激光龋蚀检测仪在乳磨牙邻面龋早期诊断中的应用

Clinical evaluation of the laser fluorescence device for detection of approximal caries in primary molars

目的评估激光龋蚀检测仪(间接法)应用于乳磨牙邻面龋早期诊断的可行性。比较该方法检查结果与临床检查及翼片的一致性。方法乳磨牙邻面龋可疑位点为187个。同时使用临床检查(视诊+探诊)、X线检查(翼片)、激光龋蚀检测仪(DIAGNODent,间接法)对乳磨牙邻面龋进行诊断。DIAGNODent检测的可疑位点均设置对照组。通过统计分析,对各种检查结果的一致性进行比较。结果DIAGNODent(间接法)检测乳磨牙邻面龋的可重复性较高,同一检测者两次检查相关系数为0.963。可疑位点DIAGNODent测量值与对照位点比较,差异有显著性(P<0.01)。DIAGNODent的诊断结果与临床诊断具有高度的一致性。但DIAGNODent检测值与临床分度指数相关性不高(γ=0.304),低于翼片分度与临床分度的相关系数0.688。结论激光荧光龋蚀检测仪(间接法)可以作为临床检查和X线检查的有效补充,应用于乳磨牙邻面龋的早期诊断。

Objective To evaluate the performance of laser fluorescence device DIAGNOdent for detection and quantification of approximal caries （ indirect method） in primary molars. Methods Totally 187 suspicious sites of primary molars were selected from 115 children, aged 5 to 11 years. The suspicious surfaces were in contact with adjacent teeth. The questionable teeth were evaluated by visual inspection and bitewing radiography. The suspicious sites were also detected twice with DIAGNOdent from ecclusal surface of the marginal ridge indirectly by one examiner. Three contrast sites were measured in one testee. The result of three diagnostic methods was compared each other. Descriptive and correlating analysis was used. Results The reproducibility of DIAGNOdent used in detecting the approximal caries （indirect method） was higher. The intra-class correlation coefficient （ICC） was 0.963. The difference between the DIAGNOdent value of suspicious sites and contrast sites was significant （ P 〈 0.01 ）. The correlation with DIAGNOdent and clinical final diagnose was high. But the correlation with clinical classification of caries vs DIAGNOdent （γ =0.304） was lower than the correlation with clinical classification vs the caries classification in bitewing radiography （ γ = 0.688 ）. Conclusion DIAGNOdent had very high reliabilities. The indirect method of laser fluorescence showed a good performance to detect approximal caries early. It could be used as an adjunct to other conventional caries diagnostic methods.