Rimmer P A, Pitts N B
Department of Dental Health, Dundee Dental School.
Br Dent J. 1990;169(3-4):87-92. doi: 10.1038/sj.bdj.4807281.
This study examined the feasibility, acceptability and potential diagnostic value of using a 'blanket' technique for placing elastomeric separators as a diagnostic aid in a general practice situation. Five practices were visited and 211 children between 5 and 15 years were examined. All 211 children accepted the 'clinical without separators' examination, 37 children were unwilling to have the radiographic examination and 12 of the 146 children who required separators refused or removed them. The use of the technique as a routine aid was acceptable to the host practitioners, the parents, most of the patients and to the clinician conducting the study. The method was shown to be valuable in revealing additional approximal lesions. A total of 703 lesions were disclosed by the 'clinical with separators' method, compared with 479 diagnosed by routine clinical examination alone. As many of the additional lesions were at the precavitation stage, this information could be used to target those patients with special needs for preventive care. While the larger dentinal lesions revealed by temporary elective tooth separation were confirmed by bitewing radiographs, many of the small precavitation lesions were not. The results showed, however, that bitewing radiographs were still an important diagnostic aid, especially in the deciduous dentition. Elastomeric separators may have a role as a diagnostic aid in conjunction with bitewings, rather than as a replacement for them.
本研究探讨了在一般临床环境中使用“全面”技术放置弹性分离器作为诊断辅助手段的可行性、可接受性及潜在诊断价值。研究走访了5家诊所，对211名5至15岁的儿童进行了检查。所有211名儿童均接受了“不使用分离器的临床检查”，37名儿童不愿接受X线检查，在146名需要放置分离器的儿童中，有12名拒绝或取下了分离器。该技术作为常规辅助手段，得到了主办医生、家长、大多数患者以及进行研究的临床医生的认可。结果表明，该方法在发现更多邻面病变方面具有价值。“使用分离器的临床检查”方法共发现703处病变，而仅通过常规临床检查诊断出479处病变。由于许多新增病变处于龋前期，这些信息可用于确定那些有特殊预防保健需求的患者。虽然通过临时选择性牙齿分离发现的较大牙本质病变经咬合翼片X线检查得以证实，但许多小的龋前期病变并非如此。然而，结果显示咬合翼片X线检查仍是重要的诊断辅助手段，尤其是在乳牙列中。弹性分离器可作为与咬合翼片联合使用的诊断辅助手段，而非替代咬合翼片。
