Kühnisch J, Heinrich-Weltzien R, Tabatabaie M, Stösser L, Huysmans M C D N J M
Department of Conservative Dentistry and Periodontology, Ludwig Maximilians University, Munich, Germany.
Caries Res. 2006;40(2):104-11. doi: 10.1159/000091055.
Because of different measurement techniques and the easier design of the CRM prototype, this in vitro study aimed to compare the diagnostic performance and reproducibility of two electrical methods (Electronic Caries Monitor III, ECM and Cariometer 800, CRM) for occlusal caries detection, and to evaluate the effect of staining/discoloration of fissures on diagnostic performance. Hundred and seventeen third molars with no apparent occlusal cavitation were selected. Six examiners inspected all specimens independently, using the CRM, and a subgroup of 4 using the ECM. Histological validation using a stereomicroscope was performed after hemisectioning. Intra- and interexaminer reproducibility was assessed by Lin's concordance correlation coefficient (CCC) and Bland and Altman analysis. Diagnostic performance parameters included sensitivity (SE), specificity (SP) and area under the ROC curve (Az). The CCC yielded an intra- and interexaminer reproducibility of 0.69/0.62 (ECM) and of 0.79/0.74 (CRM). The mean intra- and interexaminer 95% range of measurements (range between Bland and Altman limits of agreement) given in percentages of the instrument reading were 67%/65% for the ECM and 28%/33% for the CRM. Az at the D3-4 level was 0.74 (ECM) and 0.78 (CRM). The CRM showed at least equivalent diagnostic performance to the ECM. However, improvement is still desirable. Diagnostic performance appeared to be enhanced in discolored lesions; however, this may be related to sample lesion distribution characteristics.
由于测量技术不同以及龋病风险监测仪（CRM）原型设计更为简便，本体外研究旨在比较两种电学方法（电子龋监测仪III，ECM和龋病测量仪800，CRM）用于检测咬合面龋的诊断性能和可重复性，并评估裂隙染色/变色对诊断性能的影响。选取了117颗无明显咬合面龋洞的第三磨牙。六名检查者使用CRM独立检查所有标本，另有四名检查者组成的亚组使用ECM。在将标本半切后，使用体视显微镜进行组织学验证。通过林氏一致性相关系数（CCC）以及布兰德和奥特曼分析评估检查者内部和检查者之间的可重复性。诊断性能参数包括灵敏度（SE）、特异性（SP）和ROC曲线下面积（Az）。CCC得出检查者内部和检查者之间的可重复性，ECM为0.69/0.62，CRM为0.79/0.74。以仪器读数的百分比表示的检查者内部和检查者之间测量值的平均95%范围（布兰德和奥特曼一致性界限之间的范围），ECM为67%/65%，CRM为28%/33%。在D3-4水平，Az值ECM为0.74，CRM为0.78。CRM显示出与ECM至少相当的诊断性能。然而，仍有改进的必要。变色病变中的诊断性能似乎有所提高；然而，这可能与样本病变分布特征有关。
