红色荧光定量分析法评价釉质早期龋的临床研究

Detection and monitoring of enamel early caries in vivo using red fluorescence analysis by quantitative light-induced fluorescence method

目的采用定量光导荧光(QLF)技术的红色荧光分析法检测釉质早期龋,并监测含氟牙膏促进早期龋再矿化的效果,评价该技术诊断早期龋的能力。方法选择有上颌前牙光滑面釉质早期龋的96名小学生为研究对象,指导其在6个月的时间内使用含氟牙膏(氟离子质量分数为0.145%)刷牙。分析基线和6个月后的上颌前牙光滑面荧光图像,获得红色荧光变量(包括荧光面积Ar、平均荧光量△R、荧光总量R),将其与绿色荧光变量(包括荧光面积Aw、平均荧光损失量△F、荧光损失总量△Q)进行比较,并通过配对t检验评价使用含氟牙膏后龋损的变化情况。结果红色荧光变量Ar、△R、lgR与对应的绿色荧光变量Aw、△F、lg△Q的Pearson相关系数分别为0.89、0.54、0.72(P<0.05),具有高度相关性。使用含氟牙膏6个月后,红色和绿色荧光变量均较基线明显降低,其差异有统计学意义(P<0.05)。结论采用QLF技术的红色荧光分析法能够评价釉质早期龋的严重程度,并纵向监测病变,适用于评价龋损防治措施的效果。

Objective To evaluate the capability of red fluorescence analysis using quantitative light-induced fluorescence（QLF） methods, comparing with green fluorescence analysis, for detection and monitor of enamel early carious lesions on smooth surfaces. Methods 96 students with early enamel carious lesions were required to perform supervised tooth brushing with 0.145% F-dentifrice for six months. QLF images were taken from smooth surfaces of erupted maxillary anterior teeth at baseline and six months later. Both red fluorescence and green fluorescence analysis of carious lesions were carried out. QLF metrics including the areas of lesions（Ar, Aw）, average fluorescence （△R, △F）, total fluorescence（R, △Q）were exported. Results Pearson correlation coefficients between variables of red and green fluorescence were 0.89（Ar vs Aw）, 0.54（△R vs △F） and 0.72（lgR vs lg△Q）. Significant decreases were exhibited by all the quantitative variables at sixth month compared to those at baseline （P〈0.05）. Conclusion Red fluorescence analysis using QLF system could quantify the mineral content and monitor the recovery of carious lesions. It could be used to evaluate methods for prevention and cure of caries.