Pediatric Dental Resident, Pediatric Dentistry Department, University of Nevada, Las Vegas, UNLV, 89106, USA.
Visiting Faculty, Biomedical and Clinical Research, University of Nevada, Las Vegas, UNLV, 89106, USA.
Sci Rep. 2019 Apr 25;9(1):6533. doi: 10.1038/s41598-019-41270-6.
Dental caries is the most common human infectious disease and is caused by microorganisms producing acids, resulting in changes in dental tissue hardness and colour. However, the accuracy and reliability of dentine colour and hardness as indicators for carious lesion severity has never been assessed in a systematic review. By applying strict criteria, only seven papers (five randomized control trials and two diagnostic studies) were considered for full text qualitative and quantitative assessment. Only three studies produced high quality evidence and only four articles were considered for meta-analysis, as these provided log colony forming units (CFU) data from caries biopsies following colour and hardness clinical examinations. When comparing the amount of CFU isolated from carious biopsies from different colour and hardness categories, hardness clinical examination was found to be a statistically more discriminate test than colour clinical examination. Therefore, hardness clinical examination is more specific and reliable than colour to detect dentine carious lesion severity. Further large carefully designed clinical studies are needed to consolidate the findings of this systematic review.
龋齿是最常见的人类传染病，由微生物产生酸引起，导致牙齿组织硬度和颜色发生变化。然而，牙本质颜色和硬度作为龋齿病变严重程度的指标的准确性和可靠性从未在系统评价中进行过评估。通过应用严格的标准，只有七篇论文（五项随机对照试验和两项诊断研究）被认为可进行全文定性和定量评估。只有三项研究提供了高质量的证据，只有四项文章被认为可进行荟萃分析，因为这些文章提供了在颜色和硬度临床检查后从龋齿活检中分离出的对数集落形成单位（CFU）的数据。当比较不同颜色和硬度类别龋齿活检中分离出的 CFU 数量时，硬度临床检查被发现是一种比颜色临床检查更具统计学区分力的测试。因此，硬度临床检查比颜色临床检查更能特异性和可靠地检测牙本质龋齿病变的严重程度。需要进一步进行精心设计的大型临床研究来巩固本系统评价的发现。
