验证扫频源光学相干断层扫描（SS-OCT）在体外诊断平滑面龋中的应用。

Validation of swept source optical coherence tomography (SS-OCT) for the diagnosis of smooth surface caries in vitro.

机构信息

Cariology and Operative Dentistry, Oral Restitution Department, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.

出版信息

J Dent. 2013 Jan;41(1):80-9. doi: 10.1016/j.jdent.2012.10.007. Epub 2012 Oct 17.

DOI:10.1016/j.jdent.2012.10.007

PMID:23084870

Abstract

OBJECTIVE

An accurate evaluation of the extent of dental caries and possible progress of the lesion from enamel into dentin is very important in clinical dentistry. Dentists need an imaging technology that can noninvasively and reliably quantify the extent of caries. This study aimed to evaluate the effectiveness of non-polarized swept source optical coherence tomography (OCT) in evaluating the extent of caries on smooth enamel surfaces.

METHODS

One-hundred and twenty-seven investigation sites on the enamel surfaces of 93 extracted teeth were selected randomly and examined visually. The presence and extent of caries were scored by experienced and inexperienced dentists using each observation method (0: no caries; 1: enamel demineralization without surface breakdown; 2: enamel breakdown due to caries; 3: deep caries involving the dentin). The same locations were then examined using OCT, following which the teeth were sectioned using a diamond saw and viewed directly under a confocal laser scanning microscope (CLSM). Sensitivity and specificity indices for OCT and VI were calculated and compared. The results were analysed statistically using receiver operating characteristic (ROC) curves.

RESULTS

Enamel and dentin caries were outlined by a visible boundary on the cross-sectional OCT images. The modality showed superior results for the detection of dentinal caries; higher sensitivity and Az values could be obtained in the ROC curves, especially by experienced dentists.

CONCLUSIONS

Cross-sectional imaging of the natural caries lesions on smooth enamel surface by OCT enables efficient diagnosis of the lesion type, extent and dentin involvement.

CLINICAL SIGNIFICANCE

SS-OCT can demonstrate the cross-sectional image of smooth surface enamel caries as highlighted zone in tomogram. It is crucial to determine the extent of the lesion, whether it reaches beyond DEJ or not by a non-invasive and safe technique. OCT can give clinicians information about internal tooth structure and will help clinical decision making on surgical intervention.

摘要

目的

准确评估龋齿的程度以及病变从釉质向牙本质发展的可能性，在临床牙科中非常重要。牙医需要一种能够无创且可靠地量化龋齿程度的成像技术。本研究旨在评估非偏振扫频源光相干断层扫描（OCT）评估光滑釉质表面龋齿程度的有效性。

方法

随机选择 93 颗离体牙的 127 个釉质表面检查部位，并进行肉眼观察。经验丰富和缺乏经验的牙医使用每种观察方法（0：无龋齿；1：釉质脱矿但无表面破坏；2：龋齿导致的釉质破坏；3：深达牙本质的龋齿）对龋齿的存在和程度进行评分。然后，使用 OCT 对同一部位进行检查，之后使用金刚石锯将牙齿切片，并在共聚焦激光扫描显微镜（CLSM）下直接观察。计算 OCT 和 VI 的敏感度和特异性指数，并进行比较。使用接收器操作特性（ROC）曲线进行统计学分析。