Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany.
Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany.
J Dent. 2020 Nov;102:103458. doi: 10.1016/j.jdent.2020.103458. Epub 2020 Aug 28.
To evaluate the diagnostic accuracy of optical coherence tomography (OCT) for the non-invasive detection of caries adjacent to ceramic materials.
Disks made from five ceramic materials (hybrid ceramic, feldspathic ceramic, zirconia-reinforced lithium silicate, lithium disilicate, and high-translucent zirconia) were ground to the recommended material thickness for single crown restorations and laminated with a 100 μm thick layer of one of three adhesive cements. The disks were fixed to extracted human molars with or without carious lesions of one of three standardized sizes. A total of 240 stacks of cross-sectional scans obtained using an 870-nm SD-OCT with enhanced depth imaging (EDI) were presented to five raters. Diagnostic accuracy was determined by rating the teeth beneath the cemented material as carious or healthy.
Carious samples were distinguished from sound teeth with high diagnostic accuracy, even for early stage caries. Sensitivity (SE) and specificity (SP) pooled over all raters and all materials were 0.9 and 0.97, respectively. When analyzing the effect of the ceramic and cement materials on detection rates, high SE and SP values of >0.96 and >0.91, respectively, were recorded for lithium disilicate, zirconia-reinforced lithium silicate, and high-translucent zirconia irrespective of the cement type. For hybrid and feldspathic ceramics, the cement material was found to have a significant effect on caries detection.
Given its high diagnostic accuracy, 870-nm SD-OCT with EDI might be useful for the detection of caries beneath restorative materials. The effect of the prescribed ceramic and cement material on optical penetration depth is substantial.
评估光学相干断层扫描（OCT）在非侵入性检测陶瓷材料邻接龋病方面的诊断准确性。
将五种陶瓷材料（混合陶瓷、长石陶瓷、氧化锆增强锂硅、锂二硅和高透光氧化锆）制成圆盘，磨至推荐的单冠修复材料厚度，并与三种胶粘剂之一的 100μm 厚层叠层。将圆盘用或不用三种标准化大小之一的龋损固定在提取的人磨牙上。使用增强深度成像（EDI）的 870nm SD-OCT 获得了 240 个横截面扫描的堆栈，并呈现给五名评分者。通过对粘固材料下方的牙齿进行龋或健康评分来确定诊断准确性。
即使对于早期龋病，用高诊断准确性也可以区分龋样本和健康牙齿。所有评分者和所有材料的敏感性（SE）和特异性（SP）分别为 0.9 和 0.97。当分析陶瓷和粘结材料对检测率的影响时，发现锂二硅、氧化锆增强锂硅和高透光氧化锆的 SE 和 SP 值均>0.96 和>0.91，无论粘结剂类型如何，都具有很高的准确性。对于混合陶瓷和长石陶瓷，粘结剂材料对龋病检测有显著影响。
鉴于其高诊断准确性，870nm SD-OCT 与 EDI 可能有助于检测修复材料下的龋病。规定的陶瓷和粘结剂材料对光穿透深度的影响很大。
