Department of Dentomaxillofacial Surgery, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
Institute of Epidemiology and Medical Biometry, University of Ulm, Schwabstraße 13, 89075, Ulm, Germany.
Clin Oral Investig. 2017 Dec;21(9):2761-2770. doi: 10.1007/s00784-017-2078-2. Epub 2017 Feb 23.
The aim of this study was to examine the influence of experience and gender on the radiographic detection of proximal caries lesions and on therapeutic decisions.
A survey of 220 examiners (students and employees at three universities and dentists in the field) was taken using a standardized written questionnaire concerning radiographic diagnosis and therapy planning. An expert opinion of four dentists was determined as radiographic reference. A mixed effect logistic regression model was used for statistical evaluation and the odds ratio and p values were calculated (α = 0.05).
Examiners with experience had an almost four times greater chance of a correct assessment, if proximal caries lesion was present or not, than examiners with low experience (OR 3.7 (95% CI 2.4-5.8)). No gender-specific differences were discovered (OR women vs. men 0.9 (95% CI 0.6-1.4)). There was a relationship between the severity of the burnout effect on the x-ray and false positive caries diagnosis. Overall, 43% of respondents would plan invasive treatment in the enamel on a patient at low risk of caries and 78% on a high-risk patient. The results showed that the more experienced practitioners would be more likely to postpone restorative therapy on proximal caries until the lesion reached a later stage.
The results of this study suggest that examiner's experience influences the radiographic diagnosis of proximal lesions. No gender-specific differences could be found.
Examiner's professional experience is an important factor when radiography is included for detection and treatment planning of proximal lesions.
本研究旨在探讨经验和性别对近中面龋病病变放射检测和治疗决策的影响。
采用标准化书面问卷对 220 名检查者（三所大学的学生和员工以及现场的牙医）进行了一项调查，内容涉及放射诊断和治疗计划。四位牙医的专家意见被确定为放射学参考。使用混合效应逻辑回归模型进行统计评估，并计算了优势比和 p 值（α=0.05）。
如果存在近中面龋病病变，经验丰富的检查者比经验不足的检查者正确评估的可能性几乎高出四倍（OR 3.7（95%CI 2.4-5.8））。未发现性别特异性差异（OR 女性对男性 0.9（95%CI 0.6-1.4））。射线照相的倦怠效应的严重程度与假阳性龋病诊断之间存在关系。总体而言，43%的受访者会计划在低龋风险的患者的牙釉质上进行侵入性治疗，而 78%的患者会在高风险患者上进行治疗。结果表明，经验丰富的从业者更有可能将近中面龋病的修复治疗推迟到病变进展到更晚期。
本研究结果表明，检查者的经验会影响近中面病变的放射诊断。未发现性别特异性差异。
当放射线照相术用于检测和治疗计划近中面病变时，检查者的专业经验是一个重要因素。
