Rams Thomas E, Alwaqyan Abdulaziz Y
Department of Periodontology and Oral Implantology, Temple University School of Dentistry, 3223 North Broad Street, Philadelphia, PA, USA.
Department of Microbiology and Immunology, Temple University of Medicine, 3500 North Broad Street, Philadelphia, PA, USA.
Saudi Dent J. 2017 Oct;29(4):171-178. doi: 10.1016/j.sdentj.2017.08.001. Epub 2017 Aug 9.
This study assessed the reproducibility of a red diode laser device, and its capability to detect dental calculus in vitro on human tooth root surfaces.
On each of 50 extracted teeth, a calculus-positive and calculus-free root surface was evaluated by two independent examiners with a low-power indium gallium arsenide phosphide diode laser (DIAGNOdent) fitted with a periodontal probe-like sapphire tip and emitting visible red light at 655 nm wavelength. Laser autofluorescence intensity readings of examined root surfaces were scored on a 0-99 scale, with duplicate assessments performed using the laser probe tip directed both perpendicular and parallel to evaluated tooth root surfaces. Pearson correlation coefficients of untransformed measurements, and kappa analysis of data dichotomized with a >40 autofluorescence intensity threshold, were calculated to assess intra- and inter-examiner reproducibility of the laser device. Mean autofluorescence intensity scores of calculus-positive and calculus-free root surfaces were evaluated with the Student's -test.
Excellent intra- and inter-examiner reproducibility was found for DIAGNOdent laser autofluorescence intensity measurements, with Pearson correlation coefficients above 94%, and kappa values ranging between 0.96 and 1.0, for duplicate readings taken with both laser probe tip orientations. Significantly higher autofluorescence intensity values were measured when the laser probe tip was directed perpendicular, rather than parallel, to tooth root surfaces. However, calculus-positive roots, particularly with calculus in markedly-raised ledges, yielded significantly greater mean DIAGNOdent laser autofluorescence intensity scores than calculus-free surfaces, regardless of probe tip orientation. DIAGNOdent autofluorescence intensity values >40 exhibited a stronger association with calculus (36.6 odds ratio) then measurements of ≥5 (20.1 odds ratio) when the laser probe tip was advanced parallel to root surfaces.
Excellent intra- and inter-examiner reproducibility of autofluorescence intensity measurements was obtained with the DIAGNOdent laser fluorescence device on human tooth roots. Calculus-positive root surfaces exhibited significantly greater DIAGNOdent laser autofluorescence than calculus-free tooth roots, even with the laser probe tip directed parallel to root surfaces. These findings provide further in vitro validation of the potential utility of a DIAGNOdent laser fluorescence device for identifying dental calculus on human tooth root surfaces.
本研究评估了一种红色二极管激光设备的可重复性，及其在体外检测人牙根表面牙结石的能力。
在50颗拔除的牙齿上，由两名独立的检查者使用配备牙周探针样蓝宝石尖端、发射波长为655nm可见红光的低功率磷化铟镓砷二极管激光（DIAGNOdent），对有牙结石和无牙结石的牙根表面进行评估。检查的牙根表面的激光自发荧光强度读数按0 - 99分进行评分，使用激光探针尖端垂直和平行于评估的牙根表面进行重复评估。计算未转换测量值的Pearson相关系数，以及将数据按自发荧光强度阈值>40进行二分后的kappa分析，以评估激光设备在检查者内和检查者间的可重复性。使用学生t检验评估有牙结石和无牙结石牙根表面的平均自发荧光强度评分。
对于DIAGNOdent激光自发荧光强度测量，发现检查者内和检查者间具有出色的可重复性，两种激光探针尖端方向的重复读数的Pearson相关系数均高于94%，kappa值在0.96至1.0之间。当激光探针尖端垂直而非平行于牙根表面时，测量到的自发荧光强度值明显更高。然而，有牙结石的牙根，特别是在明显隆起的边缘有牙结石的牙根，无论探针尖端方向如何，其平均DIAGNOdent激光自发荧光强度评分均显著高于无牙结石的表面。当激光探针尖端平行于牙根表面推进时，DIAGNOdent自发荧光强度值>40与牙结石的关联（优势比为36.6）比测量值≥5（优势比为20.1）更强。
使用DIAGNOdent激光荧光设备在人牙根上获得了检查者内和检查者间自发荧光强度测量的出色可重复性。即使激光探针尖端平行于牙根表面，有牙结石的牙根表面的DIAGNOdent激光自发荧光也明显高于无牙结石的牙根。这些发现为DIAGNOdent激光荧光设备在识别人类牙根表面牙结石方面的潜在用途提供了进一步的体外验证。
