Department of Dental Materials, Piracicaba School of Dentistry, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil.
Lasers Med Sci. 2011 Jan;26(1):1-5. doi: 10.1007/s10103-009-0731-y. Epub 2009 Sep 26.
The aim of this study was to compare the in situ and in vitro performances of a laser fluorescence (LF) device (DIAGNOdent 2095) with visual inspection for the detection of occlusal caries in permanent teeth. Sixty-four sites were selected, and visual inspection and LF assessments were carried out, in vitro, three times by two independent examiners, with a 1-week interval between evaluations. Afterwards, the occlusal surfaces were mounted on the palatal portion of removable acrylic orthodontic appliances and placed in six volunteers. Assessments were repeated and validated by histological analysis of the tooth sections under a stereomicroscope. For both examiners, the highest intra-examiner values were observed for the visual inspection when in vitro and in situ evaluations were compared. The inter-examiner reproducibility varied from 0.61 to 0.64, except for the in vitro assessment using LF, which presented a lower value (0.43). The methods showed high specificity at the D(1) threshold (considering enamel and dentin caries as disease). In vitro evaluations showed the highest values of sensitivity for both methods when compared to the in situ evaluations at D(1) and D(2) (considering only dentinal caries as the disease) thresholds. For both methods, the results of sensitivity (at D(1) and D(2)) and accuracy (at D(1)) showed significant differences between in vitro and in situ conditions. However, the sensitivity (at D(1) and D(2)), specificity and accuracy (both at D(1)) of the methods were not significantly different when the same condition was considered. It can be concluded that visual inspection and LF showed better performance in vitro than in situ.
本研究旨在比较激光荧光（LF）设备（DIAGNOdent 2095）与肉眼观察在检测恒牙窝沟龋中的体内和体外性能。选择了 64 个部位，进行了体外肉眼观察和 LF 评估，由两名独立的检查者进行了三次评估，两次评估之间间隔 1 周。之后，将牙面固定在可摘式丙烯酸正畸矫治器的腭部，并将其置于六名志愿者口中。对每一位检查者，在体外和体内评估时，肉眼观察的观察者内值最高。除了体外 LF 评估的观察者间可重复性为 0.43 外，其余均为 0.61-0.64。当在 D(1)阈值（将牙釉质和牙本质龋视为疾病）下，两种方法均表现出高特异性。在 D(1)和 D(2)阈值下（仅将牙本质龋视为疾病），与体内评估相比，两种方法的体外评估均具有最高的敏感性值。对于两种方法，在 D(1)和 D(2)（体外）条件下，敏感性（在 D(1)和 D(2)）和准确性（在 D(1)）的结果存在显著差异。然而，当考虑相同条件时，两种方法的敏感性（在 D(1)和 D(2)）、特异性和准确性（在 D(1)）没有显著差异。可以得出结论，肉眼观察和 LF 在体外的性能优于体内。
