Creighton University School of Dentistry, Omaha, NE, USA.
Creighton University School of Dentistry, Omaha, NE, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Dec;132(6):715-726. doi: 10.1016/j.oooo.2021.02.014. Epub 2021 Feb 23.
We propose a new topical radiographic contrast method for distinguishing noncavitated from cavitated radiolucencies. Laboratory tests and a pilot clinical trial were designed to test the feasibility and efficacy of the method.
Twenty-two adults with 27 proximal radiolucencies had conventional bitewing (BW) examinations. After exclusion, 21 surfaces were evaluated. A concentrated solution of sodium iodide was placed in the interdental spaces via a microsyringe and BWs were again exposed. A class II cavity preparation was made in the adjacent tooth and polysiloxane impressions were made of the study surfaces. The impressions were scanned by visible light, creating a high resolution 3D replica. Cavitations, if present, were measured.
Nine surfaces were noncavitated and 12 surfaces were cavitated. The microsyringe dispensed a variable volume of liquid, which affected the accuracy of the test. The sensitivity for cavitation was 50%, specificity was 88.9%, and accuracy was 66.7%. This compares to a reported 60% sensitivity, 62% specificity, and 62% accuracy for BW examinations. Intraexaminer reliability for classifying noncavitated or cavitated lesions using the kappa test was 0.649.
This method needs improvement but was an advance over conventional BWs and could result in reduction of restorations in low- and high-risk patients.
我们提出了一种新的局部放射对比度方法，用于区分未穿孔和穿孔的放射性不透明区。设计了实验室测试和试点临床试验，以测试该方法的可行性和效果。
22 名成年人有 27 个近中放射性不透明区，进行了常规咬翼片（BW）检查。排除后，评估了 21 个表面。通过微注射器将碘化钠浓缩溶液放置在牙间隙中，并再次暴露 BW。在相邻牙齿上进行 II 类窝洞预备，并对研究表面进行聚硅氧烷印模。通过可见光扫描这些印模，创建了高分辨率的 3D 复制品。如果存在穿孔，则测量穿孔。
9 个表面为非穿孔，12 个表面为穿孔。微注射器分配的液体体积可变，这影响了测试的准确性。穿孔的灵敏度为 50%，特异性为 88.9%，准确性为 66.7%。这与 BW 检查报告的 60%的灵敏度、62%的特异性和 62%的准确性相比较。使用 Kappa 检验对分类非穿孔或穿孔病变的同一位检查者的可靠性为 0.649。
该方法需要改进，但优于常规 BW，可以减少低风险和高风险患者的修复。
