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114. Ricketts DN, Kidd EA, Wilson RF. A re-evaluation of electrical resistance measurements for the diagnosis of occlusal caries. Br Dent J 1995;178:11-7. 115. Ricketts DN, Ekstrand KR, Kidd EA, Larsen T. Relating visual and radiographic ranked scoring systems for occlusal caries detection to histological and microbiological evidence. Oper Dent 2002;27:231-7. 116. Rock WP, Kidd EA. The electronic detection of demineralisation in occlusal fissures. Br Dent J 1988;164:243-7. 117. Rudolphy MP, van Amerongen JP, Penning C, ten Cate JM. Validity of bitewings for diagnosis of secondary caries in teeth with occlusal amalgam restorations in vitro. Caries Res 1993;27:312-6. 118. Rudolphy MP, Gorter Y, van Loveren C, van Amerongen JP. Validity of radiographs for diagnosis of secondary caries in teeth with class II amalgam restorations in vitro. Caries Res 1997;31:24-9. 119. Rugg-Gunn AJ. Approximal carious lesions. A comparison of the radiological and clinical appearances. Br Dent J 1972;133:481-4. 120. Russell M, Pitts NB. Radiovisiographic diagnosis of dental caries: initial comparison of basic mode videoprints with bitewing radiography. Caries Res 1993;27:65-70. 121. Sanden E, Koob A, Hassfeld S, Staehle HJ, Eickholz P. Reliability of digital radiography of interproximal dental caries. Am J Dent 2003;16:170-6. 122. Schmidlin PR, Tepper SA, Scriba H, Lutz F. In vitro assessment of incipient approximal carious lesions using computer-assisted densitometric image analysis. J Dent 2002;30:305-11. 123. Syriopoulos K, Sanderink GC, Velders XL, van der Stelt PF. Radiographic detection of approximal caries: a comparison of dental films and digital imaging systems. Dentomaxillofac Radiol 2000;29:312-8. 124. Thomas MF, Ricketts DN, Wilson RF. Occlusal caries diagnosis in molar teeth from bitewing and panoramic radiographs. Prim Dent Care 2001;8:63-9. 125. Tonioli MB, Bouschlicher MR, Hillis SL. Laser fluorescence detection of occlusal caries. Am J Dent 2002;15:268-73. 126. Tveit AB, Espelid I. Class II amalgams: interobserver variations in replacement decisions and diagnosis of caries and crevices. Int Dent J 1992;42:12-8. 127. Verdonschot EH, van de Rijke JW, Brouwer W, ten Bosch JJ, Truin GJ. Optical quantitation and radiographic diagnosis of incipient approximal caries lesions. Caries Res 1991;25:359-64. 128. Virajsilp V, Thearmontree A, Aryatawong S, Paiboonwarachat D. Comparison of proximal caries detection in primary teeth between laser fluorescence and bitewing radiography. Pediatr Dent 2005;27:493-9. 129. Wenzel A, Fejerskov O. Validity of diagnosis of questionable caries lesions in occlusal surfaces of extracted third molars. Caries Res 1992;26:188-94. 130. Wenzel A, Hintze H. Comparison of microscopy and radiography as gold standards in radiographic caries diagnosis. Dentomaxillofac Radiol 1999;28:182-5. 166 Karies – diagnostik, riskbedömning och icke-invasiv behandling
131. Wenzel A, Hintze H. The choice of gold standard for evaluating tests for caries diagnosis. Dentomaxillofac Radiol 1999;28:132-6. 132. Wenzel A, Fejerskov O, Kidd E, Joyston-Bechal S, Groeneveld A. Depth of occlusal caries assessed clinically, by conventional film radiographs, and by digitized, processed radiographs. Caries Res 1990;24:327-33. 133. Wolwacz VF, Chapper A, Busato AL, Barbosa AN. Correlation between visual and radiographic examinations of non-cavitated occlusal caries lesions – an in vivo study. Pesqui Odontol Bras 2004;18:145-9. 134. Wong A, Monsour PA, Moule AJ, Basford KE. A comparison of Kodak Ultraspeed and Ektaspeed plus dental X-ray films for the detection of dental caries. Aust Dent J 2002;47:27-9. KAPITEL 4 • Diagnostik 167
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Karies - diagnostik, riskbedömning
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Karies - diagnostik, riskbedömning
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Primärt urval av studier 63 Bedöm
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Resultat 176 FOTI 176 DiFOTI 176 DI
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Metodik 356 Litteratursökning 356
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SBU:s sammanfattning och slutsatser
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Bakgrund Karies är en kronisk sjuk
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Gradering av slutsatsernas evidenss
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Visuell-taktil diagnostik Studier s
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Hur kan kariesskador predikteras me
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Barn (1-3 år) som borstar tändern
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Kostnadseffektivitet för diagnosti
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undersöks. Frekvensen röntgenunde
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sönderfall av tanden, då patiente
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av tandhälsan och har inga symtom.
