激光荧光检测仪诊断乳牙(牙合)面龋的临床研究

Clinical Study of Use of Laser Fluorescence for Detecting Occlusal Caries in Deciduous Teeth

目的探讨激光荧光检测仪(DIAGNOdent)检测乳牙面龋时测量值分布的规律及临床意义,进一步了解厂商给出的DIAGNOdent界值是否适用于诊断乳牙早期龋。方法选择72名5—6岁儿童的541颗乳磨牙为研究对象,采用Kavo公司生产的激光荧光检测仪对其面进行检测,同时根据Ekstrand制定的临床视诊检查指数进行视诊检查,分析DIAGNOdent测量值的分布规律,并与Ekstrand视诊检查指数进行比较。结果随着乳牙患龋程度的加重,临床检查的视诊指数升高,DIAGNOdent测量值也呈阶梯形升高。视诊为0、1、2、3、4时,DIAGNOdent测量值的中位数分别为0、5、19、49、99。与厂商提供的DIAGNOdent界值相比,视诊为0时DI-AGNOdent检测值更低,一旦视诊发现釉质透明度发生改变,则读数明显升高,高于厂商提供的参考界值。结论DIAGNOdent激光荧光检测仪可用于乳牙早期龋的临床检测,但其诊断界值与厂商提供的界值不完全一致。

Objective To evaluate the distribution of DIAGNOdent value according to varying clinical caries severity. Methods A total of 541 deciduous molar teeth in children aged from 5 to 6 were examined using DIAGNOdent by one trained dentist. The most severity site in every tooth was recorded. The same sites were examined visually by another dentist. The distribution regular of DIAGNOdent value was analyzed according to the clinical severity score by Ekstrand index. Results The higher the visual score, the higher the mean DIAGNOdent value. The variation of values in each visual category was larger than that of values recommended by manufacturers. When clinical severity score was 0, 1, 2, 3 and 4, the median of DIAGNOdent value was 0, 5, 19, 49 and 99 respectively. The mean value for sound surfaces was lower in primary teeth than the cut-off points recommended by manufacturers, but the value of DIAGNOdent was increased obviously when the transparency change of enamel was detected visually. Conclusion DIAGNOdent is useful in detecting occlusal caries in deciduous teeth, but the cut-off levels is not coinciding perfectly with manufacturer suggesting.