.
Correlations between dental caries experience and caries activity test (after 1 year)
Caries activity test Dd of occlusal surface Dd of smooth surface DdS DdMFfS
sulfi-A 12 grade .243** .306** .300** .232**
sulfi-B 12 grade .230** .295** .287** .214**
sulfi-A 4 grade .252* .293** .300** .218**
sulfi-B 4 grade .242** .282** .289** .201**
Dentocult SM A .246** .216** .260** .228**
Dentocult SM B .253** .214** .263** .238**

**P<0.01 (Pearson correlation coefficient). D (d), Decay; M, Missing; F (f), Filled; S, Surface. sulfi, sulfisomidine containing acidic high sucrose liquid medium; A, B, examiner.

Table 3.
Correlations between new dental caries lesion and caries activity test result
Caries activity test NDdFf of occlusal surface NDdFf of smooth surface NDdMFfS
sulfi-A 12 grade .160* .196* .231**
sulfi-B 12 grade .163* .173* .219**
sulfi-A 4 grade .136 .205** .224**
sulfi-B 4 grade .137 .189* .212**
Dentocult SM A .117 .092 .127
Dentocult SM B .143 .096 .145

**P<0.01, *P<0.05 (Pearson correlation coefficient). D (d), Decay; M, Missing; F (f), Filled, S: Surface. sulfi, sulfisomidine containing acidic high sucrose liquid medium; A, B, examiner.

Table 4.
ROC analysis
Screening criterion Examiner AUC Approximate 95% confidence interval
High Low
sulfi-12 grade A .633 .717 .549
sulfi-4 grade B .634 .718 .550
A .623 .707 .538
Dentocult SM B .622 .706 .538
A .634 .719 .549
B .634 .719 .549
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