Moreira Kelly, Kantovitz Kamila, Bueno Tamires, Agulhari Maria-Angélica, Rizzante Fabio, Aguiar Juliana, Pascon Fernanda, Arias Vanessa, Borges Ana-Flávia, Rontani Regina-Maria
Department of Operative Dentistry, Endodontics and Dental Materials. Bauru School of Dentistry-FOB-USP.
J Clin Exp Dent. 2020 Sep 1;12(9):e852-e856. doi: 10.4317/jced.56688. eCollection 2020 Sep.
The aim of the present study was to compare indirect methods to assess the clinical performance of pit and fissure sealants and validate the use of 3D scanners.
Sample consisted of 58 plaster models of upper and lower first permanent molars, sealed with resin sealants, as well as photographs obtained during the 18-month follow-up. Pre-established criteria were applied to categorize the sealant presence/absence and marginal integrity. Two calibrated examiners performed the evaluations, independently, using Scanning Electron Microscopy (SEM; gold-standard), Photography, 3D (CEREC In Lab) and Stereomicroscope analysis.
The intra-examiner Spearman correlation was 94% e 97%, respectively, and the inter-examiner was 96%. Data was submitted to Kappa test, Spearman correlation and Receiver Operating Characteristic Curve (ROC). 3D and SEM presented good concordance; Stereomicroscope showed regular concordance with SEM and 3D (<0.001). There was no concordance among Photography and the other methods (>0.05). SEM had a significant positive correlation with 3D and Stereomicroscope (r=0.76 and 0.71, respectively; <0.01). There was significant positive correlation (r=0.65) between 3D and Stereomicroscope (<0.01). The ROC estimated curve areas for Stereomicroscope and 3D were 0.90 (IC:0.81-0.99) and 1.0 (IC:1.0-1.0), respectively (<0.001).
Photography presented lower sensitivity and specificity (area=0.59). 3D method showed the best performance when compared to gold standard, exhibiting high sensitivity and specificity, therefore, it was validated as a reliable method to evaluate pit and fissure sealants. Photography, stereomicroscope, SEM, diagnostic, sealants.
本研究的目的是比较评估窝沟封闭剂临床性能的间接方法，并验证三维扫描仪的使用。
样本包括58个上下颌第一恒磨牙的石膏模型，用树脂封闭剂进行封闭，以及在18个月随访期间获得的照片。采用预先设定的标准对封闭剂的存在/缺失和边缘完整性进行分类。两名经过校准的检查者分别使用扫描电子显微镜（SEM；金标准）、摄影、三维（CEREC In Lab）和体视显微镜分析独立进行评估。
检查者内部的斯皮尔曼相关性分别为94%和97%，检查者之间为96%。数据进行了卡方检验、斯皮尔曼相关性分析和受试者工作特征曲线（ROC）分析。三维和扫描电子显微镜显示出良好的一致性；体视显微镜与扫描电子显微镜和三维显示出一般一致性（<0.001）。摄影与其他方法之间没有一致性（>0.05）。扫描电子显微镜与三维和体视显微镜有显著正相关（分别为r = 0.76和0.71；<0.01）。三维和体视显微镜之间有显著正相关（r = 0.65）（<0.01）。体视显微镜和三维的ROC估计曲线面积分别为0.90（95%置信区间：0.81 - 0.99）和1.0（95%置信区间：1.0 - 1.0）（<0.001）。
摄影的敏感性和特异性较低（面积 = 0.59）。与金标准相比，三维方法表现最佳，具有高敏感性和特异性，因此，它被验证为评估窝沟封闭剂的可靠方法。摄影、体视显微镜、扫描电子显微镜、诊断、封闭剂。
