Ekstrand K R, Kuzmina I, Bjørndal L, Thylstrup A
Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark.
Caries Res. 1995;29(4):243-50. doi: 10.1159/000262076.
The material comprised 140 extracted maxillary third molars. The central fossa area was examined with a stereomicroscope (SM) (x16) and macroscopically (M) under standardized conditions after cleaning and air-drying. Signs of caries were classified using a detailed scoring system involving 12 (SM) and 8 (M) classification criteria, ranging from 'sound' to 'cavitation with dentine involvement'. Six radiographic scores were used in the classification. Sections 250 microns in thickness were cut in buccolingual direction through the central fossa, and the fossa section with the most extensive stereomicroscopic changes was selected for histologic examination (x16). The histologic enamel and dentine changes were classified independently using 9 and 7 scores, respectively. The correlation between SM and the histologic enamel changes (HE scores) in terms of progressive demineralization and destruction were highly correlated (rs = 0.90). Dentinal changes were also highly correlated with enamel changes (rs = 0.85). The histologic classifications in conjunction with the macroscopical observations made it possible to demonstrate a clear relationship between the external degree of caries progression and the internal enamel and dentine reactions. The data did not support routine usage of radiographic examination for occlusal caries diagnosis.
该材料包括140颗拔除的上颌第三磨牙。在清洁和空气干燥后，使用体视显微镜（SM）（放大16倍）和在标准化条件下进行宏观（M）检查中央窝区域。使用详细的评分系统对龋损迹象进行分类，该系统包括12项（SM）和8项（M）分类标准，范围从“完好”到“累及牙本质的龋洞形成”。分类中使用了六种影像学评分。沿颊舌方向通过中央窝切取厚度为250微米的切片，并选择立体显微镜下变化最广泛的窝部切片进行组织学检查（放大16倍）。组织学上的釉质和牙本质变化分别使用9分和7分进行独立分类。在渐进性脱矿和破坏方面，SM与组织学釉质变化（HE评分）之间的相关性高度相关（rs = 0.90）。牙本质变化也与釉质变化高度相关（rs = 0.85）。组织学分类与宏观观察相结合，使得能够证明龋病进展的外部程度与内部釉质和牙本质反应之间的明确关系。数据不支持将影像学检查常规用于咬合面龋的诊断。
