Korrelation des International Caries Detection and Assessment System (ICDAS-II) zur okklusalen Kariesdiagnose mit Laserfluoreszenzmessungen - eine In-vitro-Studie

Aim: The aim of this study was to evaluate the correlation of visual inspection results (V) on occlusal surfaces of extracted teeth, the results of the laser fluorescence measurements (LF-Z) and histological of hard tissue sections (H). Additionally the correlation of LF-measurements on tooth slices (LF-H/LF-H pen) and visual and histological results were to be evaluated. Material & methods: 100 human extracted molars with 181 examination sites on the occlusal surfaces were examined visually (ICDAS-II) and by laser fluorescence. Thereafter the teeth were serially sectioned and assessed histologically and with LF. Statistics: Statistical analysis was made with SPSS (14.0). Cohen´s kappa was used to calculate the intra-examiner reproducibility. Additionally, the Intraclass Correlation Coefficient (ICC) was measured. The correlation was calculated using Spearman’s correlation coefficient. Sensitivity and specificity were measured for D1 and D3 level. Results: Weighted kappa value for intra-examiner reproducibility was 0.80 for LF-Z. For LF-H and LF-H pen, the weighted kappa values were 0.90 and 0.94. The Intraclass Correlation Coefficient was 0.988 for LF-H and 0.828 for LF-H pen. The correlation between V and LF-Z was rs=0.52 and between V and H 0.70. The LF-measurements of the sections showed a poor correlation with V (rs=0.29 and 0.36) and a moderate correlation with H (rs=0.60 und 0.54). The correlation between LF-Z and LF-H was rs=0.5. For visual inspection at the D1 diagnostic threshold (enamel and dentine lesions) specificity was 54.0% and sensitivity was 90.7%. At the D3 diagnostic threshold (dentine lesions) specificity was 91.1% and sensitivity was 70.1 %. Sensitivity of the laser fluorescence measurement was 47.3% for D1 level and 53.0% for D3 level. Specificity was 88.0% for D1 and 87.0% for D3. Conclusion: Caries lesions on hard tissue sections can only be registered limitedly by LF-measurements. Regarding depth of lesion histological examination is the preferable method.