国际龋病检测与评估系统(ICDAS):一种用于测量龋齿的综合系统。

The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries.

作者信息

Ismail A I, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts N B

机构信息

Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1978, USA.

出版信息

Community Dent Oral Epidemiol. 2007 Jun;35(3):170-8. doi: 10.1111/j.1600-0528.2007.00347.x.

Abstract

This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR-OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR-OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven-point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.

摘要

本文介绍了底特律口腔健康差异研究中心(DCR - OHD)对国际龋病检测与评估系统(ICDAS)进行评估的早期结果。当代标准系统之间缺乏一致性,限制了流行病学和临床研究中所测量结果的可比性。ICDAS标准由一组国际龋病研究人员制定,旨在将多个新的标准系统整合为一个用于龋病检测和评估的标准系统。在DCR - OHD队列研究中使用ICDAS时,牙科检查人员首先确定清洁干燥的牙齿表面是否完好、有窝沟封闭、已修复、有牙冠或缺失。之后,检查人员使用从完好到广泛龋洞形成的七点有序量表对每个牙齿表面的龋病状态进行分类。对拔除牙齿的组织学检查发现,随着ICDAS代码严重程度的增加,牙本质中龋病脱矿的可能性增大。在分析与龋齿相关的社会、行为和饮食因素时,该标准也具有鉴别效度。六位检查人员根据ICDAS龋病状态对牙齿表面进行分类的可靠性介于良好到优秀之间(kappa系数介于0.59和0.82之间)。虽然仍需要进一步开展工作来定义龋病活动度、验证该标准及其在评估光滑表面龋齿方面的可靠性,并开发一个用于评估预防和修复治疗需求的分类系统,但对ICDAS平台的这一早期评估发现,该系统是实用的;具有内容效度、与拔除牙齿窝沟组织学检查的相关性效度以及鉴别效度。

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