Department of Pediatric Dentistry, Araraquara Dental School, Rua Humaitá, 1680 Centro Araraquara, Sao Paulo 14801-903, Brazil.
J Dent Educ. 2010 Aug;74(8):862-8.
The aim of this study was to evaluate the influence of ICDAS training in a group of dental students for occlusal caries detection in permanent teeth. Premolars and molars (N=104) with occlusal surfaces varying from ICDAS scores 0 to 6 were cleaned, one occlusal site per tooth was selected, and a photograph taken to identify the site. Eight senior dental students examined the teeth twice with a one-week interval between examinations during each of two phases: before and after the ICDAS e-learning program. Teeth were histologically assessed for caries extension. Intraclass correlation coefficients for intra- and interexaminer repeatability were high, both before (0.75 and 0.72, respectively) and after e-learning (0.82 and 0.78, respectively). The ICDAS scores decreased significantly from before to after e-learning (p=0.0001). Correlation between ICDAS scores and histology scores was moderate (0.57 before e-learning and 0.61 after). Although the ROC curve shows an improvement in the use of the ICDAS scoring after e-learning, the difference was not significant (p=0.10). Specificity of the ICDAS scores significantly improved after e-learning (77 percent vs. 36 percent), and sensitivity was reduced slightly after e-learning (87 percent vs. 92 percent). The ICDAS e-learning program improved the performance of the diagnostic skills of the investigated students for the detection of occlusal caries lesions.
本研究旨在评估 ICDAS 培训对一组牙科学生在恒牙咬合面龋检测中的影响。共纳入 104 颗磨牙和前磨牙,其咬合面龋的 ICDAS 评分为 0 至 6 分。首先清洁牙面,然后每颗牙选择一个咬合面,拍摄照片以识别检查部位。8 名高年级牙科学生在两个阶段的两次检查中,每 1 周间隔检查一次,每次检查均使用 ICDAS 电子学习程序。采用组织学评估龋齿延伸程度。在 ICDAS 电子学习前后,检查者间和检查者内的重复性的 ICC 值均较高(分别为 0.75 和 0.72,0.82 和 0.78)。在 ICDAS 电子学习后,ICDAS 评分明显降低(p=0.0001)。ICDAS 评分与组织学评分之间的相关性为中度(ICDAS 电子学习前为 0.57,ICDAS 电子学习后为 0.61)。虽然 ROC 曲线显示 ICDAS 评分在 ICDAS 电子学习后的使用有所改善,但差异无统计学意义(p=0.10)。在 ICDAS 电子学习后,ICDAS 评分的特异性显著提高(77%对 36%),敏感性略有下降(87%对 92%)。ICDAS 电子学习程序提高了研究学生对咬合面龋病的诊断技能。