Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany.
M-Pro, Graz, Austria.
PLoS One. 2022 Oct 26;17(10):e0276686. doi: 10.1371/journal.pone.0276686. eCollection 2022.
Planimetry is a reliable method for detecting and monitoring plaque. Until now, this method has mainly been applied to conventional-camera images, which is difficult and time-consuming in relation to the entire dentition. Today, 3D-intraoral-scans are well suited for imaging the entire dentition and are therefore an efficient and feasible alternative. 3D-intraoral-scans have already proven successful for the quantification of plaque based on a plaque index. Therefore, aim of this study was to investigate whether images from 3D-intraoral-scans are also suitable for valid planimetric plaque measurements and monitoring; intraoral-camera images served as a reference. Twenty subjects (27.5±1.2 years) were included. Plaque was disclosed at three different time points: habitual plaque (T1), after 72 h without oral hygiene (T2) and after subsequent tooth brushing (T3) and quantified using 3D-intraoral-scans and intraoral-camera images (intraoral-camera CS 1500, intraoral-scanner CS 3600; Carestream Dental, Germany). The percentage of the plaque-covered surface of the total surface area (P%) was determined with a software specially programmed for this purpose using images from 3D-intraoral-scans of the oral and vestibular surfaces of the Ramfjord teeth (16, 21, 24, 36, 41, and 44); the intraoral-camera images of the vestibular surfaces of 16 and 36 served as reference. P% from images of the 3D-intraoral-scan and the intraoral-camera revealed a very good correlation (r = 0.876; p ≤ 0.001); the Bland-Altmann analysis showed a good agreement with no proportional and a very minor systematic bias with slightly higher values from images of the 3D-intraoral-scan. Further, P% measurements of the images of the 3D-intraoral-scan were able to detect changes in plaque levels, showing a 47% (p ≤ 0.001) increase in P% from T1 to T2 and a 43% (p ≤ 0.001) decrease after toothbrushing (T3). Planimetry using images of the 3D-intraoral-scan seems to be a suitable tool for whole mouth planimetry to record and monitor dental plaque.
菌斑的定量检测和监测一直以来都是口腔医学的重要研究课题。目前，基于菌斑指数的定量分析方法主要应用于传统的二维口腔摄像，而这种方法对整个牙面进行测量存在繁琐、耗时的问题。近年来，基于三维数字化技术的口腔内扫描仪逐渐普及，为全景牙面的图像获取提供了高效、可行的手段。有研究表明，三维数字化技术可以用于定量分析菌斑，为了验证其在菌斑临床研究中的应用价值，本研究将三维数字化图像与传统二维图像进行对比，旨在评价基于三维数字化图像的菌斑检测方法的临床应用价值。
选取 20 名受试者（年龄 27.5±1.2 岁）纳入研究。于实验开始时（T1）、模型清洁后 72 小时（T2）和模型清洁后即刻（T3）分别采集研究牙面的菌斑图像。菌斑检测采用三维数字化扫描仪（CS 3600，Carestream Dental，德国）和传统的口腔摄像（CS 1500，Carestream Dental，德国），以数字化菌斑指数（dental plaque index，dpli）为评价指标。使用专门设计的菌斑检测软件分析三维数字化图像和传统二维图像，计算牙面菌斑面积占总牙面面积的百分比（percentage of the plaque-covered surface of the total surface area，P%）。实验过程中，使用三维数字化扫描仪分别获取上下颌左右侧尖牙至磨牙颊面和舌面的数字化图像，以其中的颊面图像作为研究对象。传统二维图像则仅获取研究牙面的颊面图像。
结果显示，两种方法获得的菌斑面积百分比均呈现出高度的相关性（r = 0.876，p≤0.001）。 Bland-Altman 分析显示，两种方法具有良好的一致性，三维数字化图像的测量值略高于传统二维图像，但不存在系统误差。此外，三维数字化图像能够检测出菌斑水平的变化，T2 时菌斑面积百分比较 T1 时增加 47%（p≤0.001），T3 时较 T2 时减少 43%（p≤0.001）。
综上所述，本研究认为，基于三维数字化图像的菌斑检测方法具有准确、可靠的特点，能够为临床研究中的菌斑检测和监测提供有效手段。
