3种检查方法对早期邻面龋诊断水平的评价

The evaluation of three methods for the diagnosis of initial posterior approximal caries

目的 :体外评价比较平行投照的牙合翼片 (BWR)、激光荧光法 (LF)和模拟临床检查 (CE)等 3种诊断方法对早期邻面龋的诊断水平。方法 :分别对模拟临床排列的 81颗离体牙的 162个早期龋损和正常邻面进行BWR、LF、CE检查 ,以组织学结果为金标准 ,评价准确性、敏感性、特异性 ,以及与组织学深度的相关性和一致性水平等指标。结果 :BWR的准确性、敏感性、一致性水平明显优于CE和LF ,但敏感度仍属中等 ,观察者自身一致性不理想。结论 :平行投照的BWR是目前较好的临床诊断方法 ,对于早期邻面龋有一定的诊断能力 ,但诊断水平尚有待提高。LF法诊断效果总体上不如BWR法 ,主要与其对于邻面的可操作性差有关。

Objective: To evaluate the diagnostic efficacy of the bitewing radiograph(BWR),clinic examination(CE) and laser fluorescence examination (LF) for detection of initial posterior approximal caries . Methods:A total of 162 approximal surfaces from 81 extracted posterior teeth were examined by BWR, CE and LF. The histological diagnosis of sectioned teeth was used as the validating criterion (gold standard) to assess the sensitivity, specificity, accuracy and reproducibility. Results: The sensitivity and accuracy of BWR was higher than those of CE or LF at the level of enamel caries. Conclusions: BWR is an accurate diagnostic method for initial posterior approximal caries in present clinic practice. The inferior efficacy of LF is mainly due to its poor reproducibility of approximal surfaces.