Virajsilp V, Thearmontree A, Aryatawong S, Paiboonwarachat D
Division of Community Dentistry, Department of Preventive Dentistry, Prince of Songkla University, Songkhla, Thailand.
Pediatr Dent. 2005 Nov-Dec;27(6):493-9.
The purposes of this in vitro study were to: (1) compare the accuracy of a laser fluorescence system (DIAGNOdent) in proximal caries diagnosis in primary teeth with that of bitewing radiography, using the histological examination as a gold standard; and (2) evaluate the reliability of the DIAGNOdent examination.
Included were 107 extracted primary molars without obvious cavities on proximal surfaces. The teeth were examined by 2 examiners using DIAGNOdent directly on the lesions (without contact; ie, proximal surfaces were not in contact with other teeth) and indirectly (with contact; ie, proximal surfaces were in contact with adjacent teeth). To simulate contacting teeth, the studied surface was set adjacent to a sound surface in a wax base. The contacting teeth were also diagnosed using bitewing radiography. Results of the diagnoses were compared with a histological gold standard. Sensitivity and specificity were calculated for each diagnostic system. Inter- and intraexaminer reliabilities of DIAGNOdent were calculated using intraclass correlation (ICC).
At the dentine caries (D3) level, the sensitivities of bitewing radiography (with contacting teeth) and DIAGNOdent with and without contacting teeth (direct application) were 0.41, 0.85 and 0.93, respectively, and the specificities were 1, 0.89, and 0.87, respectively. Both inter- and intraexaminer reliabilities using DIAGNOdent with and without contacting teeth (direct application) were very high (ICC=0.97 to 0.99).
The reliability of DIAGNOdent is very high and its diagnostic validity (sum of sensitivity and specificity) is higher than that of bitewing radiography for proximal caries detection in primary teeth.
本体外研究的目的是：（1）以组织学检查作为金标准，比较激光荧光系统（DIAGNOdent）与咬合翼片X线摄影术对乳牙邻面龋诊断的准确性；（2）评估DIAGNOdent检查的可靠性。
纳入107颗近中面无明显龋洞的拔除乳牙。由2名检查者分别直接（不接触；即近中面不与其他牙齿接触）和间接（接触；即近中面与相邻牙齿接触）使用DIAGNOdent对牙齿进行检查。为模拟接触牙齿，将研究表面置于蜡基中的健康表面旁边。接触牙齿也通过咬合翼片X线摄影术进行诊断。将诊断结果与组织学金标准进行比较。计算每个诊断系统的敏感性和特异性。使用组内相关系数（ICC）计算DIAGNOdent检查者间和检查者内的可靠性。
在牙本质龋（D3）水平，咬合翼片X线摄影术（接触牙齿）以及DIAGNOdent直接应用（接触和不接触）的敏感性分别为0.41、0.85和0.93，特异性分别为1、0.89和0.87。DIAGNOdent直接应用接触和不接触牙齿时检查者间和检查者内的可靠性均非常高（ICC = 0.97至0.99）。
DIAGNOdent的可靠性非常高，其诊断有效性（敏感性和特异性之和）高于咬合翼片X线摄影术对乳牙邻面龋的检测。
