Minston William, Li Gang, Wennberg Rikard, Näsström Karin, Shi Xie-Qi
Division of Image and Functional Odontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Swed Dent J. 2013;37(2):79-85.
The objective was to investigate diagnostic performance on approximal caries detection among Swedish and Chinese dental students using analogue and digital radiographs in vitro. Additionally, to compare the diagnostic accuracy of two image modalities for approximal caries detection. 46 extracted premolars and molars were mounted in blocks and exposed with two intra-oral systems, one CCD based digital radiographs and one with conventional films. 10 Swedish and 10 Chinese senior dental students diagnosed the approximal sites of the teeth exposed with the digital and analogue images. A 5 point diagnosis confidence scale was applied for caries registration for all the observers. Subsequently, the teeth were sectioned and histo-pathologically analyzed in order to obtain a gold standard. The data were analyzed in terms of receiver operating characteristic (ROC) curves for evaluation of diagnostic accuracy of the two radiographic methods and for the two groups of students for enamel and dentinal caries detection, respectively. The area under the ROC curve was significantly higher for dentinal caries detection compared with enamel caries detection for both Chinese and Swedish students and for both imaging modalities (p<0.001). The present results indicated that the students' ability for enamel caries detection on approximal surfaces was poor. Neither between the two student groups (p=0.15-0.64) nor between the two image modalities (p=0.34-0.91) a statistically significant difference in detecting approximal caries was found.
The two different intra-oral x-ray systems were equally accurate. Chinese and Swedish students showed similar outcomes in their performance for approximal caries detection.
目的是在体外研究瑞典和中国牙科学生使用模拟和数字X线片检测邻面龋的诊断性能。此外,比较两种成像方式检测邻面龋的诊断准确性。将46颗拔除的前磨牙和磨牙固定在块体中,并用两种口腔内系统进行曝光,一种是基于电荷耦合器件(CCD)的数字X线片,另一种是传统胶片。10名瑞典和10名中国高年级牙科学生对用数字和模拟图像曝光的牙齿邻面进行诊断。所有观察者对龋病记录采用5分诊断置信度量表。随后,将牙齿切片并进行组织病理学分析以获得金标准。分别根据受试者操作特征(ROC)曲线分析数据,以评估两种放射学方法以及两组学生检测釉质龋和牙本质龋的诊断准确性。对于中国和瑞典学生以及两种成像方式,牙本质龋检测的ROC曲线下面积均显著高于釉质龋检测(p<0.001)。目前的结果表明,学生检测邻面釉质龋的能力较差。在两组学生之间(p=0.15 - 0.64)以及两种成像方式之间(p=0.34 - 0.91),未发现检测邻面龋有统计学显著差异。
两种不同的口腔内X线系统准确性相同。中国和瑞典学生在邻面龋检测表现上结果相似。