Korrelation des visuellen Diagnosesystems ICDAS-II für die okklusale Karies mit drei verschiedenen Verfahren der Fluoreszenzmessung – eine In-vitro-Studie
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Philipps-Universität Marburg
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Aim: This in-vitro study aimed to assess the reproducibility of ICDAS-II and three fluorescence methods for caries detection when used by an experienced and a novice examiner. Furthermore, the correlation among the ICDAS-II and the fluorescence methods should be evaluated. Additionally, the performance of all methods for the detection of dentine caries should be assessed as compared to radiographic detection.
Material & Methods: 53 freshly extracted permanent teeth were available for the
study. Two examiners (A: experienced dentist, B: final-year dental student) examined 99 investigation sites on the occlusal surfaces of the teeth using the following methods: ICDAS-II, the laser fluorescence devices DIAGNOdent (DD) and DIAGNOdent Pen (DDPen), and the fluorescence camera VistaProof (VP). All sites were examined twice within the same day. Bitewing radiographs (BW) were taken and assessed for presence of caries at D3-Level (dentine caries).
Statistics: Statistical analyses were made by means of SPSS, Version 14.0. Cohen´s kappa was used to calculate the intra- and inter-examiner reproducibility of ICDASII.
Intra-class-correlation coefficients (ICC) were calculated for intra- and inter-examiner reproducibility of the fluorescence measurements. The Bland-Altman method was applied for the fluorescence measurements to identify systematic differences and the extent of concordance between two readings. Correlations among the fluorescence methods were assessed using Spearman´s correlation coefficient (rs). All methods were crosstabulated versus radiography.
Results: Kappa values for intra-examiner reproducibility (ICDAS-II) were for examiner A: 0.73 (unweighted) and 0.78 (weighted); Examiner B: 0.47 (unweighted) and 0.70 (weighted). Inter-examiner reproducibility was κ = 0.60 (unweighted) and κ = 0.74 (weighted). Intra-examiner reproducibility (ICC) for examiner A was: 0.95 (DD), 0.97 (DDPen), 0.81 (VP) and for examiner B: 0.98 (DD), 0.98 (DDPen), 0.95 (VP). Inter-examiner reproducibility (ICC) was 0.86 (DD), 0.93 (DDPen) and 0.76 (VP). Bland-Altman-Plots showed for intra-examiner reproducibility means between – 3.63 and 0.02. The 95 % limits of agreement were between 16,84 and – 24,12. Significant positive correlations were observed among all methods (p < 0.001). Correlation between ICDAS-II and other methods (DD, DDPen, VP) were moderate rs = 0,64 – 0.67 (Examiner A) and rs = 0.57 – 0.63 (Examiner B). rs for examiner A were: 0.93 (DD/DDPen), 0.79 (DD/VP), 0.80 (DDPen/VP) and for examiner B: 0.93 (DD/DDPen), 0.60 (DD/VP), 0.62 (DDPen/VP). rs with bitewing radioagraphy were: Examiner A: 0.60 (ICDAS-II), 0.44 (DD), 0.36 (DDPen), 0.48 (VP); Examiner B: 0.60 (ICDAS-II), 0.39 (DD), 0.41 (DDPen), 0.45 (VP). 30 sites were found by BW to have dentinal caries. The performance of different methods in detecting dentinal caries was: Examiner A: 60% (ICDAS-II), 70% (DD), 73% (DDPen), 10% – 73% (VP); Examiner B: 57% (ICDAS-II), 77% (DD), 80% (DDPen), 7% – 80% (VP).
Conclusion: All detection methods for occlusal caries demonstrated high reproducibility whether they were used by a dental student or an experienced examiner. The findings support the view that final-year dental students are able to apply a fluorescence system as a supportive device for caries diagnostic and monitoring purposes.
Each diagnostic procedure has own characteristics, indications and limitations in the application, thus a combination of several methods is recommended for carefully recording occlusal caries. Since the clinical database of the suggested cut-off values for the VistaProof is limited to date, the values should be interpreted carefully until more clinically validated results are available.
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Created: 2010Issued: 2010-10-13Updated: 2011-08-10
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
ICDAS-IIKorrelationCorrelationICDAS-II
DFG-subjects
Diagnosesystem
DDC-Numbers
610
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Rosen, Simon Martin (142551759): Korrelation des visuellen Diagnosesystems ICDAS-II für die okklusale Karies mit drei verschiedenen Verfahren der Fluoreszenzmessung – eine In-vitro-Studie. : Philipps-Universität Marburg 2010-10-13. DOI: https://doi.org/10.17192/z2010.0561.
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This item has been published with the following license: In Copyright