Department of Endodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina.
Department of Orthodontics, University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, North Carolina.
J Endod. 2020 Feb;46(2):252-257. doi: 10.1016/j.joen.2019.10.031. Epub 2019 Dec 9.
This study evaluated 4 different light-emitting diode (LED) transilluminators and the impact of operator experience in the detection of dentinal defects through an ex vivo TRUEJAW surgical model (Dental Engineering Laboratories, Santa Barbara, CA).
Forty-four extracted and endodontically treated mandibular premolar teeth were evaluated. Teeth were mounted in the models followed by surgical flaps and osteotomies to expose the apical third of the roots. After apical resection, the root-end surfaces were randomly inspected for the presence or absence of dentinal defects using a dental operating microscope (DOM) at ×19.4 magnification by experienced and novice LED evaluators. The assessment was made with the DOM light and 4 masked LED transilluminators of different diameters and luminous flux. The teeth were examined outside the models to establish the ground truth. The sensitivity, specificity, and kappa and McNemar test values of each light source by examiner were calculated.
The use of LED transilluminators improved the diagnostic sensitivity of dentinal defects when compared with the DOM light alone for both examiners. For the LED-experienced evaluator, the medium-low transilluminator had statistically significant higher sensitivity than the DOM light and the small-low and small-high transilluminators (P < .05). For the novice LED evaluator, the medium-high transilluminator had the highest sensitivity. There was a statistically significant difference between the sensitivities of the medium-low transilluminator between the examiners (P < .05).
Within the limitations of this ex vivo surgical study, dentinal defects were more often detected with the LED transilluminators with a larger diameter and increased lumens. The operator's LED transilluminator experience was found to have a positive effect on the detection of dentinal defects using transillumination.
本研究通过 ex vivo TRUEJAW 手术模型（加利福尼亚州圣巴巴拉的 Dental Engineering Laboratories）评估了 4 种不同的发光二极管（LED）透照器以及操作人员经验对牙本质缺损检测的影响。
评估了 44 颗离体和牙髓治疗的下颌前磨牙。将牙齿安装在模型中，然后进行外科瓣和骨切开术，以暴露根尖的三分之一。根尖切除后，使用牙科手术显微镜（DOM）以 ×19.4 放大倍数，由经验丰富和经验不足的 LED 评估员随机检查根端表面是否存在牙本质缺损。评估是在 DOM 光和 4 个不同直径和光通量的掩蔽 LED 透照器下进行的。在模型外检查牙齿以建立真实情况。计算每个光源的每个检查者的敏感性、特异性、kappa 和 McNemar 检验值。
与单独使用 DOM 光相比，LED 透照器的使用提高了牙本质缺损的诊断敏感性。对于经验丰富的 LED 评估员，中低强度透照器的敏感性明显高于 DOM 光和小低强度和小高强度透照器（P<.05）。对于经验不足的 LED 评估员，中高强度透照器的敏感性最高。两个检查者之间中低强度透照器的敏感性存在统计学差异（P<.05）。
在这项离体手术研究的限制范围内，使用直径较大和光通量增加的 LED 透照器更常检测到牙本质缺损。操作人员的 LED 透照器经验被发现对使用透照法检测牙本质缺损有积极影响。