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ning. Riskbedömning görs rutinmä
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Betydelsen av effektiv tidig behand
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Validitet och reliabilitet Validite
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negativa prediktionsvärdet (NPV) b
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ytterligare i Faktaruta 1.6. Exempe
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Samhällsnivå Sociodemografi och v
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Faktaruta 1.1 Olika aspekter på va
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Faktaruta 1.3 Fyrfältstabell med k
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Faktaruta 1.4 Diagram som illustrer
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Faktaruta 1.6 Beräkning av likelih
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Faktaruta 1.7 Nomogram som visar hu
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Referenser 1. Fiske J, Davis DM, Fr
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2. Metodik för sökning och utvär
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Primärt urval av studier För att
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laget för slutsatserna. En metod s
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• Förklarat/analyserat bortfall
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Otillräckligt vetenskapligt underl
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3. Praxisundersökning avseende bit
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svenska och norska tonåringar unde
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Totalt antal undersökta Stockholm
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Østfold Totalt antal undersökta %
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4. Diagnostik 4.1 Visuell-taktil di
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Bakgrund Den primära metoden för
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undersökare och bedömdes ha ett m
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diagnostik av emaljkaries på tuggy
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Aktiv (pågående) och inaktiv (kro
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Tabell 4.1.1 Inklusionskriterier f
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Dropout/ missing data Method or tec
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Table 4.1.7 continued Author, year,
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Table 4.1.7 continued Author, year,
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Referenser 1. Rocha RO, Ardenghi TM
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tion compared with conventional rad
Page 113 and 114: 63. Banerjee A, Watson TF, Kidd EA.
Page 115 and 116: 93. Rosén B, Birkhed D, Nilsson K,
Page 117 and 118: 4.2 Röntgendiagnostik Slutsatser G
Page 119 and 120: antingen med kabel eller via trådl
Page 121 and 122: Risker med röntgenstrålning Rönt
Page 123 and 124: När observatörerna skulle bestäm
Page 125 and 126: Faktaruta 4.2.2 Nomogrammet som byg
Page 127 and 128: Metodik för litteraturgenomgång E
Page 129 and 130: procent och specificiteten mellan 9
Page 131 and 132: 0,1 99 0,2 LR+ LR- 0,5 Visuell insp
Page 133 and 134: Intern och extern validitet Diagnos
Page 135 and 136: Kommentarer Vilka tänder eller tan
Page 137 and 138: för att en tvådimensionell bild a
Page 139 and 140: Method Number of teeth and surfaces
Page 141 and 142: 52 molars and 11 premolars with occ
Page 143 and 144: Method Comparison method Outcome me
Page 153 and 154: Table 4.2.4 continued Author, year,
Page 157 and 158: Referenser 1. Akdeniz BG, Grondahl
Page 159 and 160: 33. Espelid I, Tveit AB. A comparis
Page 161 and 162: 66. Caliskan Yanikoglu F, Östurk F
Page 163: in proximal surfaces versus direct
Page 167 and 168: 4.3 Tilläggsmetoder för kariesdia
Page 169 and 170: kariesskada [81,82]. En diagnostisk
Page 171 and 172: (a) (b) (c) (d) (e) Figur 4.3.1 Eff
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Page 175 and 176: förhållandet var tvärtom för pr
Page 177 and 178: Tabell 4.3.1 Inklusionskriterier f
Page 179 and 180: Dropout/ missing data Comparison me
Page 181 and 182: Number of individuals Number of tee
Page 183 and 184: Number of individuals Number of tee
Page 185 and 186: Dropout/ missing data Method or tec
Page 189 and 190: Referenser 1. Grossman ES, Cleaton-
Page 191 and 192: 30. Hall AF, DeSchepper E, Ando M,
Page 193 and 194: of occlusal caries in children. Car
Page 195: 4.4. Etiska aspekter Som det framg
Page 198 and 199: • Salivens flöde och/eller buffr
Page 200 and 201: för riskfaktorn ifråga innan sjuk
Page 202 and 203: medel vid beslutsfattande. I slutä
Page 204 and 205: 55 procent). Karjalainen och medarb
Page 206 and 207: Kariesskador i primära tänder som
Page 208 and 209: som hade högst sockerkonsumtion fa
Page 210 and 211: Övriga inkluderade studier har lå
Page 212 and 213: områdena Aiken och Portland i Nort
