TODENTJ-25-03-2019_TODENTJ-4-124 1553505176 Bentham Open doi@benthamopen.net Bentham Open The Open Dentistry Journal TODENTJ 1874-2106 7 16 2010 4 1 Bauer JG Spackman S Dong J Garrett N Compared to younger adults, older adults are at greater risk for root caries. A model of root caries may assist dentists in predicting disease outcomes. OBJECTIVES: Using the Iowa 65+ Oral Health Survey, analysis was done to model the patterns of the root caries development in older adults. Methods: The statistical analysis included Markov chain modeling, model estimation and validation. Results: The model effectively predicts root caries using an 18-month predictive cycle and is validated up to 36 months (two cycles), with no significant differences (Chi-square test p-values >0.1) between predicted and observed distributions. However, we do not have observed data for validation beyond 36 months since the model was designed to perform only at single or multiple 18-month cycles. As expected, the predicted distribution at 54-month (3 cycles) and the observed distribution at 60-month differed significantly (p<0.0001). Conclusions: The model demonstrated a high probability that a sound surface will remain caries free. However, one and multiple-surface lesions aggressively infect adjoining surfaces. Maturing of the carious lesion occurs with the 4-surface lesion, decreasing the probability of tooth loss. Thus, maintaining a sound root surface and early treatment intervention reduces the risk of tooth dysfunction (morphological destruction) and loss. DATABASE FILTERS: P: Tooth/Subject characteristics-Older adults, 65 years of age or more, male and female participants, regional rural Iowa residents, race unspecified, functional status-non-institutionalized level unspecified, risk level unspecified I: Root caries P (C-not applicable): Probability/Statistical significance for decision data only/Clinical significance-dataset over 20 years old/Utility data not included/Cost data not included/Meaning in practice undetermined. O: Each year through a three year cycle, caries progression from a sound root surface A: Data attached: ■ Published manuscript □ Unpublished manuscript □ Raw data R: Primary author contact information present 7 16 2010 124 132 TODENTJ-4-124 1 10.2174/crossmark_policy opendentistryjournal.com benthamopen.com true Peer Reviewed Single blind Checked with iThenticate 2009-9-9 2009-10-14 2009-10-14 2010-7-16 http://creativecommons.org/licenses/by-nc/3.0/ 10.2174/1874210601004010124 1553505176 https://opendentistryjournal.com/VOLUME/4/PAGE/124/ https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.pdf https://opendentistryjournal.com/contents/volumes/V4/TODENTJ-4-124/TODENTJ-4-124.xml J Dent Educ White BA 59 19 1995 White BA, Caplan DJ, Weintraub JA. A quarter century of changes in oral health in the United States J Dent Educ 1995; 59 (1) : 19-57. J Dent Educ Woolfolk MW 57 346 1993 Woolfolk MW. The social responsibility model J Dent Educ 1993; 57 (5) : 346-9. J Dent Educ Bauer JG 52 622 1988 Bauer JG, Cretin S, Schweitzer SO, Hunt RJ. The reliability of diagnosing root caries using oral examinations J Dent Educ 1988; 52 : 622-9. Roberson TM, Lundeen TF. Chapter 3. Cariology: the lesion, etiology, prevention, and control In: Roberson TM, Heymann HO, Swift EJ, Eds. sturdevant’s art & science of operative dentistry. 4th. St. Louis: Mosby 2002; pp. 63-132. PlanetOrg.com. Markov Chain [article online] available from: http://planetmath.org/encyclopedia/MarkovChain.html [cited 2006 Jan 28]; J Am Dent Assoc Beck JD 111 962 1985 Beck JD, Hunt RJ, Hand JS, Field HM. Prevalence of root and coronal caries in a noninstitutionalized older population J Am Dent Assoc 1985; 111 : 962-7. Ann Math Stat Anderson TW 28 89 1957 Anderson TW, Goodman LA. Statistical inference about markov chains Ann Math Stat 1957; 28 : 89-110. Aharonov D. Markov chains in theoretical computer science [article online] Available from: http://www.cs.huji.ac.il/~doria/markovchains.huji2002.html 2002 [cited 2006 Jan 28]; Kendall W, Liang F, Wang JS. Markov chain monte carlo: innovations and applications in statistics, physics, and bioinformatics institute for mathematical scinces, National University of Singapore, 2004, [article online] available from: http://www.ims.nus.edu.sg/Programs/mcmc [cited 2006 Jan 28]; Chapter III. The Markov chain process [article online] available from: http://classes.ses.wsu.edu/460/ClassMaterials/MarkovProcessDoc.pdf [cited 2006 Jan 28]; Comm Dent Health Helfenstein U 19 152 2002 Helfenstein U, Menghini G, Steiner M, Murati F. An example of complex modeling in dentistry using Markov chain Monte Carlo (MCMC) simulation Comm Dent Health 2002; 19 (3) : 152-60. Comm Dent Health Helfenstein U 16 220 1999 Helfenstein U, Steiner M, Menghini G. An outline of graphical Markov models in dentistry Comm Dent Health 1999; 16 (4) : 220-6. Comm Dent Health Kay EJ 10 217 1993 Kay EJ, Nuttal NM. An example of the application of Markov models in dentistry: a prediction of the fate of molar teeth in 12-year-old Scottish children Comm Dent Health 1993; 10 (3) : 217-3. Comm Dent Oral Epidemiol Koycka-Kedzierawski DT 32 123 2006 Koycka-Kedzierawski DT, Billlings RJ. Application of nonhomogenous Markov models for analyzing longitudinal caries risk Comm Dent Oral Epidemiol 2006; 32 (2) : 123-9. Hill T, Lewicki P, Eds. Statistics: methods and applications: a comprehensive reference for science, industry, and data mining. 1st. Tulsa: StatSoft 2006; 41-57: pp. 81-348. J Am Dent Assoc Greenstein G 134 583 2003 Greenstein G. Clinical versus statistical significance as they relate to efficacy of periodontal therapy J Am Dent Assoc 2003; 134 (5) : 583-91.