Jaafar Nada, Ragab Hala, Abedrahman Ahmed, Osman Essam
Clinical instructor of Pediatric Dentistry, Department of Developmental Sciences, Division of Pediatric Dentiry, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon.
Professor of Operative and Esthetic Dentistry, Department of Restorative Sciences, Division of Operative and Esthetic Dentistry, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon.
J Int Soc Prev Community Dent. 2020 Jun 15;10(3):246-254. doi: 10.4103/jispcd.JISPCD_480_19. eCollection 2020 May-Jun.
The aim of this study was to evaluate and compare the diagnostic performance of a quantitative light-induced fluorescence (DIAGNOdent pen [DP]) and a photothermal radiometry (Canary System [CS]) for assessment and monitoring occlusal enamel caries under fissure sealants placed on young permanent teeth.
Forty-five patients of mean age 9.96 (1.4) years, having at least two occlusal surface sites of non-cavitated lesions (International Caries Detection and Assessment System [ICDAS], 1-3 at baseline), were assigned for this clinical study as per specific inclusion/exclusion criteria. A total of 90 permanent teeth were examined using a visual examination method (ICDAS), a quantitative light-induced fluorescence (DP), and a photothermal radiometry (CS). Teeth were randomly divided into two groups based on the type of fissure sealants: a resin sealant and a glass-ionomer sealant. Sealants were placed over the study sites, and caries assessment was performed with each caries detection method at 3- and 6-month recall appointments. Numerical data were presented as mean, standard deviation, median, and interquartile range values. Qualitative data were presented as frequencies and percentages. Receiver operating characteristic (ROC) curve was constructed to determine the diagnostic accuracy measures of the two modalities and compared using -statistic. ROC curve analysis was performed with MedCalc software, Ostend, Belgium, version 11.3 for Windows (MedCalc Software). Changes by time in caries progression were analyzed using McNemar test and Cochran test. The significance level was set at ≤ 0.05. Statistical analysis was performed with the IBM Statistical Package for the Social Sciences (SPSS) software for Windows, version 23.0 (IBM, Armonk, New York).
The CS and DP were able to distinguish between sound and carious tissue beneath fully and partially retained sealants at 6-month follow-up with an accuracy of 46.7% and 33.4%, respectively.
The diagnostic performance of the CS and DP are acceptable and can be considered as useful adjunct tools in the clinical evaluation and monitoring the changes in enamel due to lesion progression under fissure sealants. However, in the clinical setting, sensitivity and specificity of these devices may be influenced by the sealant type, thickness, retention, and the differences in the lesion characteristics over time.
本研究的目的是评估和比较定量光诱导荧光（DIAGNOdent笔[DP]）和光热辐射测量法（Canary系统[CS]）在评估和监测年轻恒牙窝沟封闭剂下的咬合面釉质龋方面的诊断性能。
根据特定的纳入/排除标准，将45名平均年龄为9.96（1.4）岁、至少有两个非龋损咬合面部位（国际龋病检测与评估系统[ICDAS]，基线时为1 - 3级）的患者纳入本临床研究。使用视觉检查方法（ICDAS）、定量光诱导荧光（DP）和光热辐射测量法（CS）对总共90颗恒牙进行检查。根据窝沟封闭剂的类型将牙齿随机分为两组：树脂封闭剂组和玻璃离子封闭剂组。在研究部位放置封闭剂，并在3个月和6个月的复诊时使用每种龋病检测方法进行龋病评估。数值数据以均值、标准差、中位数和四分位数间距值表示。定性数据以频率和百分比表示。构建受试者工作特征（ROC）曲线以确定两种方法的诊断准确性指标，并使用 - 统计量进行比较。使用比利时奥斯坦德的MedCalc软件Windows版11.3（MedCalc软件）进行ROC曲线分析。使用McNemar检验和Cochran检验分析龋病进展随时间的变化。显著性水平设定为≤0.05。使用适用于Windows的IBM社会科学统计软件包（SPSS）软件23.0版（IBM，纽约州阿蒙克）进行统计分析。
在6个月的随访中，CS和DP能够区分完全和部分保留的封闭剂下方的健康组织和龋损组织，准确率分别为46.7%和33.4%。
CS和DP的诊断性能是可以接受的，可被视为临床评估和监测窝沟封闭剂下釉质因病变进展而发生变化的有用辅助工具。然而，在临床环境中，这些设备的敏感性和特异性可能会受到封闭剂类型、厚度、保留情况以及病变特征随时间的差异的影响。
