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基于视觉检测系统的本科生和研究生龋病治疗决策。

Caries treatment decisions among undergraduate and postgraduate students supported by visual detection systems.

机构信息

Department of Pediatrics, Araraquara Dental School, UNESP-Univ Estadual Paulista, Araraquara, SP, Brazil.

Department of Dentistry and Oral Health, Aarhus University, Aarhus C, Denmark.

出版信息

Int J Paediatr Dent. 2018 Jan;28(1):92-101. doi: 10.1111/ipd.12312. Epub 2017 Jun 19.

Abstract

BACKGROUND

The difficulties of caries diagnosis and the level of examiner's experience may influence the treatment decision, resulting excessive and inefficient intervention.

AIM

This randomized experimental study evaluated caries treatment decisions made by undergraduate (UG) and postgraduate (PG) students when examination was performed through conventional visual clinical examination (CVCE) and when supported by ICDAS (IC) or Nyvad's (NY) criteria.

DESIGN

Four UG and four PG initially analyzed, by CVCE, 300 primary incisors and molars surfaces of 25 children aged 5-12 years, and choose between no treatment, non-operative, and operative treatment. Students were randomized between IC (2UG; 2PG) and NY (2UG; 2PG) and, after one week of receiving training, repeated evaluations and treatment suggestions. Reference standard was established by two researchers' consensus. Sensitivity, specificity, ROC analysis, and kappa were calculated. Treatment decisions were analyzed by means of contingency tables.

RESULTS

Only sensitivity showed statistical difference (P < 0.05). Operative treatment had high percentage for initial lesions at first evaluation for both criteria; second evaluation showed higher percentage of non-operative treatments for the same lesions.

CONCLUSIONS

IC and NY present satisfactory performance in primary teeth by UG and PG, and their use may assistance UG to adopt a less interventionist approach for initial enamel lesions.

摘要

背景

龋齿诊断的困难和检查者经验水平可能会影响治疗决策,导致过度和低效的干预。

目的

本随机实验研究评估了本科生(UG)和研究生(PG)在通过常规视觉临床检查(CVCE)和 ICDAS(IC)或 Nyvad's(NY)标准进行检查时做出的龋齿治疗决策。

设计

4 名 UG 和 4 名 PG 最初通过 CVCE 分析了 25 名 5-12 岁儿童的 300 颗乳前牙和磨牙表面,并在不治疗、非手术和手术治疗之间做出选择。学生在 IC(2UG;2PG)和 NY(2UG;2PG)之间随机分组,并在接受一周培训后重复评估和治疗建议。参考标准由两位研究人员的共识确定。计算了灵敏度、特异性、ROC 分析和 Kappa。通过列联表分析治疗决策。

结果

只有灵敏度显示出统计学差异(P < 0.05)。两种标准下,初始病变的手术治疗比例在第一次评估时均较高;第二次评估显示,同一病变的非手术治疗比例较高。

结论

IC 和 NY 在 UG 和 PG 对乳牙的表现令人满意,它们的使用可能有助于 UG 对初始釉质病变采取较少干预性的方法。

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