Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
Dental clinic, Ministry of Foreign Affairs, Tokyo, Japan.
Clin Oral Investig. 2019 Feb;23(2):863-872. doi: 10.1007/s00784-018-2503-1. Epub 2018 Jun 8.
To assess the remineralization capacity of carious, non-carious, and combined white spot lesions (WSLs) using the ICDAS and SS-OCT.
This clinical trial was based on a quasi-experimental design. Forty-two healthy subjects (median age 26.6 years), who visited university hospital and had at least one WSL with an ICDAS score of 2 or 1, were recruited. The subjects chewed a non-blind sugar-free gum containing bioavailable calcium and fluoride for 3 months. The remineralization capacities of carious and non-carious 121 WSLs were assessed using ICDAS by two calibrated non-blind examiners and optical boundary depth (BD) by SS-OCT at a monthly recall. The outcome variables, transitions of ICDAS score, mean BD, and mean BD recovery rate (RR%), were statistically analyzed using the chi-square test, two way-repeated measures ANOVA, and Wilcoxon rank sum test, respectively (alpha = 0.05).
Based on the visual inspection, OCT images at the baseline, 72 WSLs were purely carious, 20 were non-carious (developmental) lesions, while 29 were combined (carious-developmental). The responses of WSLs over time showed to be highly variable. There was a significant difference in transitions of ICDAS scores after 3 months between carious and non-carious WSLs (p < 0.05) and non-carious and combined WSLs (p < 0.05). Carious and combined WSLs underwent significant changes in the mean BD between baseline (161.8 ± 56.8 μm) and 2 months (130.7 ± 57.4 μm) or 3 months (119.1 ± 57.5 μm) (p < 0.05), while there was no significant difference between baseline (132.2 ± 26.2 μm) and 2 months (122.8 ± 24.1 μm) or 3 months (119.8 ± 22.6 μm) in non-carious WSLs (p > 0.05). There was a significant difference in mean RR% after 2 and 3 months between carious and non-carious WSLs (p < 0.05).
The remineralization capacity of WSL was variable among the cases and subjects, and depended on the WSLs history, etiology (carious, non-carious, or combined lesion) and structure (histological pattern).
Carious WSLs showed the highest remineralization potential.
使用 ICDAS 和 SS-OCT 评估龋性、非龋性和混合性白斑病变（WSL）的再矿化能力。
本临床试验基于准实验设计。招募了 42 名健康受试者（中位年龄 26.6 岁），他们曾就诊于大学医院，至少有一个 WSL 的 ICDAS 评分为 2 或 1。受试者咀嚼含有生物可利用钙和氟的无糖口香糖 3 个月。使用 ICDAS 由两名经过校准的非盲检员对 121 个 WSL 的再矿化能力进行评估，并在每月复诊时使用 SS-OCT 测量光学边界深度（BD）。使用卡方检验、双向重复测量方差分析和 Wilcoxon 秩和检验分别对 ICDAS 评分变化、平均 BD 和平均 BD 恢复率（RR%）等结果变量进行统计学分析（α=0.05）。
基于视觉检查，OCT 图像在基线、72 个 WSL 是纯龋性病变，20 个是非龋性（发育性）病变，而 29 个是混合性病变（龋性-发育性）。WSL 随时间的反应表现出高度的可变性。3 个月后，在 ICDAS 评分变化方面，龋性 WSL 和非龋性 WSL 之间（p<0.05）以及非龋性和混合性 WSL 之间（p<0.05）存在显著差异。在基线（161.8±56.8μm）和 2 个月（130.7±57.4μm）或 3 个月（119.1±57.5μm）时，龋性和混合性 WSL 的平均 BD 均发生显著变化（p<0.05），而在非龋性 WSL 中，基线（132.2±26.2μm）和 2 个月（122.8±24.1μm）或 3 个月（119.8±22.6μm）之间没有显著差异（p>0.05）。在 2 个月和 3 个月时，在平均 RR%方面，龋性 WSL 和非龋性 WSL 之间存在显著差异（p<0.05）。
WSL 的再矿化能力在病例和受试者之间存在差异，取决于 WSL 的病史、病因（龋性、非龋性或混合性病变）和结构（组织学模式）。
龋性 WSL 表现出最高的再矿化潜力。
