289

Comparison between indexes for diagnosis and guidance for

treatment of dental caries

Noemi E. Bordoni1,2, Pablo A. Salgado1,2, Aldo F. Squassi1,2

1.Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria,
Buenos Aires, Argentina
2.Universidad de Buenos Aires, Facultad de Odontología, Instituto de Investigaciones en Salud Pública, Buenos
Aires, Argentina

ABSTRACT
The objective of this study was to establish the correlation Results revealed that in the group of 3-year-old children, a
between an index for caries treatment needs and an index for significant correlation was observed in G1 (rho = -0.822);
caries lesions detection and evaluation. A cross-sectional G2 (rho = 0.330); G3 (rho = 0.509) and G4 (rho = 0.710)
study was performed on three samples of children aged 3 (n = between both indexes. For the group of 5-year-old children, a
302), 5 (n = 183), and 11-14 years old (n = 60), attending significant correlation was observed in G1 (rho = -0.821); G2
early childhood centers and schools in the cities of (rho = 0.260); G3 (rho = 0.344) and G4 (rho = 0.840). In the
Avellaneda, Rio Grande, and Buenos Aires. Dental caries group of children 11-14 years of age, a significant correlation
treatment needs were estimated on every child through the was observed in G1 (rho = -0.692); G3 (rho = 0.437) and G4
Caries Treatment Needs Index (CTNI) for programming (rho = 0.764). The indices analyzed in this study (CTNI and
resources allocation. Also, a diagnosis of dental caries was ICDAS II) show reasonable equivalence for use in clinical
made according to ICDAS II criteria. After the diagnostic and epidemiological studies based on the statistical analysis.
procedures, a dental care program was developed. The ICDAS Received: November 2021; Accepted: December 2021.
II variable was operationalized by grouping the codes into
four categories: G1: code 0; G2: code 1-2; G3: code 3; G4: Keywords: dental caries - epidemiology - Argentina - children
code 4-5-6. Measures of central tendency and dispersion were - validation study.
calculated for both variables, and the correlation was
calculated using the Spearman coefficient.

Comparación entre índices para el diagnóstico y orientación del tratamiento de

caries dental

RESUMEN
El objetivo de este estudio fue establecer la correlación entre
ambas variables y la correlación se calculó mediante el
un índice de necesidad de tratamiento de caries y un índice
coefici- ente de Spearman. Los resultados revelaron que en el
para la detección y evaluación de lesiones de caries. Se
grupo de niños de 3 años se observó una correlación
realizó un estudio de corte transversal en tres muestras de
significativa en G1 (rho = -0,822); G2 (rho = 0,330); G3 (rho
niños de 3 años (n = 302), 5 años (n = 183) y 11-14 años (n =
= 0,509) y G4 (rho
60), que asistían a centros y escuelas de primera infancia en
= 0,710) entre ambos índices. Para el grupo de niños de 5
las ciudades de Avel- laneda, Rio Grande y Buenos Aires. Las
años se observó una correlación significativa en G1 (rho = -
necesidades de trata- miento de caries dentales se estimaron
0,821); G2 (rho = 0,260); G3 (rho = 0,344) y G4 (rho =
en cada niño a través del Índice de Necesidad de Tratamiento
0,840). En
de Caries (INTC) para la asignación de recursos de
el grupo de niños de 11 a 14 años se observó una correlación
programación. Además, se realizó un diagnóstico de caries
significativa en G1 (rho = -0,692); G3 (rho = 0,437) y G4
dental según los criterios de la ICDAS
(rho
II. Después de los procedimientos de diagnóstico, se
= 0,764). Los índices analizados en este estudio (INTC e IC-
desarrolló un programa de atención odontológica. La variable
DAS II) muestran una equivalencia razonable para su uso en
ICDAS II se operacionalizó agrupando los códigos en cuatro
estudios clínicos y epidemiológicos, basado en el análisis es-
categorías: G1: código 0; G2: código 1-2; G3: código 3; G4:
tadístico realizado.
código 4-5-6. Se calcularon medidas de tendencia central y
dispersión para
Palabras clave: caries dental - epidemiología - Argentina -
niños - estudio de validación.

