Ozkan Gokhan, Guzel Kadriye Gorkem Ulu
Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Adnan Menderes University, Aydin, Turkey.
Faculty of Dentistry, Department of Pedodontics, Adnan Menderes University, Aydin, Turkey.
Lasers Med Sci. 2017 Aug;32(6):1417-1422. doi: 10.1007/s10103-017-2265-z. Epub 2017 Jun 26.
The objective of this clinical study was to compare conventional caries detection techniques, pen-type laser fluorescence device, and near-infrared light transillumination method in approximal dentin caries lesions. The study included 157 patients, aged 12-18, without any cavity in the posterior teeth. Two calibrated examiners carried out the assessments of selected approximal caries sites independently. After the assessments, the unopened sites were excluded and a total of 161 approximal sites were included in the study. When both the examiners arrived at a consensus regarding the presence of dentin caries, the detected lesions were opened with a conical diamond burr, the cavity extent was examined and validated (gold standard). Sensitivity, specificity, negative predictive value, positive predictive value, accuracy, and area under the ROC curve (Az) values among the caries detection methods were calculated. Bitewing radiography and near-infrared (NIR) light transillumination methods showed the highest sensitivity (0.83-0.82) and accuracy (0.82-0.80) among the methods. Visual inspection showed the lowest sensitivity (0.54). Laser fluorescence device and visual inspection showed nearly equal performance. Near-infrared light transillumination can be used as an alternative method to approximal dentin caries detection. Visual inspection and laser fluorescence device alone should not be used for approximal dentin caries.
这项临床研究的目的是比较传统龋病检测技术、笔式激光荧光装置和近红外光透照法在邻面牙本质龋损中的应用。该研究纳入了157名年龄在12至18岁之间、后牙无任何龋洞的患者。两名经过校准的检查者独立对选定的邻面龋部位进行评估。评估后,排除未打开的部位,共161个邻面部位纳入研究。当两名检查者就牙本质龋的存在达成共识后,用锥形金刚砂车针打开检测到的龋损,检查并验证龋洞范围(金标准)。计算了龋病检测方法之间的敏感性、特异性、阴性预测值、阳性预测值、准确性和ROC曲线下面积(Az)值。咬合翼片X线摄影和近红外(NIR)光透照法在这些方法中显示出最高的敏感性(0.83 - 0.82)和准确性(0.82 - 0.80)。视觉检查显示出最低的敏感性(0.54)。激光荧光装置和视觉检查表现出近乎相同的性能。近红外光透照可作为邻面牙本质龋检测的替代方法。仅靠视觉检查和激光荧光装置不应用于邻面牙本质龋的检测。