Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Caries Res. 2009;43(6):442-8. doi: 10.1159/000258551. Epub 2009 Nov 12.
The aim of this in vitro study was to assess the validity and reproducibility of the ICDAS II (International Caries Detection and Assessment System) criteria in primary teeth. Three trained examiners independently examined 112 extracted primary molars, ranging from clinically sound to cavitated, set up in groups of 4 to mimic their anatomical positions. The most advanced caries on the occlusal and approximal surfaces was recorded. Subsequently the teeth were serially sectioned and histological validation was undertaken using the Downer and Ekstrand-Ricketts-Kidd (ERK) scoring systems. For occlusal surfaces at the D(1)/ERK(1) threshold, the mean specificity was 90.0%, with a sensitivity of 75.4%. For approximal surfaces, the specificity and sensitivity were 85.4 and 66.4%, respectively. For occlusal surfaces at ICDAS code > or =3 (ERK(3) threshold), the mean specificity and sensitivity were 87.0 and 78.1%, respectively. For approximal surfaces, the equivalent values were 90.6 and 75.3%. At the D(3) threshold for occlusal surfaces, the mean specificity and sensitivity were 92.8 and 63.1%, and for approximal surfaces 94.2 and 58.3%, respectively. Mean intraexaminer reproducibility (Cohen's kappa) ranged from 0.78 to 0.81 at the ICDAS code > or =1 cut-off and at the ICDAS code > or =3 cut-off from 0.74 to 0.76. Interexaminer reproducibility was lower, ranging from 0.68 to 0.70 at the ICDAS code > or =1 cut-off and from 0.66 to 0.73 at the ICDAS code > or =3 cut-off. In conclusion, the validity and reproducibility of the ICDAS II criteria were acceptable when applied to primary molar teeth.
本体外研究旨在评估 ICDAS II（国际龋病检测与评估系统）标准在乳牙中的有效性和可重复性。三名经过培训的检查者独立检查了 112 颗从临床完好到龋损的已拔除乳牙，将其分组为 4 个一组，以模拟其解剖位置。记录在咬合面和近中面最严重的龋损。随后，对牙齿进行连续切片，并使用 Downer 和 Ekstrand-Ricketts-Kidd (ERK) 评分系统进行组织学验证。对于在咬合面的 D(1)/ERK(1)阈值，平均特异性为 90.0%，敏感性为 75.4%。对于近中面，特异性和敏感性分别为 85.4%和 66.4%。对于在 ICDAS 代码>或=3（ERK(3)阈值）的咬合面，平均特异性和敏感性分别为 87.0%和 78.1%。对于近中面，等效值分别为 90.6%和 75.3%。在咬合面的 D(3)阈值，平均特异性和敏感性分别为 92.8%和 63.1%，近中面为 94.2%和 58.3%。在 ICDAS 代码>或=1 截止值时，观察者内重复性（Cohen's kappa）的平均值为 0.78 至 0.81，在 ICDAS 代码>或=3 截止值时为 0.74 至 0.76。观察者间重复性较低，在 ICDAS 代码>或=1 截止值时为 0.68 至 0.70，在 ICDAS 代码>或=3 截止值时为 0.66 至 0.73。结论，当应用于乳牙时，ICDAS II 标准的有效性和可重复性是可以接受的。