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 2 Noemi E. Bordoni , et

INTRODUCTION
Health is interpreted as the outcome of factors been identified, the assessment can be established.
related to ways of life, lifestyles and quality of life, Pitts et al.12-14 and Ekstrand et al.15,16 developed
and recognizes the involvement of the following the International Caries Detection and Assessment
variables: (a) the oral and dental healthcare models System (ICDAS II) – a system for caries detection
in different countries as a result of the and assessment that integrates three dimensions
characteristics of their respective healthcare based on the lesion development process, which
systems and (b) the characteristics of knowledge synthesizes substantial evidence for making
management implemented at graduate and political, sanitary and clinical decisions.
postgraduate levels of healthcare studies1-3. In 1993, the Caries Treatment Needs Index (CTNI)
Dental caries is the outcome of complex interaction (Fig. 1) was designed and applied. The CTNI is
over time between acid-producing bacteria, based on the interaction of two axes: one based on
fermentable carbohydrates, and the host’s internal the lesion’s progression and the other based on the
and external factors. The risk of developing caries technological resources needed to control the risk
includes physical, biological, socio-environmental, of dental caries17-18. The progression axis identifies
and behavioral characteristics and factors related the magnitude of severity and extent. The
to living conditions and lifestyle. The micro- component referring to the magnitude of severity
circumstances for caries development include identifies the process of tissue compromise of the
different microorganisms, incompetent salivary dental caries lesion, going from a clinical
flow, insufficient exposure to fluoride, and threshold recognized as white spot19, which is
chemically propitious nutrition variables. The distinct from the white spot caused by
outcome of these processes causes a progressive hypomineralization to subsequent progression in
net loss of minerals in dental tissues, enabling cavitation, including dental tissues. The magnitude
caries lesions to develop4. The initial caries lesion of extent in the “mouth unit” is expressed by the
is intended to maintain or recover the health of the number of mouth quadrants with visible lesions.
affected tooth/teeth5. The technological axis includes the risk component
Available indicators for addressing dental caries and the available technological development
conceptually and operatively must conform to the component. The risk component results from
theoretical framework on which studies are based variables identified and often caused by the
and enable precise identification of the process of previous omission of appropriate actions for
clinical development of the disease from its early controlling the process. Technological development
stages to its complications. The available indicators is based on contextualized scientific evidence
may be simple or complex. The transfer of the and expressed as the proper strategies and their
results expressed by the different values must help application per mouth unit and teeth, according to
to systematize diagnosis and guide proactive, the magnitude recorded in dental quadrants.
efficacious, effective, and long-lasting interventions. Any index must be validated regarding the
The various indicators that have been developed reliability and validity of the construct, contents,
can be classified according to the different and criteria20. Rigorous application of indices by
variables that they address6: the past history of the examiner requires a calibration process
caries; the risk factors involved7; the stages in the including (a) theoretical knowledge of the indicator
development process of dental caries lesions8-9; and and cutoff points between its categories, (b)
the integration between the process of caries practical recognition in situations “on paper” and in
lesion development in terms of magnitude the clinic, and (c) calibration per se, establishing
(severity and extension) and the treatments inter-examiner differences between the “gold
recommended according to the approach for risk standard” or “reference examiner” and the new
control10-11. Also, it is necessary to clarify the examiner, and intra-examiner differences, i.e., the
differences between caries diagnosis and lesion variations recorded among observations made by
identification. Diagnosis involves the dental one professional.
professional’s interpretation regarding the sum of Dental caries is one of the most prevalent chronic
available data, while lesion identification involves diseases globally, affecting people throughout their
applying an objective method to determine whether lifetime21. Today, its distribution and severity vary
or not the lesion is present, and once it has among different regions, and its onset is strongly
Acta Odontol. Latinoam. ISSN 1852- Vol. 34 Nº 3 / 2021 / 289-
 Diagnosis and treatment need indexes for 2

