Lussi A, Hack A, Hug I, Heckenberger H, Megert B, Stich H
Department of Operative, Preventive and Paediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
Caries Res. 2006;40(2):97-103. doi: 10.1159/000091054.
The laser device DIAGNOdent developed for the detection of occlusal caries has limited value on approximal surfaces. The aim of this study was to develop and to test a new laser fluorescence (LF) device for the detection of approximal caries. Light with a wavelength of 655 nm was transported to the approximal surface using two different sapphire fibre tips. Seventy-five teeth were selected from a pool of extracted permanent human molars, frozen at -20 degrees C until use. Before being measured, they were defrosted, cleaned and calculus was removed with a scaler. The molars were set in blocks simulating the contact area of adults. Bitewing radiographs were obtained using Kodak Insight films. After two independent assessments with the new LF device, the teeth were histologically prepared, and assessed for caries extension. Using the laser, specificity values for D1 threshold (outer half of enamel), D2 threshold (inner half of enamel), D3 threshold (dentine) ranged between 0.81 and 0.93, sensitivity between 0.84 and 0.92 with no difference between the two tips. Bitewing radiography showed an inferior performance compared to LF (p<0.05). Intraex aminer reproducibility was high (kappa>.74). The new LF system might be a useful additional tool in detecting approximal caries. Because of its good reproducibility, it could be used to monitor caries regression or progression on approximal surfaces.
为检测咬合面龋损而研发的激光设备DIAGNOdent在邻面龋损检测方面价值有限。本研究旨在研发并测试一种用于检测邻面龋的新型激光荧光（LF）设备。使用两种不同的蓝宝石光纤头将波长为655 nm的光传输至邻面。从拔除的恒牙人类磨牙中选取75颗牙齿，在-20℃下冷冻保存直至使用。测量前，将其解冻、清洁并用洁治器去除牙结石。将磨牙置于模拟成人接触区域的模块中。使用柯达Insight胶片拍摄咬合翼片。使用新型LF设备进行两次独立评估后，对牙齿进行组织学处理，并评估龋损扩展情况。使用该激光设备，D1阈值（釉质外半层）、D2阈值（釉质内半层）、D3阈值（牙本质）的特异性值在0.81至0.93之间，敏感性在0.84至0.92之间，两种光纤头之间无差异。与LF相比，咬合翼片摄影表现较差（p<0.05）。检查者内再现性较高（kappa>.74）。新型LF系统可能是检测邻面龋的一种有用的辅助工具。由于其良好的再现性，可用于监测邻面龋损的消退或进展情况。
