Shakibaie Fardad, Walsh Laurence J
School of Dentistry, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.
Lasers Med Sci. 2016 Nov;31(8):1621-1626. doi: 10.1007/s10103-016-2027-3. Epub 2016 Jul 19.
Deposits of subgingival calculus on the root surfaces of the teeth are difficult to detect with conventional methods such as tactile probing. This study compared the performance of a 655-nm wavelength laser fluorescence (LF) system (DIAGNOdent Classic with a periodontal tip) with conventional periodontal probing under defined conditions in a laboratory simulation, using an experienced examiner. Models with a total of 30 extracted teeth with varying levels of subgingival deposits scattered on their root surfaces were prepared, and silicone impression material applied to replicate periodontal soft tissues. The models were located in a phantom head, and the presence of subgingival calculus recorded at 8 points per tooth (240 sites), then the entire scoring process repeated after 1 and 2 weeks. The optimal LF threshold was determined as a fluorescence score of 7 using Receiver Operating Characteristic curves. When compared the gold standard of direct microscopic examination of roots, LF was more sensitive, specific, and accurate than tactile probing (68.3 vs. 51.7 %; 92.1 vs. 67.8; and 80.2 vs. 59.8 %, respectively), and was also more reproducible (Cohen kappa 0.60 vs. 0.39). These data support the concept of using LF as an adjunct to clinical diagnosis.
牙齿根面上的龈下牙石沉积物很难用诸如触觉探查等传统方法检测到。本研究在实验室模拟的特定条件下，由一位经验丰富的检查者，将655纳米波长的激光荧光（LF）系统（配备牙周探头的DIAGNOdent Classic）与传统牙周探查的性能进行了比较。制备了总共30颗拔除牙齿的模型，其根面上有不同程度的龈下沉积物，并应用硅橡胶印模材料复制牙周软组织。将模型置于仿真头模中，每颗牙齿的8个点（共240个位点）记录龈下牙石的存在情况，然后在1周和2周后重复整个评分过程。使用受试者工作特征曲线将最佳LF阈值确定为荧光评分为7。与牙根直接显微镜检查的金标准相比，LF更敏感、特异且准确（分别为68.3%对51.7%；92.1对67.8；80.2对59.8%），并且重复性也更好（科恩kappa系数为0.60对0.39）。这些数据支持将LF用作临床诊断辅助手段的概念。