CODE DIAGNOSTIC ANALYSIS UNIT TREATMENT PLAN

Sound teeth with history of
00 Preventive program: Low or moderate caries risk
preventive measures
Sound teeth without history of
01 Mouth Preventive program: Low or moderate caries risk
preventive measures
Presence of non-cavitated
02 Preventive program: High caries risk
caries lesions (white
spots)
Preventive program: High caries risk + Restorative
03 1 quadrant
treatment
Preventive program: High caries risk + Restorative
04 2 quadrants
Presence of cavitated lesions treatment
affecting enamel and/or Preventive program: High caries risk + Restorative
05 dentine 3 quadrants
treatment
Preventive program: High caries risk + Restorative
06 4 quadrants
treatment
Preventive program: High caries risk + Restorative
07 1 quadrant
treatment + Pulp treatment
Preventive program: High caries risk + Restorative
08 2 quadrants
Presence of cavitated lesions treatment + Pulp treatment
affecting enamel and/or dentine Preventive program: High caries risk + Restorative
09 and with pulp involvement 3 quadrants
treatment + Pulp treatment
Preventive program: High caries risk + Restorative
10 4 quadrants
treatment + Pulp treatment
Preventive program: High caries risk + Restorative
11 1 quadrant treatment + Surgical treatment and eventual
rehabilitation
Preventive program: High caries risk + Restorative
12 2 quadrants treatment + Surgical treatment and eventual
Presence of extense cavitated rehabilitation
lesions without possibilities of
restorative treatment or presence of Preventive program: High caries risk + Restorative
13 abscess or fistula 3 quadrants treatment + Surgical treatment and eventual
rehabilitation
Preventive program: High caries risk + Restorative
14 4 quadrants treatment + Surgical treatment and eventual
rehabilitation
Fig. 1: Caries Treatment Needs Index (CTNI)

associated with environmental, sociocultural, respectively, using the Global Burden of Disease
economic, and behavioral factors22-24. The model24.
epidemiological profile of dental caries differs Different authors have compared dental caries
significantly between central and developing indices. Campus et al.25 compared ICDAS, CAST,
countries. However, variables that identify NYVAD, and DMF indices. They demonstrated
complex social issues such as poverty provide a that the most significant difference among methods
perspective from which to analyze heterogeneity was shown by the number of sound teeth (p <
within the homogeneity of countries. In Argentina, 0.01). In a cross-sectional study, Sarno et al.26
Piovano et al.22 studied the magnitude of dental demonstrated that the mean time taken to apply
caries, establishing the treatment needs in a sample the DMF was
of 2917 children, adolescents, and adults. 3.8 min; for ICDAS, it took 8.9 min, and for
Kassebaum et al.23conducted a worldwide CAST, 4.7 min. The mean numbers of decayed,
systematic review and meta-regression using missing, and filled teeth were 6.0 according to the
epidemiological data on untreated caries and DMF, 6.2 according to ICDAS, and 5.9 according
subsequent estimates of internally consistent to CAST. When the disease extension indicator
prevalence and incidence. Separate meta-regression was used, the following percentages of teeth were
was performed for untreated caries in primary affected by caries: DMF 22.12%, ICDAS 49.11%,
and permanent teeth, and CAST 33.2%. The DMF underestimated the
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 2 Noemi E. Bordoni , et

occurrence of caries lesions in individuals but dental care program at local institutions.
was the fastest method to apply. ICDAS obtained
detailed information regarding lesion severity, but
it was a time-consuming method and challenging to
analyze. A systematic review based on specificity
and sensitivity studies of each system27 revealed
that sensitivity and specificity are greater with
ICDAS than with the dmft/DMFT index and
provide up to 43% more information in identifying
non-cavitated lesions. Still, it takes longer to
perform and involves more resources because it
uses light, compressed air, and prophylaxis before
the examination. Banava et al.28 revealed that the
ICDAS provides more accurate information than
DMF for the investigators and epidemiologists.
Similar findings were reported by Melgar et al.,
who informed that the DMFT index might
underestimate 60% of non-cavitated lesions in
children and 16.6% in adults29.
The objective of this study was to establish the
correlation between an index for caries treatment
needs and an index for caries lesions detection and
evaluation.

MATERIALS AND METHODS

The study project was approved by the Ethics
Committee of the School of Dentistry of the
University of Buenos Aires. (PAIIO-02 2019-
2024). A cross-sectional study was designed on a
non-probabilistic sample of children and early
adolescents (n=546) with no previous dental care
during the last year (Table 1):
(a) A group 3-year-old children (n= 302) from an
early childhood center (Avellaneda, Provincia
de Buenos Aires).
(b) A group of 5-year-old children (n= 183) from
two kindergartens (Rio Grande, Provincia de
Tierra del Fuego, Antártida e Islas del Atlántico
Sur).
(c) A group of 11 to 14-year-old early adolescents
(n= 61) from a middle school (Ciudad
Autónoma de Buenos Aires).
According to existing national criteria, the three
institutional settings were classified as belonging to
marginal urban level neighborhoods.
Before including children in the study, their legal
guardians were asked for informed consent,
and each child’s formal assent was verified. All
participants and their legal guardians were
informed of the results of the examinations and
diagnoses and included in and/or referred to a

