Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
J Dent. 2020 Dec;103:103505. doi: 10.1016/j.jdent.2020.103505. Epub 2020 Oct 17.
To prolong tooth life expectancy, tooth wear resulting in dentin exposure should be detected early. However, the most objective methods are clinically limited. We validated fluorescence parameters for distinguishing enamel from dentin-exposed wear in clinical images.
Quantitative light-induced fluorescence (QLF) images of 73 adults (age range: 22-48 years, mean: 33.81 ± 7.71 years), including 1949 teeth with varying tooth wear degrees, without restorations, caries, or cusp area fractures, were used to calculate the ΔF values. Areas-of-interest (AOIs) were selected from QLF images; the ΔF values and the tooth wear index (TWI) were calculated for each tooth. The ΔF values were compared according to the TWI scores. The optimum ΔF values for distinguishing enamel and dentin-exposed wear were determined using the receiver operating characteristic (ROC) curve analysis.
Overall, 1949 AOIs were evaluated. The median ΔF values for teeth with TWI scores 0, 1, and 2 (5.7 %, 10.3 %, and 17.0 %) differed significantly (P < 0.001). The optimum cutoff ΔF values were 12.1 and 14.7 in the anterior and posterior teeth, respectively; the corresponding areas under the ROC values (AUROCs) were 0.86 and 0.93 (sensitivity: 0.79 and 0.85; specificity: 0.79 and 0.85, respectively). The ΔF cutoff values for different age groups were within a range (12.7-13.7) and showed high validity (sensitivity, specificity, and AUROC: 0.78, 0.77-0.78, and 0.87-0.88, respectively).
At the optimum threshold, the ΔF values showed high validity for distinguishing dentin exposure in worn teeth (AUROC: 0.87‒0.93) and could determine pathological tooth wear, particularly in posterior teeth.
We demonstrated the feasibility of using QLF to detect dentin-exposed tooth wear and present optimal thresholds according to age. In addition, we confirmed the possibility using such image data for objective and cost-effective epidemiological investigation and application in tele-dentistry.
为了延长牙齿的预期寿命，应尽早发现导致牙本质暴露的牙齿磨损。然而，最客观的方法在临床上受到限制。我们验证了用于区分临床图像中釉质和暴露牙本质磨损的荧光参数。
使用来自 73 名成年人（年龄范围：22-48 岁，平均：33.81±7.71 岁）的定量光致荧光（QLF）图像，共 1949 颗牙齿具有不同程度的牙齿磨损，无修复体、龋齿或牙尖区骨折，计算 ΔF 值。从 QLF 图像中选择感兴趣区域（AOI）；为每颗牙齿计算 ΔF 值和牙齿磨损指数（TWI）。根据 TWI 评分比较 ΔF 值。使用受试者工作特征（ROC）曲线分析确定区分釉质和暴露牙本质磨损的最佳 ΔF 值。
总体而言，评估了 1949 个 AOI。TWI 评分为 0、1 和 2 的牙齿的中位数 ΔF 值（5.7%、10.3%和 17.0%）差异有统计学意义（P<0.001）。前牙和后牙的最佳截断 ΔF 值分别为 12.1 和 14.7；ROC 值下的相应面积（AUROC）分别为 0.86 和 0.93（敏感性：0.79 和 0.85；特异性：0.79 和 0.85）。不同年龄组的 ΔF 截断值在一定范围内（12.7-13.7），具有较高的有效性（敏感性、特异性和 AUROC：0.78、0.77-0.78 和 0.87-0.88）。
在最佳阈值下，ΔF 值对区分磨损牙齿的牙本质暴露具有较高的有效性（AUROC：0.87-0.93），可确定病理性牙齿磨损，特别是后牙。
我们证明了使用 QLF 检测暴露牙本质的牙齿磨损的可行性，并根据年龄提出了最佳阈值。此外，我们还证实了使用此类图像数据进行客观和具有成本效益的流行病学研究以及在远程牙科中的应用的可能性。
