Mendes Fausto Medeiros, Ganzerla Emily, Nunes Ana Fátima, Puig Alexandre Vidal Cucurull, Imparato José Carlos Pettorossi
Department of Pediatric Dentistry, Faculty of Dentistry, University São Paulo, Brazil.
Am J Dent. 2006 Feb;19(1):19-22.
To evaluate if high-powered magnification could improve the performance of visual inspection and compare with other methods to detect occlusal caries lesions in primary teeth.
110 suspected sites were analyzed by two examiners with four methods: visual inspection, visual inspection aided with high-powered magnification (x20), laser fluorescence (DIAGNOdent) and radiographs. The first examiner performed the examinations in a second session to assess the intra-examiner reproducibility. Then, the teeth were cut and the sections were evaluated in stereomicroscope. Sensitivity, specificity and accuracy were calculated at enamel and dentin caries thresholds, and compared using McNemar change test. The ROC analysis was performed and the mean of areas under ROC curves were compared using ANOVA and Student-Newman-Keuls test. Inter- and intra-examiner reproducibility was assessed by calculating Cohen's Kappa.
The visual inspection with magnification did not change the accuracy and reproducibility of the visual inspection alone. The best caries detection method was laser fluorescence, and the least accurate was with radiographs.
评估高倍放大是否能提高目视检查的性能，并与其他方法比较以检测乳牙的咬合面龋损。
由两名检查者采用四种方法对110个可疑部位进行分析：目视检查、高倍放大（×20）辅助的目视检查、激光荧光（DIAGNOdent）和X线片。第一名检查者在第二次检查中进行检测，以评估检查者内部的可重复性。然后，将牙齿切开并在体视显微镜下评估切片。计算釉质和牙本质龋阈值时的灵敏度、特异度和准确度，并使用McNemar变化检验进行比较。进行ROC分析，并使用方差分析和Student-Newman-Keuls检验比较ROC曲线下面积的均值。通过计算Cohen's Kappa评估检查者间和检查者内部的可重复性。
放大的目视检查并未改变单纯目视检查的准确度和可重复性。最佳的龋损检测方法是激光荧光，最不准确的是X线片。
