Fennis-Ie Y L, Verdonschot E H, van't Hof M A
Department of Cariology and Endodontology/117, Faculty of Medical Sciences, University of Nijmegen, The Netherlands.
J Dent. 1998 Jul-Aug;26(5-6):403-8. doi: 10.1016/s0300-5712(97)00060-2.
Attempts have been made to develop diagnostic methods which enable an early diagnosis of occlusal lesions which are not detectable by visual inspection. The aim of this study was to compare the performance of visual inspection focused on finding signs of fissure decalcification and discoloration, visual inspection upon fibre-optic transillumination (FOTI), and electrical conductance measurements (ECMs) in predicting the onset of occlusal caries in 6- and 11-year-old children.
Fifty children aged 5-7 and 11-15 years, having first or second permanent molar teeth that were not exposed to the oral environment for more than half a year, participated in the study. Following baseline data recording, the diagnostic measurements were repeated six times at 6-month intervals over a period of 2.5 years.
Data were collected at predefined sites in the fissures. During the study, 220 of the 652 sites, i.e. 75 of 197 molars in 31 of the 50 children were judged to require a sealant or a sealant restoration. Two examiners jointly decided on the decay status at the sites. Survival plots showed that ECMs were superior to FOTI and fissure discoloration in predicting the onset of occlusal caries, although the differences were small.
ECM is a better predictor of occlusal caries than fissure discoloration and FOTI, although the differences among the performance of the three methods in this study were very small. A cost-effective analysis is envisaged to obtain insight into the practical value of ECMs in the prediction of occlusal caries and, thus, into the effectiveness of sealant application.
人们一直在尝试开发诊断方法，以便能够早期诊断出通过目视检查无法检测到的咬合面病变。本研究的目的是比较专注于发现窝沟脱矿和变色迹象的目视检查、光纤透照（FOTI）下的目视检查以及电导率测量（ECM）在预测6岁和11岁儿童咬合面龋齿发病情况方面的性能。
50名年龄在5 - 7岁和11 - 15岁之间的儿童参与了这项研究，他们的第一或第二恒磨牙未暴露于口腔环境超过半年。在记录基线数据后，在2.5年的时间里每隔6个月重复进行6次诊断测量。
在窝沟的预定义部位收集数据。在研究期间，652个部位中的220个，即50名儿童中31名儿童的197颗磨牙中的75颗，被判定需要进行窝沟封闭或窝沟封闭修复。两名检查人员共同确定这些部位的龋坏状况。生存曲线表明，尽管差异很小，但在预测咬合面龋齿发病方面，ECM优于FOTI和窝沟变色。
尽管本研究中三种方法的性能差异非常小，但与窝沟变色和FOTI相比，ECM是咬合面龋齿更好的预测指标。设想进行成本效益分析，以深入了解ECM在预测咬合面龋齿方面的实用价值，从而了解窝沟封闭应用的有效性。