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studier visar att låg- och mellanr
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Faktaruta 5.1 Inklusionskriterier f
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Table 5.1 Caries prediction in pre-
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Table 5.1 continued Author Year, re
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Table 5.2 Caries prediction in pre-
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Table 5.3 Caries prediction in scho
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Table 5.4 Caries prediction in scho
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Table 5.5 Caries prediction in adul
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Table 5.6 Caries prediction in adul
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Table 5.7 Tillförlitligheten hos t
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Table 5.8 Post-eruptive age as risk
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Table 5.9 Post-eruptive age as risk
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Table 5.10 Excluded studies. Author
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Table 5.10 continued Author, year,
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19. Karjalainen S, Söderling E, Se
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social factors and diseases. Int De
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isk assessment program in an elderl
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121. Demers M, Brodeur JM, Simard P
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study. Community Dent Oral Epidemio
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private practice. Community Dent Or
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221. Schröder U, Granath L. Dietar
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groups. Oral Surg Oral Med Oral Pat
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287. Ravald N, Birkhed D, Hamp SE.
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En nyss frambruten tand är mer mot
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Övriga produkter Ozon De syraprodu
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En studie, som undersökte effekten
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för få för slutsatser om effekti
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Table 6.2 Treatment of early corona
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Table 6.3 Treatment of early corona
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Table 6.4 Treatment of early root s
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Table 6.5 Excluded studies. Author,
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Referenser 1. Abernathy JR, Graves
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composite resin restorations. Acta
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7. Ekonomiska aspekter Slutsatser A
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Kostnaden för visuell-taktil under
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Faktaruta 7.1 Hur beräknas kostnad
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7.1 7.1 1 800 Kronor Kronor 1 600 1
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8. Tänkbara praxisförändringar T
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Referenser 1. Ekstrand K. Faglig vi
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DFS DFT dft DiFOTI Dikotomisering D
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Likelihood-kvot Lingual Makroskopis
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Rotcement Sensitivitet Specificitet
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Svante Twetman Professor, odontolog
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Bilaga 1. Sökstrategier Kapitel 4.
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Kapitel 5 fortsättning NOT Cariost
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Bilaga 2. Granskningsmallar Diagnos
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Studier om riskbedömning Första f
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Studier om behandling av tidiga kar
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Bilaga 3. Sensitivitet, specificite
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9 8 8,0 8,0 LR+ emalj LR- emalj LR
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Sensitivitet och specificitet 2,0 1
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200 Procent 180 160 140 120 100 80
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180 160 140 120 100 80 60 40 20 0 8
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15. Lussi A. Comparison of differen
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49. Kordic A, Lussi A, Luder HU. Pe
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Ont i ryggen, ont i nacken (2000),
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Rapporter på engelska Obstructive
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