Acta Odontol. Latinoam. ISSN 1852- Vol. 34 Nº 3 / 2021 / 289-

 Diagnosis and treatment need indexes for 2
= 0, ICDAS>0, and ICDAS 3 or higher among the
Table 1: Frequency and percentage distribution per sex according to age groups
Sex

Age groups Total

MaleFemale
155147302
Up to 3 years Frequency 51.3%48.7%100.0%
%
Frequency 8895183
5 years % 48.1%51.9%100.0%
Frequency 293261
11 to 14 years % 47.5%52.5%100.0%
Frequency 272274546
% 49.8%50.2%100.0%
Total

No statistical difference observed in the proportion of sexes in age groups.

Clinical diagnoses were performed by one

researcher who was calibrated in caries
diagnosis according to CTNI (18) and ICDAS II
criteria (kappa 0.75). Results of dental
examinations were recorded in individual charts
and used to design individual treatment plans.
On each patient, the indexes were operationalized
as follows: CTNI grouped according to 4
standardized categories: code 00-02 (sound teeth
with or without preventive measures or presence
of non-cavitated caries lesions; code 03-07
(presence of cavitated lesions affecting enamel
and/or dentine in 1 to
4 quadrants); code 07-10 (presence of cavitated
lesions affecting enamel and/or dentine and with
pulp involvement in 1 to 4 quadrants); and code
11- 14 (presence of extense cavitated lesions
without possibilities of restorative treatment or
presence of abscess or fistula in 1 to 4 quadrants).
ICDAS II were grouped in 7 categories: Code>0;
Code ≥3; Code 1-2; Code 3; Code 3-4; Code 5-6
and Codes 4-5-6. In all cases, only active caries
lesions were included. Also we grouped for other
analysis ICDAS codes in 3 categories: Category
ICDAS >0 (number of surfaces with lesions
ICDAS code 1 to 6); category ICDAS 3 to 6
(number of surfaces with lesions ICDAS code 3
to 6); and category ICDAS =0 (number of
surfaces without lesions ICDAS code =0).

Statistical analysis
Frequencies, percentages, median, and quartiles
were calculated for the values recorded using
both diagnostic methods. The Jonckheere-
Terpstra ordered alternatives test for independent
samples was used to compare the distribution of
lesions ICDAS
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2 Noemi E. Bordoni , et

