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

Problemstellung: Der Rückgang der Kariesprävalenz und die Verschiebung der Ausprägung von kariösen Läsionen haben zur Folge, dass die Karies nicht mehr ausschließlich auf dem Kavitationsniveau erfasst werden sollte. Das International Caries Detection and Assessment System (ICDAS-II) ist ein siebenst...

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Bibliographic Details
Main Author: Rolfsen, Stefanie
Contributors: Jablonski-Momeni, Anahita (Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2009
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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.