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Na, Park, Ju, Kim, and Lee: Caries prediction using the caries activity test with a sulfisomidine mixture: a 3-year follow-up study
Original Article

J Korean Acad Oral Health 2016;40(3):183-189.

Published online: 15 September 2016

DOI: https://doi.org/10.11149/jkaoh.2016.40.3.183

Caries prediction using the caries activity test with a sulfisomidine mixture: a 3-year follow-up study

Ja-Young Na1, Sun-Wha Park1, Hyun-Jeong Ju1, In-Ja Kim1, Heung-Soo Lee1, 2,

1Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, Iksan, Korea

2Institute of Wonkwang Dental Research, Wonkwang University, Iksan, Korea

Corresponding Author: Heung-Soo Lee Department of Preventive and Public Health Dentistry, College of Dentistry, Wonkwang University, 460 Iksan-daero, Iksan 54538, Korea Tel: +82-63-850-6851 Fax: +82-63-850-6851 E-mail: smagn@wonkwang.ac.kr

Received 16 August 2016       Revised 8 September 2016       Accepted 12 September 2016

Copyright © 2016 by Journal of Korean Academy of Oral Health

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to evaluate the prediction validity of the caries activity test with a sulfisomidine mixture (SAHS test).

Methods

This longitudinal follow-up study was conducted for 3 years. The subjects were 155 elementary schoolchildren. Oral examination was performed by examining each tooth surface of the subjects. The number of teeth with new caries lesions was calculated by comparing between the baseline data of the initial oral examination and the results of the second oral examination performed after 3 years. The Dentocult SM test was used as the reference in the analysis of the caries prediction validity of the SAHS test. The items of the validity test for carries prediction were as follows: sensitivity, specificity, predictive value, and likelihood ratio

Results

The correlation between new caries lesions and the SAHS test scores was greater than that between new caries lesions and the Dentocult SM test scores. The receiver-operating analysis revealed that the area under the curve of the SAHS test was higher than that of the Dentocult SM test. The caries prediction validity of the SAHS test (grade 12) was as follows: sensitivity, 0.71-0.70; specificity, 0.60-0.58; positive predictive value, 0.79-0.78; negative predictive value, 0.49 (screening criterion 5). The SAHS test scores were similar to or higher than the scores in the items of the Dentocult SM test.

Conclusions

The SAHS test is considered useful for clinical applications.

Keywords: Children, Dental caries, Dental caries activity tests, Prediction, ROC curve

References

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Fig. 1.
ROC curve by Dentocult SM test and Sulfisomidine test (grade 12, 4).
jkaoh-40-183f1.tif
Table 1.
Correlations between dental caries experience and caries activity test score
Caries activity test DdS DdMFfS NDdMFfS
Sulfisomidine-A grade 12 0.325** 0.189* 0.250**
Sulfisomidine-B grade 12 0.323** 0.181* 0.238**
Sulfisomidine-A grade 4 0.314** 0.201* 0.260**
Sulfisomidine-B grade 4 0.321** 0.194* 0.253**
Dentocult SM A 0.284** 0.268** 0.203*
Dentocult SM B 0.282** 0.263** 0.201*

*P<0.05, **P<0.01.

† A, B: examiner.

