窝沟龋的早期诊断

A Possible Criteria for Diagnosis of Early Caries in Pits and Fissures

目的 :探讨可疑窝沟龋的病理变化及早期窝沟龋的临床诊断。方法 :收集临床认为可疑窝沟龋的 31颗离体牙 ,制备成 10 0～ 140 μm厚的磨片 ,用软X射线和光镜进行观察。 结果 :本研究 31颗牙的窝沟 ,光镜观察均有早期釉质龋的改变 ;软X射线检查 30颗牙有釉质脱矿。 31颗牙有 4种窝沟形态 ;2 8颗牙的窝沟深度超过了釉质厚度的1/ 2。结论 :仅窝沟严重着色 (深褐色或黑色 )的可疑龋 ,经软X射线和组织病理证实均已是早期窝沟龋。

Objective:The aim of this study was to examine pits and fissures of occlusal surfaces with severe stains by both histological and clinical methods, and to evaluate the criteria for diagnosis of early caries in pits and fissures. Methods:Thirty-one fresh extracted molars and premolars, severely stained but no detectable defects in the surfaces, walls and floors of occlusal fissures, were collected. The teeth were longitudinally sliced across the stained fissures and ground into sections of 100～140 microns. The sections were observed using microscopy and microradiography. Results:All samples showed early carious lesions in pits and fissures under microscope. Demineralization in walls or floors was identified by microradiography in 30 samples. Conclusion:Although without detectable defects, severely stained pits and fissures showed demineralization by using microscopy and microradiography. Thus, early caries in pits and fissures may be identified by the severely stained appearance.