临床验证近红外光透射法用于早期近侧龋检测的复合参考标准。

Clinical validation of near-infrared light transillumination for early proximal caries detection using a composite reference standard.

机构信息

Department of Pediatric Oral Health and Orthodontics, University Center for Dental Medicine, UZB, University of Basel, Switzerland.

Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.

出版信息

J Dent. 2020;103S:100025. doi: 10.1016/j.jjodo.2020.100025. Epub 2020 Sep 7.

DOI:10.1016/j.jjodo.2020.100025

PMID:34059307

Abstract

OBJECTIVES

The aim of this in vivo prospective clinical study was to validate a near-infrared light transillumination (NILT) device for the detection of proximal caries lesions and compare it to the established diagnostic method of bitewing radiography (BWR).

MATERIALS AND METHODS

A total of 116 interproximal posterior teeth/surfaces without gross cavitation were included and assessed with BWR and NILT. After clinical examination, the teeth with sound surfaces or non-cavitated caries lesions were separated with the use of an orthodontic separation rubber for 24h. Upon removal of the separator a silicon impression was obtained and the teeth surfaces were directly investigated. Intra- and inter-examiner reproducibility, sensitivities (SE) and specificities (SP) as well as the area under ROC curves (AUC) were calculated.

RESULTS

The SE of NILT was 0.92 in D lesions and 1.00 in D and D lesions, respectively. BWR showed SE values of 0.81 in D lesions, 0.74 in D and 1.00 in D lesions, respectively. However, NILT showed lower values of SP (D 0.38, D 0.42 and D 0.99) compared to BWR (D 0.65, D 0.88, D 1.00). Intra-examiner reproducibility increased for both examiners from the initial examination (0.68 and 0.62) to the recall appointment (0.89 and 0.76) respectively.

CONCLUSION

The performance of NILT in detection of enamel caries was comparable to BWR. NILT could be considered as a useful and reliable tool in clinical practice. However, monitoring of enamel lesions might not be accurate, since a low specificity of NILT at D level and a tendency to false positive ratings have been shown. Therefore, it is recommended that treatment decisions should not be based on NILT alone.

CLINICAL RELEVANCE

This study might indicate that NILT can be used for routine patient screening but the use of BWR is still important for treatment decisions.

摘要

目的

本体内前瞻性临床研究旨在验证一种近红外光透射（NILT）设备用于检测近表层龋损的效果，并将其与公认的诊断方法——咬翼片放射照相术（BWR）进行比较。

材料与方法

共纳入 116 颗无明显空洞的近中后牙/面，分别采用 BWR 和 NILT 进行检查。临床检查后，使用正畸分离橡胶将无表面完好或无窝沟龋损的牙齿隔离开 24 小时。分离后取出分离橡胶，获得硅印模，直接对牙齿表面进行检查。计算了内、外观察者的重现性、敏感度（SE）和特异度（SP）以及 ROC 曲线下面积（AUC）。

结果

NILT 在 D 病变的 SE 为 0.92，在 D 和 D 病变的 SE 为 1.00。BWR 在 D 病变的 SE 值为 0.81，在 D 和 D 病变的 SE 值分别为 0.74 和 1.00。然而，NILT 的 SP 值（D 为 0.38、D 为 0.42、D 为 0.99）低于 BWR（D 为 0.65、D 为 0.88、D 为 1.00）。两名观察者的内观察者重现性均从初始检查（分别为 0.68 和 0.62）增加到召回检查（分别为 0.89 和 0.76）。