Almosa Naif A, Lundgren Ted, Bresin Andrea, Birkhed Dowen, Kjellberg Heidrun
Department of Orthodontics, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Göteborg , Sweden.
Acta Odontol Scand. 2014 Aug;72(6):474-80. doi: 10.3109/00016357.2013.865788. Epub 2013 Dec 9.
The aims of this study were (1) to evaluate the severity of buccal caries lesions according to the International Caries Detection and Assessment System (ICDAS) criteria via scoring buccal caries lesions on digital photographs at the time of de-bonding and (2) to compare this method with clinical examination.
In total, 89 patients treated with upper and lower fixed appliances were clinically examined immediately after de-bonding by the first author and buccal caries were scored according to the ICDAS-II. Close-up digital photographs were taken of 245 teeth with different buccal caries lesion scores according to the ICDAS-II. Thirteen postgraduate orthodontics students independently scored the buccal caries lesions in the digital photographs using the modified clinical criteria (ICDAS-II). Intra- and inter-examiner reliabilities were evaluated by calculating the weighted kappa. To evaluate the validity of diagnosing the severity of buccal caries lesions using digital photographs compared to clinical examination, Spearman's correlation coefficient was calculated.
Intra-examiner reliability and the reliability between each examiner and the clinical examination showed moderate-to-excellent agreement, with kappa values of 0.52-0.83. Scoring buccal caries lesions via clinical examinations and scoring via photographs were well correlated according to the modified ICDAS-II criteria (Spearman's correlation coefficient, 0.76).
Thus, scoring buccal caries lesions on digital photographs according to ICDAS-II criteria is a reliable and valid method for assessing the severity of buccal caries lesions.
本研究的目的是：（1）根据国际龋病检测与评估系统（ICDAS）标准，通过在脱粘结时对数码照片上的颊面龋损进行评分，评估颊面龋损的严重程度；（2）将该方法与临床检查进行比较。
共有89例接受上下固定矫治器治疗的患者在脱粘结后立即由第一作者进行临床检查，并根据ICDAS-II对颊面龋进行评分。根据ICDAS-II对245颗具有不同颊面龋损评分的牙齿拍摄特写数码照片。13名正畸研究生使用改良的临床标准（ICDAS-II）独立对数码照片中的颊面龋损进行评分。通过计算加权kappa值评估检查者内和检查者间的可靠性。为了评估与临床检查相比，使用数码照片诊断颊面龋损严重程度的有效性，计算了Spearman相关系数。
检查者内可靠性以及每位检查者与临床检查之间的可靠性显示出中度至高度一致性，kappa值为0.52 - 0.83。根据改良的ICDAS-II标准，通过临床检查对颊面龋损进行评分与通过照片评分具有良好的相关性（Spearman相关系数为0.76）。
因此，根据ICDAS-II标准对数码照片上的颊面龋损进行评分是评估颊面龋损严重程度的一种可靠且有效的方法。
