Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions
Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions
复制标题
DOI：
10.1159/000016526
复制
发表时间：
1999-07-01
期刊：
影响因子：
4.2
通讯作者：
Baelum, V
中科院分区：
文献类型：
--
作者：
Nyvad, B;Machiulskiene, V;Baelum, V
目前的龋齿评分系统没有考虑疾病的动态性质。本研究的目的是描述一套新的临床龋病诊断标准，区分活动性和非活动性龋病变的空化和非空化水平，并评估该标准系统的可靠性，在人口中具有较高的龋齿经验。定义了10个诊断代码：0 =完好; 1 =活动性（完整）; 2 =活动性（表面不连续）; 3 =活动性（龋洞）; 4 =非活动性（完整）; 5 =非活动性（表面不连续）; 6 =非活动性（龋洞）; 7 =填充; 8 =填充有活动性龋; 9 =填充有非活动性龋。活动性和非活动性龋损之间的区别是在视觉和触觉标准相结合的基础上作出的。在3年的时间内，通过对50名儿童进行2名记录员的重复检查来评估检查员间和检查员内的可靠性。龋病诊断符合率在94.2%~ 96.2%之间。检查员内部检查的Kappa值范围为0.74 - 0.85，检查员间检查的Kappa值范围为0.78 - 0.80;所有错误分类中有81.6%涉及非空洞性龋损。健全表面与非空化活动性或非空化非活动性病变之间的不一致（分别为31.3%和31.2%）比非空化活动性和非空化非活动性病变之间的不一致（10.6%）更常见。考虑到在第一次检查时表面被诊断为健全的、非空穴化的活动性或非空穴化的非活动性龋损，再次确认健全的、非空穴化的活动性或非空穴化的非活动性龋损的概率分别为98.0%、68.7%和72.5%。结果表明，使用一套新的临床龋齿诊断标准的基础上活动评估，可以进行高可靠性，即使非空化诊断包括在标准系统。
Current scoring systems for dental caries do not consider the dynamic nature of the disease. The aims of the present study were to describe a new set of clinical caries diagnostic criteria which differentiate between active and inactive caries lesions at both the cavitated and non-cavitated levels and to evaluate the reliability of this criteria system in a population with high caries experience. Ten diagnostic codes were defined: 0 = sound; 1 = active (intact); 2 = active (surface discontinuity); 3 = active (cavity); 4 = inactive (intact); 5 = inactive (surface discontinuity); 6 = inactive (cavity); 7 = filling; 8 = filling with active caries; 9 = filling with inactive caries. Distinction between active and inactive caries lesions was made on the basis of a combination of visual and tactile criteria. The inter- and intra-examiner reliability was assessed through repeated examinations of 50 children by 2 recorders over a period of 3 years. The percentage agreement of caries diagnoses varied between 94.2 and 96.2%. The kappa values ranged between 0.74 and 0.85 for intra-examiner examinations and between 0.78 and 0.80 for inter-examiner examinations; 81.6% of all misclassifications involved non-cavitated caries lesions. Disagreement between sound surfaces and non-cavitated active or non-cavitated inactive lesions (31.3 and 31.2%, respectively) was more common than disagreement between non-cavitated active and non-cavitated inactive lesions (10.6%). The probability of reconfirming a sound, non-cavitated active or non-cavitated inactive caries lesion - given that the surface was diagnosed as either sound, non-cavitated active or non-cavitated inactive at the first examination - was 98.0, 68.7 and 72.5%, respectively. The results show that the use of a new set of clinical caries diagnostic criteria based on activity assessment can be performed with a high reliability, even when non-cavitated diagnoses are included in the criteria system.