Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
Oper Dent. 2010 Sep-Oct;35(5):564-71. doi: 10.2341/09-332-L.
This study evaluated the performance of the DIAGNOdent pen laser fluorescence device (LFpen) in comparison with visual examination (VE), bitewing radiographs (BW) and visual examination combined with bitewing radiographs (VEBW) in detecting secondary approximal caries associated with composite restorations. In total, 60 approximal surfaces from 43 permanent molars with composite restorations were assessed twice by two examiners using the LFpen, VE, BW and VEBW. After histological preparation and hardness measurements, the sample was assigned to either a crown or root caries group, depending on the location of the lesions as the gold standard. For crown caries at D1, the highest values of specificity and sensitivity were observed for the LFpen at a cutoff value of 18 (1.00) and for the VEBW (0.89). At D3 (cutoff of 30), the LFpen showed the highest values of sensitivity and specificity. For root caries, the LFpen and VEBW showed the highest values of specificity (0.54), sensitivity (0.81) and accuracy (0.69). The Spearman rank correlation coefficients for crown/root caries with histology were 0.54/0.37 (LFpen), 0.29/0.10 (BW), 0.29/0.18 (VE) and 0.23/0.37 (VEBW). For the LFpen, the ICC varied from 0.80 (interexaminer) to 0.97 (intraexaminer B); the kappa value was 0.19 for BW and 0.35 for VE (interexaminer). Intraexaminer kappa values for BW were 0.25 (A) and 0.29 (B), and those for VE were 0.31 (A) and 0.32 (B). The LFpen device exhibited a performance comparable to that of conventional methods but with higher interexaminer reproducibility. Therefore, the LFpen should be considered an auxiliary method for the detection of secondary approximal caries associated with composite restorations.
本研究评估了 DIAGNOdent 笔激光荧光设备（LFpen）与肉眼检查（VE）、咬翼片（BW）以及肉眼检查结合咬翼片（VEBW）在检测与复合树脂修复体相关的继发性邻面龋方面的性能。共有 43 颗有复合树脂修复体的磨牙的 60 个邻面，由两位检查者使用 LFpen、VE、BW 和 VEBW 进行了两次评估。在进行组织学准备和硬度测量后，根据病变位置，样本被分配到冠龋或根龋组，作为金标准。对于 D1 处的冠龋，在截断值为 18（1.00）时，LFpen 和 VEBW 的特异性和敏感性最高。在 D3（截断值为 30）时，LFpen 显示出最高的敏感性和特异性。对于根龋，LFpen 和 VEBW 的特异性（0.54）、敏感性（0.81）和准确性（0.69）最高。与组织学对照的冠/根龋的 Spearman 秩相关系数分别为 0.54/0.37（LFpen）、0.29/0.10（BW）、0.29/0.18（VE）和 0.23/0.37（VEBW）。对于 LFpen，检查者间的 ICC 为 0.80（A）至 0.97（B）；BW 的 Kappa 值为 0.19，VE 为 0.35（A）和 0.32（B）。BW 的 A 检查者和 B 检查者的内检者 Kappa 值分别为 0.25 和 0.29，VE 分别为 0.31 和 0.32。LFpen 设备的性能与传统方法相当，但具有更高的检查者间可重复性。因此，LFpen 可被视为检测与复合树脂修复体相关的继发性邻面龋的辅助方法。
