Mendes Fausto Medeiros, Siqueira Walter Luiz, Mazzitelli Julianna Fernandes, Pinheiro Sérgio Luiz, Bengtson Antônio Lucindo
Department of Pediatric Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227 São Paulo, Brazil.
J Dent. 2005 Jan;33(1):79-84. doi: 10.1016/j.jdent.2004.10.010. Epub 2004 Dec 8.
To evaluate the performance of the laser fluorescence device (DIAGNOdent) for detection and quantification of smooth-surface caries lesions in primary teeth.
Seventy-seven approximal surfaces with no caries or with white spot caries lesions without cavitation was selected from 51 primary molars. Laser fluorescence readings were performed and the site of higher value in each surface was indicated. After the readings, the surfaces were cut and the samples were destined for histopathological and cross-sectional microhardness evaluation. ROC analysis was conducted and the area under the ROC curve and the best cut-off points were obtained at D1, D2 and D3 thresholds. With these cut-off values, the sensitivity, specificity and accuracy were calculated at these thresholds. The regression lines of laser fluorescence readings as function of lesion extension, lesion depth and cross-sectional microhardness values were plotted and the Pearson correlation coefficients were obtained.
The best DIAGNOdent performance was obtained at D3 threshold (A(z)=0.90) and the worst performance was achieved at D1 threshold (A(z)=0.82). The correlation was better between the laser fluorescence readings and lesion depth obtained in polarized light microscope examination (r=0.78), than that obtained with the microhardness values (r=-0.57).
The laser fluorescence shows a good performance to predict caries lesions extension. Device presents a better correlation with the lesion depth than with mineral loss in smooth-surface caries lesions.
评估激光荧光装置(DIAGNOdent)检测和定量乳磨牙光滑面龋损的性能。
从51颗乳磨牙中选取77个无龋或有非空洞性白斑龋损的邻面。进行激光荧光读数,并标记每个表面读数较高的部位。读数后,将这些表面切开,样本用于组织病理学和横断面显微硬度评估。进行ROC分析,在D1、D2和D3阈值处获得ROC曲线下面积和最佳截断点。利用这些截断值,计算这些阈值下的灵敏度、特异性和准确性。绘制激光荧光读数随病变扩展、病变深度和横断面显微硬度值变化的回归线,并获得Pearson相关系数。
在D3阈值时DIAGNOdent表现最佳(A(z)=0.90),在D1阈值时表现最差(A(z)=0.82)。激光荧光读数与偏振光显微镜检查中获得的病变深度之间的相关性更好(r=0.78),优于与显微硬度值的相关性(r=-0.57)。
激光荧光在预测龋损扩展方面表现良好。在光滑面龋损中,该装置与病变深度的相关性优于与矿物质流失的相关性。