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评估三年级牙科学员龋病检测方法的性能。

Evaluating performance of dental caries detection methods among third-year dental students.

机构信息

Institute of Dentistry, Department of Cariology, Endodontology and Paedodontics, University of Oulu, Oulu POB 5281 , Finland.

出版信息

BMC Oral Health. 2013 Dec 6;13:70. doi: 10.1186/1472-6831-13-70.

Abstract

BACKGROUND

Reliable caries detection is a cornerstone in the modern caries treatment schema. This study aimed to evaluate adopting traditional and new caries detection methods by third-year dental students.

METHODS

Fifty-seven students were given lectures on caries detection, after which they evaluated 27 extracted carious teeth using traditional clinical assessment (CE), Nyvad's, and ICDAS methods. On three teeth they also performed DIAGNOdent pen® (LF) scanning. Histological scores of the sectioned teeth (ICDAS, LF) and activity estimations of the lesions by the supervisors were used as golden standards (Nyvad, CE). For the ICDAS method , sensitivity and specificity were calculated using dentine caries (D3) as a cut-off point. Mean ICC and kappa values were calculated to evaluate interexaminer agreement for all lesions and methods. Spearman's correlation coefficient evaluated LF scanning.

RESULTS

ICDAS method presented good sensitivity (0.78) and specificity (0.87). The inter-examiner agreement for different methods was fair or good (CE ICC = 0.69, κ = 0.53; Nyvad's method ICC = 0.68, κ = 0.48, ICDAS ICC = 0.66, κ = 0.47). Variation in LF values was the greatest with lesions extending to middle third of dentin. In that case, the Spearman's correlation coefficient was also the weakest.

CONCLUSIONS

To follow the guidelines by the European Core Curriculum on Cariology, the third year dental students are introduced to methods for detecting lesion depth and assessing lesion activity as well as using new caries detection methods. Their performance in estimating lesion depth is good, and fair to good in estimating lesion activity even after basic training only.

摘要

背景

可靠的龋齿检测是现代龋齿治疗方案的基石。本研究旨在评估三年级牙科学生采用传统和新的龋齿检测方法。

方法

57 名学生接受了龋齿检测讲座,之后他们使用传统临床评估(CE)、Nyvad 法和 ICDAS 方法评估了 27 颗拔出的龋齿。在三颗牙齿上,他们还使用了 DIAGNOdent 笔(LF)扫描。切片牙齿的组织学评分(ICDAS、LF)和主管的病变活动估计值被用作金标准(Nyvad、CE)。对于 ICDAS 方法,使用牙本质龋(D3)作为截断点计算灵敏度和特异性。计算所有病变和方法的观察者间一致性的平均 ICC 和 Kappa 值。Spearman 相关系数评估 LF 扫描。

结果

ICDAS 方法具有良好的灵敏度(0.78)和特异性(0.87)。不同方法的观察者间一致性为一般或良好(CE ICC = 0.69,κ = 0.53;Nyvad 法 ICC = 0.68,κ = 0.48,ICDAS ICC = 0.66,κ = 0.47)。LF 值的变化最大的是病变延伸到牙本质中间三分之一的情况。在这种情况下,Spearman 相关系数也最弱。

结论

为了遵循欧洲龋病核心课程指南,三年级牙科学生开始学习检测病变深度和评估病变活性的方法,以及使用新的龋齿检测方法。他们在估计病变深度方面的表现良好,即使只经过基本培训,在估计病变活性方面也达到了一般到良好的水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdd2/3878964/7c387d58be85/1472-6831-13-70-1.jpg

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