4 CTNI groups. For pairwise comparison, they lesions according to CTNI increases, there is an
were adjusted using Bonferroni’s correction. increase in the number of surfaces diagnosed with
Correlation between CTNI and ICDAS was ICDAS>0 and with ICDAS ≥ 3, and a decrease in
established by Spearman’s rho coefficient. For caries-free surfaces recorded with ICDAS II.
comparison between indices, the ROC curve was The correlation between CTNI scores and
used with Hanley and McNeil´s approximation distribution of surfaces for ICDAS>0, ICDAS=3-6,
method. Area under the curve was calculated with ICDAS=4-6, ICDAS=5-6, ICDAS=3-4, ICDAS=1-
95% confidence intervals; cutoff variable was 2 and for the
established as CTNI 00-02 / 03- 14 and CTNI 00- number of surfaces without lesions ICDAS=0 was
06 / 07-14; and variable dependent on the calculated for the age groups studied and for the
distribution of affected surfaces as ICDAS > 0, total sample (Table 2; Fig. 3). In all cases, the
ICDAS 3-6, ICDA 4-6, and ICDAS 5-6. results of Spearman’s correlation were statistically
significant, except for the group 11-14 years for
RESULTS distribution of lesions ICDAS=1-2. The correlation
Analysis of correlation of surfaces diagnosed between CTNI scores and the distribution of
according to ICDAS II and CTNI surfaces for ICDAS>0, ICDAS=3-6, ICDAS=4-6,
The distribution of lesions ICDAS = 0, ICDAS > ICDAS=5-6,
0 and ICDAS 3 or greater with CTNI grouped as: ICDAS=3-4 for each age group was very high. For
00-02, 03-06, 07-10 and 11-14 is shown in Fig. 2. distribution of lesions ICDAS=1-2, the correlation
Statistically significant differences are observed was low but statistically significant. The
upon comparing CTNI grouped in 4 categories to correlation between CTNI score and distribution of
the distribution of surfaces according to ICDAS=0, lesions ICDAS=0 (number of surfaces without
ICDAS>0, ICDAS 3 or greater (p<0.000). Pairwise lesions) was very high, and high and inverse
comparison of CTNI according to distribution of (negative) for each age group. Fig. 3 describes the
ICDAS lesions showed statistically significant correlation between CTNI and ICDAS>0.
difference except between categories 07-10 and 11-
14, with non-significant differences in the three Analysis of the results of the ROC curve for
comparisons performed. As the complexity of the distribution of lesions ICDAS for CTNI 00-02
record of lesions according to CTNI increases, vs. 03-14 and CTNI 00-06 vs. 07-14.
there is an increase in the number of surfaces For CTNI 00-02 / 03-14, area under the ROC curve
diagnosed with ICDAS>0 and with ICDAS ≥ 3, is very high for ICDAS>0 and ICDAS=3-6, and
and a decrease in caries-free surfaces recorded with high for ICDAS=4-6 and ICDAS=5-6 (Table 3;
ICDAS II., except between categories 07-10 and Fig. 4). For CTNI 00-06 / 07-14, area under the
11-14, with non-significant differences in the three ROC curve is very high for ICDAS>0, ICDAS=3-
comparisons performed. As the complexity of the 6, ICDAS=4-6 and ICDAS=5-6 (Table 4; Fig. 5).
record of

Fig. 2: Distribution of quantity of ICDAS surfaces per grouped CTNI

ICDAS>0: number of surfaces with lesions ICDAS 1 to 6
ICDAS 3to 6: number of surfaces with lesions ICDAS 3 to 6
ICDAS=0: number of surfaces without lesions ICDAS =0
Acta Odontol. Latinoam. ISSN 1852- Vol. 34 Nº 3 / 2021 / 289-
 Diagnosis and treatment need indexes for 2

Table 2: Spearman’s correlation between CTNI and different groupings of ICDAS lesions for the 3
age groups and for the total
Up to 3
ICDAS>0 ICDAS=3-6 ICDAS=4-6 ICDAS=5-6 ICDAS=3-4 ICDAS=1-2 ICDAS=0
years
n=302
Spearman’s rho 0.822 0.804 0.710 0.653 0.605 0.319 -0.724
p value 0.000 0.000 0.000 0.000 0.000 0.000 0.000
5 years
ICDAS>0 ICDAS=3-6 ICDAS=4-6 ICDAS=5-6 ICDAS=3-4 ICDAS=1-2 ICDAS=0
n=183
Spearman’s rho 0.821 0.870 0.844 0.839 0.439 0.214 -0.791
p value 0.000 0.000 0.000 0.000 0.000 0.004 0.000
11-14 years
ICDAS>0 ICDAS=3-6 ICDAS=4-6 ICDAS=5-6 ICDAS=3-4 ICDAS=1-2 ICDAS=0
n=61
Spearman’s rho 0.656 0.784 0.660 0.615 0.582 -0.068 -0.619
p value 0.000 0.000 0.000 0.000 0.801 0.603 0.000
Total
n=546 ICDAS>0 ICDAS=3-6 ICDAS=4-6 ICDAS=5-6 ICDAS=3-4 ICDAS=1-2 ICDAS=0

Spearman’s rho 0.897 0.900 0.812 0.777 0.698 0.529 -0.486

p value 0.000 0.000 0.000 0.000 0.000 0.000 0.000

Fig. 3: Spearman’s correlation between CTNI and ICDAS

lesions > 0 for total sample.
Fig. 4: ROC Curve. Cutoff values CTNI: 00-02 vs. 03-14 for
distribution of surfaces ICDAS>0, ICDAS 3 or greater,
ICDAS 4 or greater, ICDAS 5 or greater

Table 3: Area under the curve and CI95% for cutoff values CTNI: 00-02 vs. 03-14 for
distribution of surfaces ICDAS>0, ICDAS 3 or greater, ICDAS 4 or greater, ICDAS 5 or greater
Area under the curve for CTNI: 00-02 vs. 3-14
CI 95%
Variables of test

