Desempenho clínico da flurescência, imagens digitais ampliadas e ICDAS na detecção de cárie em superfícies oclusais
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Data
2013-03-19
Autores
Presoto, Cristina Dupim [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo deste estudo foi avaliar o desempenho clínico da câmera de fluorescência VistaProof, da câmera intraoral digital Vista Cam e do critério ICDAS para detecção de cárie oclusal. Cento e sete dentes posteriores de pacientes adultos foram examinados visualmente e por meio de radiografias digitais por dois examinadores, que os classificaram de acordo com a presença ou ausência de cárie oclusal, em dois momentos, a fim de determinar a reprodutibilidade intra e interexaminadores. Esta avaliação foi considerada padrão-ouro. Os dentes foram então avaliados pelo critério visual ICDAS, fluorescência e imagem digital ampliada por outros dois examinadores, em dois momentos. Para estudo da efetividade estimou-se a sensibilidade, especificidade, razão de verossimilhança positiva e negativa. Construiu-se a curva ROC e estimou-se sua área (AUROC). A concordância intra e interexaminadores para a microcâmera intraoral e para o ICDAS foi ótima (κ˃0,81) e no mínimo boa para a câmera VistaProof (κ˃0,63). Houve excepcional capacidade discriminante para a imagem intraoral (AUROC=0,93) e para o ICDAS (AUROC=0,91) e diferença estatística não significativa entre eles (z= 0,35; p=0,73). A fluorescência apresentou capacidade discriminante aceitável (AUROC=0,78), porém menor que os demais. A razão de verossimilhança positiva encontrada para a fluorescência foi de apenas 2,32, enquanto que para a imagem intraoral foi 20,58 e para o ICDAS, 58,11. Pode-se concluir que a reprodutibilidade intra e interexaminadores para o ICDAS e para os métodos de detecção de cárie utilizados foi considerada adequada. Os três apresentaram adequado desempenho clínico, sendo este melhor para o ICDAS e para a imagem intraoral.
The aim of this study was to evaluate the clinical performance of the VistaProof fluorescence camera, Vista Cam digital intraoral camera and ICDAS criterion for occlusal caries detection. One hundred and seven posterior teeth of adult patients were examined visually and by means of digital radiographs by two examiners who rated them according to the presence or absence of occlusal caries in two stages in order to determine the reproducibility intra and interexaminers. This evaluation was considered the gold standard. The teeth were then evaluated by the visual criterion ICDAS, fluorescence and digital image magnified by two other examiners, on two occasions. The effectiveness of the methods was estimated by sensitivity, specificity, positive and negative likelihood ratio. For each method was constructed ROC curve and its area (AUROC) was estimated. The intra and interexaminer agreement for the intraoral camera and the ICDAS was excellent (κ˃0.81) and at least good for the VistaProof camera (κ˃0.63). There was exceptional discrimination capacity for intraoral image (AUROC=0.93) and for ICDAS (AUROC=0.91) and no significant statistical difference between them (z=0.35, p=0.73). The fluorescence showed acceptable discrimination capacity ROC (AUROC=0.78), but lower than the others. The positive likelihood ratio found for the fluorescence was only 2.32, while for intraoral image was 20.58 and the ICDAS, 58.11. It can be concluded that the reproducibility intra and interexaminer to ICDAS and for caries detection methods utilized was considered adequate. The three had good clinical performance, which is better for the ICDAS and for intraoral image.
The aim of this study was to evaluate the clinical performance of the VistaProof fluorescence camera, Vista Cam digital intraoral camera and ICDAS criterion for occlusal caries detection. One hundred and seven posterior teeth of adult patients were examined visually and by means of digital radiographs by two examiners who rated them according to the presence or absence of occlusal caries in two stages in order to determine the reproducibility intra and interexaminers. This evaluation was considered the gold standard. The teeth were then evaluated by the visual criterion ICDAS, fluorescence and digital image magnified by two other examiners, on two occasions. The effectiveness of the methods was estimated by sensitivity, specificity, positive and negative likelihood ratio. For each method was constructed ROC curve and its area (AUROC) was estimated. The intra and interexaminer agreement for the intraoral camera and the ICDAS was excellent (κ˃0.81) and at least good for the VistaProof camera (κ˃0.63). There was exceptional discrimination capacity for intraoral image (AUROC=0.93) and for ICDAS (AUROC=0.91) and no significant statistical difference between them (z=0.35, p=0.73). The fluorescence showed acceptable discrimination capacity ROC (AUROC=0.78), but lower than the others. The positive likelihood ratio found for the fluorescence was only 2.32, while for intraoral image was 20.58 and the ICDAS, 58.11. It can be concluded that the reproducibility intra and interexaminer to ICDAS and for caries detection methods utilized was considered adequate. The three had good clinical performance, which is better for the ICDAS and for intraoral image.
Descrição
Palavras-chave
Cáries dentárias, Diagnostico, Fluorescencia, Dental caries
Como citar
PRESOTO, Cristina Dupim. Desempenho clínico da flurescência, imagens digitais ampliadas e ICDAS na detecção de cárie em superfícies oclusais. 2013. 75 f. Dissertação (mestrado) Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Odontologia de Araraquara, 2013.