Table 2.
ROC analysis
Screening criterion Examiner AUC Approximate 95% confidence interval
High Low
Sulfisomidine-grade 12 A 0.654 0.745 0.564
B 0.656 0.746 0.565
Sulfisomidine-grade 4 A 0.643 0.735 0.551
B 0.629 0.720 0.537
Dentocult SM A 0.621 0.717 0.526
B 0.626 0.722 0.530
Table 3.
The validity of Sulfisomidine containing with acidic high sucrose liquid medium test (grade 12)
Screening criterion Sensitivity Specificity Sensitivity + Specificity Hit rate Positive predictive value Negative predictive value Positive likelihood ratio Negative likelihood ratio
Examiner-A
1 0.98 0.08 1.06 0.69 0.69 0.67 1.07 4.00
2 0.94 0.08 1.02 0.66 0.68 0.40 1.02 1.33
3 0.88 0.12 1.00 0.63 0.68 0.32 1.00 1.00
4 0.81 0.38 1.19 0.67 0.73 0.49 1.31 2.00
5 0.71 0.58 1.29 0.67 0.78 0.49 1.69 2.00
6 0.49 0.72 1.21 0.56 0.78 0.40 1.75 1.41
7 0.40 0.78 1.18 0.52 0.79 0.38 1.82 1.30
8 0.32 0.88 1.20 0.50 0.85 0.38 2.67 1.29
9 0.18 0.94 1.12 0.43 0.86 0.35 3.00 1.15
10 0.05 0.98 1.03 0.35 0.83 0.33 2.50 1.03
Examiner-B
1 0.95 0.08 1.03 0.67 0.68 0.44 1.03 1.60
2 0.94 0.10 1.04 0.67 0.69 0.45 1.04 1.67
3 0.87 0.20 1.07 0.65 0.69 0.42 1.09 1.54
4 0.81 0.32 1.13 0.65 0.71 0.44 1.19 1.68
5 0.70 0.60 1.30 0.67 0.79 0.49 1.75 2.00
6 0.49 0.72 1.21 0.56 0.78 0.40 1.75 1.41
7 0.41 0.80 1.21 0.54 0.81 0.39 2.05 1.36
8 0.32 0.88 1.20 0.50 0.85 0.38 2.67 1.09
9 0.19 0.94 1.13 0.43 0.87 0.36 3.17 1.16
10 0.06 0.96 1.02 0.35 0.75 0.33 1.50 1.02
Table 4.
Comparison of caries prediction validity by Dentocult SM test and Sulfisomidine containing with acidic high sucrose liquid medium test (grade 4)
Screening criterion Sensitivity Specificity Sensitivity + Specificity Hit rate Positive predictive value Negative predictive value Positive likelihood ratio Negative likelihood ratio
Sulfisomidine-A
1 0.81 0.38 1.19 0.67 0.73 0.49 1.31 2.00
2 0.49 0.72 1.21 0.56 0.78 0.40 1.75 1.41
3 0.18 0.94 1.12 0.43 0.86 0.35 3.00 1.15
Dentocult SM-A
1 0.68 0.56 1.24 0.64 0.76 0.45 1.55 1.75
2 0.47 0.72 1.19 0.55 0.78 0.39 1.68 1.36
3 0.20 0.86 1.06 0.41 0.75 0.34 1.43 1.08
Sulfisomidine-B
1 0.81 0.32 1.13 0.65 0.71 0.44 1.19 1.68
2 0.49 0.72 1.21 0.56 0.78 0.40 1.75 1.41
3 0.19 0.94 1.13 0.43 0.87 0.36 3.17 1.16
Dentocult SM-B
1 0.71 0.52 1.23 0.65 0.76 0.46 1.84 1.79
2 0.48 0.72 1.20 0.55 0.78 0.40 1.71 1.38
3 0.20 0.86 1.06 0.41 0.75 0.34 1.43 1.08

*A, B: examiner.

Table 5.
The new caries lesions by caries activity test score N=155
Score Sulfisomidine-A grade 4
 Sulfisomidine-B grade 4
 Dentocult SM A
 Dentocult SM B
N (%) M±SD N (%) M±SD N (%) M±SD N (%) M±SD
0 39 (25.2) 1.82±2.64 36 (23.2) 2.00±2.69 62 (40.0) 1.97±2.75 56 (36.1) 2.05±2.86
1 51 (32.9) 2.63±2.77 54 (34.8) 2.41±2.72 30 (19.4) 3.10±3.03 35 (22.6) 2.71±2.84
2 43 (27.7) 3.30±3.34 42 (27.1) 3.33±3.40 35 (22.6) 3.94±3.27 36 (23.2) 3.83±3.08
3 22 (14.2) 4.27±3.19 23 (14.8) 4.30±3.13 28 (18.1) 3.14±3.01 28 (18.1) 3.32±3.31

*A, B: examiner.

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