Areap value LowerUpper

result
limitlimit
0.9360.969
ICDAS>00.9520.000 0.9600.989
ICDAS 3 -60.9740.000 0.8580.922
ICDAS 4 or greater0.8900.000 0.8210.893
ICDAS 5 or greater0.8570.000

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2 Noemi E. Bordoni , et
Table 4: Area under the curve and CI95% for cut- off values CTNI: 00-06 vs. 07-14 for distribution of surfaces ICDAS>0
Area under the curve for ICDAS= 7-14

Variables of test

Areap value LowerUpper

result
limitlimit
0.9000.955
ICDAS>00.9270.000 0.9080.959
ICDAS 3 -60.9330.000 0.9070.955
ICDAS 4 or greater0.9310.000 0.8850.954
ICDAS 5 or greater0.9190.000

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 Diagnosis and treatment need indexes for 2

Health indicators also depend on the policy for

disseminating them, including the timeliness and
frequency they are compiled. Availability of a
basic set of indicators provides the raw material
for analyzing health. Moreover, it can facilitate the
monitoring of health objectives and goals, foster
analytical capacities in healthcare teams, and serve
as a platform for promoting the development of
intercommunicated health information systems.
Valid and reliable health indicators are essential
tools required by epidemiology for health
management. The indices compared in this study
provide the possibility of analyzing the impact on
health scenarios. Clinical discrimination among
different stages in caries lesion processes, activity,
and arrest, supported by various histological and
histochemical studies, finds appropriate clinical
Fig. 5: ROC Curve. Cutoff values CTNI: 00-06 vs. 07-14 for instruments.
distribution of surfaces ICDAS>0, ICDAS 3 or greater,
ICDAS 4 or greater, ICDAS 5 or greater. In statistics, a proxy variable is a measure that
enables other more valuable variables to be found,
whether for designs or for including the results
DISCUSSION indistinctly in information technology. For such
In general terms, health indicators represent purpose, the proxy variable must have a strong
summary measurements capturing relevant correlation –though not necessarily linear or
information on different attributes and dimensions positive– with the inferred value. Both the indices
of health status and healthcare system performance analyzed in this study meet this requirement. When
which, viewed jointly, intend to reflect the health comparing results obtained by other authors, the
situation and can be used for surveillance. INTC takes as criteria for categorizing the
Indicators must be easy for analysts to use, development process of dental caries, identifying
interpret, and understand to users, such as decision- the first of the visual differences with healthy
makers and managers. tissue. In such a sense, it coincides with the ICDAS
A set of health indicators with quality attributes in all its formulations.
that are appropriately defined and maintained The CTNI index. Based showed a higher
provide information for preparing an epidemiological correlation than other indicators with ICDAS II. It
profile and other kinds of analysis of the health- is worth highlighting the frequent calibrations
disease- attention-care situation. The selection of requiring and verifying the equivalence between
such a set of indicators –and its levels of the therapeutic criteria recommended in the CTNI
disaggregation– can vary according to the and the ICDAS II. The indices analyzed in this
availability of information systems, data sources, study (CTNI and ICDASII) show reasonable
resources, needs, and specific priorities in each equivalence for use in clinical and epidemiological
region or country. studies based on the statistical analysis.
It is essential to monitor indicator quality because Comparing these indicators to other indicators,
it conditions users’ confidence level in health including their application in studies on different
information, and therefore, the regular use of life stages, would enable their validity and
indicators. relevance to be considered for global health
studies.

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 2 Noemi E. Bordoni , et

DECLARATION OF CONFLICTING INTERESTS

CORRESPONDENCE
The authors declare no potential conflicts of interest regarding
Dr.Aldo Squassi
the research, authorship, and/or publication of this article
Cátedra de Odontología Preventiva y Comunitaria
Facultad de Odontología, UBA
FUNDING
Marcelo T. de Alvear 2142
This study was funded by Universidad de Buenos Aires (Grant Buenos Aires – Argentina
UBACYT 20720190100007BA) and the Programa de Apoyo a aldo.squassi@odontologia.uba.ar
la Investigación Integrada de la Facultad de Odontología de la
Universidad de Buenos Aires (PAIIO 02/19).

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