Mortensen Diana, Ekstrand Kim Rud, Twetman Svante
PhD student, section of Cariology and Endodontics, Department of Odontology, University of Copenhagen, Denmark.
Private practice in Allerød, Denmark.
Am J Dent. 2016 Aug;29(4):229-233.
To (1) investigate the influence of fissure sealants on impedance spectroscopy (ACIS) and laser fluorescence (LF) readings, (2) compare the performance of the ACIS device with the LF technique and visual inspection (ICDAS) in permanent molars with various degrees of occlusal caries, and (3) validate all methods against radiographs and histological hemi-sectioning.
102 permanent molars were randomly selected to represent different stages of occlusal caries, from clinically sound to minor cavities. The teeth were examined by one trained examiner and scored with CarieScan PRO, the DIAGNOdent pen and ICDAS at baseline, after bleaching, etching and placement of a clear fissure sealant. A digital radiograph was exposed at baseline. After the assessments, the actual lesion depth was histologically determined.
Bleaching did not affect the readings but significantly higher ACIS and LF-pen values were recorded after acid etching (P< 0.05). The placement of a fissure sealant increased the LF-pen readings significantly (P< 0.05) while no values could be obtained with the ACIS device. Both the baseline ACIS and LF-pen values were significantly associated (P< 0.05) with the lesion depth but visual inspection displayed the best correlation with radiographs and histology. The ACIS technology displayed high sensitivity and specificity for detecting extensive occlusal lesions.
The findings demonstrated that placement of a fissure sealant had a significant impact on the ACIS and LF-pen readings. Both methods mirrored the actual histological and radiographic lesion depth to various extents but could not match the performance of visual inspection.
（1）研究窝沟封闭剂对阻抗谱（ACIS）和激光荧光（LF）读数的影响；（2）比较ACIS设备与LF技术及视觉检查（ICDAS）在不同程度咬合面龋的恒牙中的性能；（3）对照X线片和组织学半切片验证所有方法。
随机选择102颗恒牙代表咬合面龋的不同阶段，从临床健康到轻度龋洞。由一名经过培训的检查者对牙齿进行检查，并在基线、漂白、酸蚀和放置透明窝沟封闭剂后，分别使用CarieScan PRO、DIAGNOdent笔和ICDAS进行评分。在基线时拍摄数字化X线片。评估后，通过组织学方法确定实际病变深度。
漂白不影响读数，但酸蚀后ACIS和LF笔的值显著升高（P<0.05）。放置窝沟封闭剂后LF笔的读数显著增加（P<0.05），而ACIS设备无法获得读数。基线时ACIS和LF笔的值均与病变深度显著相关（P<0.05），但视觉检查与X线片和组织学的相关性最佳。ACIS技术在检测广泛的咬合面病变方面显示出高灵敏度和特异性。
研究结果表明，放置窝沟封闭剂对ACIS和LF笔的读数有显著影响。两种方法在不同程度上反映了实际的组织学和影像学病变深度，但无法与视觉检查的性能相匹配。
