Dutra Eduarda Rodrigues, Chisini Luiz Alexandre, Cademartori Mariana Gonzalez, Oliveira Luísa Jardim Corrêa de, Demarco Flávio Fernando, Correa Marcos Britto
Universidade Federal de Pelotas, Pelotas, Brazil.
Cad Saude Publica. 2018;34(4):e00077217. doi: 10.1590/0102-311x00077217. Epub 2018 Apr 23.
The aim of this study was to test accuracy and reliability of a partial protocol (PP) of oral examination involving the permanent first molars. This cross-sectional study was carried out in two stages. First, a cross-sectional study was performed in a representative sample of 1,211 children using DMFT-index in a full-mouth protocol (FM). A PP was simulated from FM data using only data from the permanent first molars. A second part was performed with 202 children examined by a gold standard examiner (FM) and three dentists using the PP to assess its reliability. Accuracy of PP was assessed by sensitivity/specificity/predictive positive and negative values. Inter-examiner reliability in comparison with gold standard examiner was assessed using weighted kappa. The prevalence of dental caries observed using DMFT index was 32.4% and was 30.2% for PP . The PP presented high sensitivity (93.1%; 95%CI: 91.5-94.5), showing similar magnitude of association's measures for all associated factors investigated. When compared with the gold standard FM examination, all examiners obtained high parameters of sensitivity and specificity (around 90%). Predictive negative values were higher than predictive positive values for the examiners. This study showed that this partial protocol involving the permanent first molars is accurate and reliable as a screening tool to assess dental caries prevalence and associated factors in schoolchildren.
本研究的目的是测试涉及恒牙第一磨牙的口腔检查部分方案（PP）的准确性和可靠性。这项横断面研究分两个阶段进行。首先，对1211名儿童的代表性样本进行横断面研究，采用全口检查方案（FM）中的DMFT指数。仅使用恒牙第一磨牙的数据从FM数据模拟出PP。第二部分对202名儿童进行检查，由一名金标准检查者（FM）和三名牙医使用PP来评估其可靠性。通过敏感性/特异性/预测阳性和阴性值评估PP的准确性。使用加权kappa评估与金标准检查者相比的检查者间可靠性。使用DMFT指数观察到的龋齿患病率为32.4%，PP为30.2%。PP表现出高敏感性（93.1%；95%CI：91.5 - 94.5），对所有调查的相关因素显示出相似程度的关联测量。与金标准FM检查相比，所有检查者均获得了高敏感性和特异性参数（约90%）。检查者的预测阴性值高于预测阳性值。本研究表明，这种涉及恒牙第一磨牙的部分方案作为评估学龄儿童龋齿患病率和相关因素的筛查工具是准确且可靠的。
