Wenzel A, Pitts N, Verdonschot E H, Kalsbeek H
Department of Oral Radiology, Royal Dental College Aarhus, Denmark.
J Dent. 1993 Jun;21(3):131-40. doi: 10.1016/0300-5712(93)90022-i.
The developments that have been taking place in radiographic caries diagnosis, within the context of the changes occurring in both the disease process and the available technology, are reviewed. The decline in caries prevalence seen in many western countries has been accompanied by changes in the pattern and behaviour of lesions. More lesions are now seen on occlusal surfaces, more are concealed (and thus imperceptible to conventional diagnostic techniques), while the average progression rates for approximal lesions have also slowed. Systems employed for caries diagnosis must take account of these changes and the varying needs of users employing different diagnostic thresholds. This paper reviews and discusses developments in: conventional film radiography; xeroradiography; indirect digital imaging (with computer image analysis and subtraction radiography), and direct digital imaging. It is concluded that: for the detection in high caries prevalence groups of both approximal caries (especially small lesions in enamel) and dentinal occlusal lesions in teeth with little or no surface breakdown, radiography is still a significant and reasonably accurate diagnostic method; and that, in spite of the more limited resolution, digital imaging methods seem to perform as well or better than conventional film radiography. Digital systems possess a number of advantages, primarily the possibility for image enhancement and significant dose reduction. It may be predicted that digital imaging techniques will enter the clinical routine in the near future.
本文回顾了在龋病进程和现有技术均发生变化的背景下，放射龋诊断领域所取得的进展。许多西方国家龋病患病率的下降伴随着龋损模式和行为的改变。现在，更多的龋损出现在咬合面，更多的龋损被隐藏起来（因此传统诊断技术无法察觉），而邻面龋损的平均进展速度也有所减缓。用于龋病诊断的系统必须考虑到这些变化以及采用不同诊断阈值的使用者的不同需求。本文回顾并讨论了以下方面的进展：传统胶片放射摄影；干板X线摄影；间接数字成像（包括计算机图像分析和减影放射摄影）以及直接数字成像。得出的结论是：对于高龋病患病率人群中邻面龋（尤其是牙釉质中的小龋损）以及表面几乎没有或没有破坏的牙齿中的牙本质咬合面龋损的检测，放射摄影仍然是一种重要且相当准确的诊断方法；并且，尽管分辨率更有限，但数字成像方法似乎与传统胶片放射摄影表现相当或更好。数字系统具有许多优点，主要是图像增强的可能性和显著的剂量减少。可以预测，数字成像技术将在不久的将来进入临床常规应用。
